At the last inspection in June 2013 we found Tooth Smart Dental Care non-compliant with Regulation 21 of the Health and Social Care Act (HSCA). This was because references and security checks had not been completed for three members of staff before they started work at the practice. At this inspection we found that the provider had taken the steps they needed to achieve compliance.

We found that outstanding checks were carried out to ensure staff were of good character had been carried out .There were now systems to ensure appropriate checks were carried out before people started work. The manager told us, “They are not allowed to start in the practice until all relevant documents have been collected and processed and we have seen the result." Records we saw confirmed this.

We spoke with six people who used the practice and with a dentist, dental nurse, receptionist and two managers. We also looked at a wide range of patient and other records to help us understand how the practice operated.

Patients were given treatment choices and information to help them decide before they agreed to treatment. A dentist said, “I give all the options available and the risks and benefits in the short and long term. If they want time to decide then that’s fine, it’s their tooth, their body, their health.” Patients received a comprehensive oral examination and were given advice to help them maintain their oral health. People were given options before treatment was given in accordance with their agreed plan. A patient said, “It’s very good, they have modern equipment, they’re very friendly and the waiting times are OK. As far as medical care in England goes, it’s up there.” Another commented, “It’s very good, excellent.”

Staff were appropriately qualified and where necessary registered with the General Dental Council. However, not all required checks were always completed before people started work.

People said they thought the clinic was clean. We found there were systems to prevent and control infection and processes for the decontamination of dental equipment which met government standards.

The provider gathered the views of people who used the service, and acted on these. There were systems to ensure the clinic was safe.