We carried out this announced 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 carried out by two CQC inspectors who had access to remote specialist dental advice.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They provided information which we took into account.

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 Together St Mary’s Hospital is in St Mary’s Hospital in St Mary’s, Isles of Scilly and provides NHS treatment to patients of all ages to the five inhabited Isles of Scilly (St Mary’s, St. Agnes, St Martin, Tresco and Bryher). The Isles of Scilly are an archipelago off the south western tip of Cornwall.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including spaces for patients with disabled badges, are available at the hospital.

The dental team consists of one dentist and two dental nurses/receptionists. The practice has two treatment rooms.

The practice is owned by a Community Investment 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 Together St Mary’s Hospital was the company’s clinical director.

During the inspection we collected one CQC comment card filled in by patients and spoke with ten other patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist and the two dental nurses, the company clinical governance lead and the company area manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday – Friday 9am – 5pm. Saturday appointments are available by on-call requests.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected 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.
• The practice had suitable safeguarding processes and staff 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 care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

There was one area where the provider could make improvements. They should:

• Review the practices’ infection control procedures, taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular with regard to Legionella, decontamination room extractor fan repair and frequency of Infection Prevention Society (IPS) audits.