We carried out an announced comprehensive inspection on 9 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

Warrington Smile Clinic is located in a residential suburb close to the centre of Warrington and comprises a reception and waiting area and two treatment rooms downstairs, and four treatment rooms and a further waiting room on the first floor. Parking is available on nearby streets and in car parks. The practice is accessible to patients with disabilities and impaired mobility but not to wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Thursday 8.30am to 5.00pm and Friday 8.30am to 4.30pm. The practice is staffed by a principal dentist, a practice manager, six associate dentists, nine dental nurses, of which three are trainees, and three receptionists.

The practice manager is the registered manager. 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.

We received feedback from 24 people during the inspection about the services provided. Patients commented that they found the practice excellent and that staff were professional and friendly and caring. They said that they were always given good and helpful explanations about dental treatment and that the dentists listened to them. Patients commented that the practice was clean and comfortable.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean, secure and well maintained.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards and guidance.
• Patients received information about their care, proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took into account patient feedback.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and for the delivery of high quality person centred care.
• Infection prevention and control procedures were in place; however improvements were needed to the decontamination room and checks on one of the autoclaves.

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

• Review the practice’s infection control procedures and protocols having due regard to guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance, specifically in relation to the decontamination room and checks on one of the autoclaves.
• Review the practice’s recruitment protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes making appropriate notes of verbal references obtained, and ensuring recruitment checks, including references and proof of identification are carried out and recorded.
• Review the practice’s procedure for ensuring all staff are up to date with their mandatory training and continuing professional development.
• Establish whether the practice is in compliance with its legal obligations under the Ionising Radiations Regulations 1999, in relation to notification to the Health and Safety Executive of a material change in the X-ray equipment.

We spoke with seven people who were registered as patients with the Smile clinic.

People told us that they were happy with the service provided. They felt their dignity was maintained and their privacy protected. For example people told us that staff dealt with any questions relating to payment or other personal business in a private area of the clinic and not within the busy reception area of the building.

People said they were encouraged to ask questions and felt staff had the time to answer their questions. Direct comments included; ““Staff are very caring and reassuring”, “Dentists always explain what the process involves”, “Staff tell you things in a way you can understand”.

“This is a well run practice and we feel happy with all the treatment provided”.