We carried out this announced inspection on 15 April 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 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

The Smile Clinic Colchester Town is in Colchester, Essex and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available in public car parks near the practice.

The dental team includes four dentists, two dental nurses and two trainee dental nurses, two receptionists and the practice manager. The practice has five treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected eight CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, one dental nurse, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday from 9am to 7pm.

Wednesday from 9am to 6pm.

Thursday and Friday from 9am to 5pm.

Saturdays by appointment only.

Our key findings were:

• Strong and effective leadership and a culture of continuous improvement was provided by the management team which included the principal dentist and the practice manager. Staff felt involved and supported and informed us this was a good place to work.
• The practice staff 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 provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. The safeguarding policy, poster and contact details were displayed in each treatment room.
• The practice had thorough staff recruitment procedures.
• The practice appeared clean and well maintained. The practice employed an external cleaning company. Not all cleaning equipment was available, in an appropriate condition or was stored in line with recommended guidance.
• 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. The practice offered an emergency ‘walk in sit and wait’ service for all patients and non registered patients who required emergency treatment. The practice offered extended hours appointments for private patients opening until 7pm on Monday, Tuesday and Wednesday evenings.
• 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 staff dealt with complaints positively and efficiently.
• Safety alerts were received by the practice but there were no systems in place to evidence that where relevant any action had been undertaken.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.

• Review the practice’s systems for environmental cleaning taking into account the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

When we inspected The Smile Clinic Dental Practice on 10 January 2014 we found that people were provided with information about treatment and were asked for their consent. One person using the service on the day of our inspection told us. “ I wanted to look at the options and the dentist is very good at giving you time to think." People’s needs were assessed and treatment was planned and delivered in line with those needs. This assessment took account of people's general health and dental history. Treatment plans were detailed. Staff received relevant training.

The practice operated safe decontamination techniques according to government guidance. People were protected against the risk of infection because staff followed appropriate infection control practices.

Staff were supported to maintain their professional registration through continuing professional development. Staff received training in key aspects of their role.

The provider had an effective system to regularly assess and monitor the quality of service that people receive and took account of their feedback.