We carried out this unannounced inspection on 25 April 2019 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.

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

Smile Dental Practice is in the London Borough of Croydon and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs via a portable ramp. Pay and display car parking spaces are available near the practice.

The dental team includes four dentists, one of whom is the principal dentist, a periodontist, an endodontist, two dental nurses, one dental nurse/receptionist, two dental hygienists, two dental technicians, two receptionists, a practice manager and a general manager, who works across three sites. The practice has four treatment rooms.

The practice is owned by a company 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 registered manager at Smile Dental Practice is the practice manager.

On the day of inspection, we received feedback from two patients.

During the inspection we spoke with two dentists, including the principal dentist, a dental nurse, a receptionist, the general manager and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday – Friday 9am - 6pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which were being reviewed to reflect published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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 care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.

Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular guidance for the wearing of nail polish.

During this inspection we spoke with the registered manager, the practice manager, a dentist, a receptionist and two people using the service.

One person said “I had been to a few other dentists in the last few years but I wasn’t happy with them. I have been coming here for four months now and it’s the best practice I have been to. The dentist always explains what they are doing which is quite refreshing”. Another person said “I find the practice is very good. The dentist takes time to explain things to me”.

We found the practice had arrangements in place to deal with foreseeable emergencies. There were safeguarding policies that related to adults and children. People were protected from the risk of infection because appropriate guidance had been followed. We also found that there was an effective complaints system available.