We carried out an announced comprehensive inspection on 16 August 2016 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

Smilestylist House of Fraser Birmingham Dental Practice has two dentists who work part time, one qualified dental nurse who is registered with the General Dental Council (GDC) a practice manager and a receptionist. The practice’s opening hours are 9.30am to 6pm on Monday, Tuesday, Wednesday and Friday, and 10.30am to 7pm Thursday. The practice is also open every Saturday from 9am to 5.30pm. The practice is closed for 30 minutes each day between 2.30pm to 3pm.

Smilestylist Dental Practice provides private dental treatment for adults and children. The practice is located within the House of Fraser department store. There are a few small steps within the store to gain access to the dental practice. There are two dental treatment rooms one of which is used for the specific purpose of tooth whitening. There is a separate decontamination room for cleaning, sterilising and packing dental instruments and a consultation room. There is also a reception and waiting area.

The registered manager was present during this inspection. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from seven patients who provided an overwhelmingly positive view of the services the practice provides. All of the patients commented that the quality of care was very good and that staff were friendly and helpful.

Our key findings were

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• Infection control procedures were in place with infection prevention and control audits being undertaken on a six monthly basis. Staff had access to personal protective equipment such as gloves and aprons.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. Systems were in place to check these to ensure that they were within their expiry dates; however checks were not completed regularly as recommended by national guidance.
• Staff had been trained to deal with medical emergencies.
• The practice was well-led and staff felt involved and worked as a team.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the timescales for the checking and documentation of checks regarding medicines to manage medical emergencies giving due regarding to the guidelines issued by the Resuscitation Council (UK).
• Review systems in place for the recording of medicines dispensed at the practice to ensure documentation kept is signed by the prescriber.
• Review the systems in place for scheduling of appointment times to ensure that patients are given times of appropriate length for the treatment to be completed.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records to help improve the quality of service. Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

Our inspection visit was discussed and arranged with the practice two days in advance. This was to ensure that we had time to see and speak with all levels of staff working at the practice. We were able to speak with six people by telephone after our visit.

People that used the practice told us that they were happy with the quality of treatment they received. They felt they were given enough information about their treatment options and were able to ask all the questions they wanted to. Their comments included: "They were very professional and the results were good," " it has been fantastic" and "They are friendly and not stuffy."

When we observed one consultation we saw, and later people told us, that the treatment people needed was discussed with them. People told us they were informed about the cost of their treatments. This meant people were able to make informed decisions about the next steps they wanted to take.

The provider had robust infection control processes in place and staff were fully aware of them. This meant the risk of infection for people using the service was minimised.

Staff received training so that they had up to date knowledge and skills in order to ensure that people received safe treatment.

There were systems in place to monitor how the practice was run to ensure people received a quality service. This meant people using the service were asked their views about the service so the provider could use the information to improve.