We carried out this announced inspection on 14 March 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 Care Quality Commission (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

Smile4u-Chislehurst is in Chislehurst in the London borough of Bromley. The practice provides NHS and private treatment to people of all ages.

The dental team includes a principal dentist, a dentist completing their foundation training, three associate dentists, four trainee dental nurses, a qualified dental nurse, a dental hygienist, a practice manager, and two receptionists.

The practice has three treatment rooms.

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 registered manager at Smile4u-Chislehurst at the time of the inspection was the practice manager.

On the day of this inspection, we obtained feedback from 73 patients.

During the inspection we spoke with the practice manager, the principal dentist, the dentist in foundation training, a trainee dental nurse and a receptionist.

We checked practice policies and procedures and other records about how the service is managed.

The practice is open from 8:30am to 5:30pm Monday to Friday, and 9am to 1pm on Saturdays.

Saturday: 9:00am - 1:00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 risks to patients and staff.
• The provider 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.
• 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.
• The provider had effective leadership and culture of continuous improvement.

We carried out an announced comprehensive inspection on 01September 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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 4 U Chislehurst is located in the London Borough of Bromley and provides NHS and private dental services. The demographics of the practice is a mixture of working professionals, families and older people.

The staff structure of the practice is comprised of two principal dentists (who are also the owners), two dentists, two dental nurses and an assistant practice manager.

Facilities within the practice include two treatment rooms, a dedicated decontamination room, a designated Orthopantomogram (OPG) (a panoramic scanning dental X-ray of the upper and lower jaw) room and a reception area.

Our key findings were:

• There were effective processes in place to reduce and minimise the risk and spread of infection.
• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE).
• Patients were involved in their care and treatment planning.
• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
• Patients told us that staff were caring and treated them with dignity and respect.
• There were processes in place for patients to give their comments and feedback about the service including making complaints and compliments.
• There was a clear vision for the practice. Governance arrangements were in place for the smooth running of the practice.

There were areas where the provider could make improvements and should:

• Review the practice’s protocols for monitoring the use of x-ray equipment giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• Review complaint procedure in regards to providing patients with details of external bodies to escalate complaints to if the patients remained dissatisfied with the practice’s complaint handling.