We carried out this announced inspection on 13 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 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

Smileright Dencare Limited is in Waterloo, in the London Borough of Southwark. It provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Restricted car parking spaces are available near the practice.

The dental team includes five dentists, two trainee dental nurses, an acting practice manager, an operations manager, a finance/human resources director, a clinical lead, and a receptionist. The practice has three treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC as the registered manager. The registered manager has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated guidelines about how the practice is run. The registered manager’s application was in progress at the time of the inspection. There was a nominated individual in place. The nominated individual was responsible for supervising the management of the practice’s regulated activities.

On the day of inspection we collected feedback from five patients. This information gave us a positive view of the practice.

During the inspection we spoke with a dentist, two trainee dental nurses, the clinical lead, the acting practice manager, the finance/human resources director and the receptionist. We checked practice policies and procedures and other records about how the service is managed.

The practice is open at the following times:

Monday - Wednesday: 9:30am to 6.30pm

Thursday: 10am to 7pm

Friday: 8:15am to 5.15pm

Saturday: 9am to 3pm

Our key findings were:

• The practice had systems to help them manage risk.
• 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 asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice was clean and the premises were well maintained.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice had infection control procedures which reflected published guidance.
• The practice had safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with emergencies. Some life-saving equipment was not available; however, the practice told us these had been ordered shortly after the inspection.
• The clinical staff provided patients’ care and treatment in line with current guidelines in most cases; improvements could be made to ensure all dental care records included the necessary information.
• The practice had staff recruitment procedures. Improvements could be made to ensure Disclosure and Barring Service (DBS) checks were made prior to staff commencing employment at the practice.
• There was evidence of staff training; however, evidence of key training for several staff was not in place. Shortly after the inspection the practice sent us evidence of training for some staff and ensured others completed outstanding training.

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

• Review the practice's protocols for the completion of dental care records, taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, and supervision of all staff.
• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.
• Review the practice's responsibilities to respond to the needs of patients with a disability, and the requirements of the Equality Act 2010.