We carried out this unannounced inspection on 26 September 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

The Smile Care Centre is located in Chesterfield, north Derbyshire. The practice provides mostly NHS dental treatment (90%) and some private dental treatment (10%) to patients of all ages.

We carried out this unannounced inspection following concerns raised relating to infection control.

The practice is located on the ground floor with ramped access to the front door. There are three treatment rooms. There is a small car park to the rear of the practice or road side car parking in the area.

The dental team includes three dentists; one dental hygienist/ therapist; four qualified dental nurses; two trainee dental nurses, and one practice manager.

The practice is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The principal dentist is the registered manager at the practice.

On the day of inspection we collected four CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, four dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice opening hours are: Monday to Friday: 9 am to 5 pm. The practice closes for lunch between 12:45 pm and 2 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

There were areas where the provider could make improvements. They should:

• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

We spoke with two National Health Service patients at Smile Care Centre. Both patients said that they were very happy with their dental treatment, and they had been attending the dental practice for several years.

One patient told us: “I have had some serious health problems recently, but the staff have been very understanding and helpful, particularly when arranging appointments. The patient also said that at a previous dentist they were very anxious and worried before appointments; however at this dentist it’s very different. The staff are very kind and gentle with me and I am very reassured.

The second patient said they were very happy with the treatment they received, they said they had confidence in the staff, and the dentist was very reassuring. They told us: "I have been coming here for years, if I wasn't happy I would find another dentist."

We asked both patients if they consented to their treatment. They said that they provided written consent before any treatment started, and they also gave verbal consent during their treatment.

The patients said that they were made aware of the cost of any treatment before it started. They also said that their dentist always explained the options available including any additional costs.

Both patients said they had no concerns about hygiene, cleanliness or infection control at the dental surgery.