We carried out this announced inspection on 8 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

Smilecare Dental Clinic - Chiswick is in Chiswick in the London Borough of Hounslow. The practice provides private treatment to patients of all ages including dental implants and treatments using conscious sedation techniques.

The practice is located at ground and first floor level in a purpose adapted premises. There is step free access to the practice and two of the five treatment rooms are located on the ground floor.

The practice is located close to public transport bus and train services.

The dental team includes the principal dentist, three associate dentists, two dental hygienists and three dental nurses. The clinical team are supported by three receptionists.

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 Smilecare Dental Clinic - Chiswick was the principal dentist.

On the day of inspection we received feedback from seven patients including two patients who we spoke with on the day.

During the inspection we spoke with the principal dentist, one associate dentist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between 8 am and 5pm on Mondays, Tuesdays and Thursdays, between 8am and 4pm on Wednesdays and between 8am and 2pm on Fridays:

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Our key findings were:

• The practice appeared 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 practice was providing preventive care and supporting patients to ensure better oral health.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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

Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

During our inspection we spoke with two people who use the service and six staff, including dentists, dental nurses and administrative staff. People told us that they were able to get an appointment when they wanted one, and if they needed to be seen in an emergency they were asked to come to the service and were seen on the day. Some comments we received from people were "the staff are very friendly", "there is a lovely atmosphere here" and "I am explained what treatment I need and I can discuss different options with the dentist”.

We saw the people who use the service and the staff had developed positive relationships with each other and there was a relaxed atmosphere within the practice.

There were systems and procedures in place to minimise the risk of infection to people when they received treatment.

There were processes in plans to gain feedback from people who use the service and monitor the quality of the service provided. Feedback was acted upon to ensure people received a service that met their needs.