Smile Rooms

We undertook a follow-up desk based focused inspection of Smile Rooms on 8 July 2020.

This inspection was carried out to review, in detail, the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was carried out by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of 17 October 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of Regulations 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Smile Rooms on our website www.cqc.org.uk.

When one or more of the five questions are not met, we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

This desk-based inspection was undertaken during the Covid 19 pandemic. Due to the demands and constraints in place because of Covid 19 we reviewed the action plan and asked the provider to confirm compliance after a reasonable interval, focusing on the area where improvement was required.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 17 October 2019.

Background

Smile Rooms is in Windsor and provides private treatment to adults and children.

Car parking spaces, including those for blue badge holders, are available near the practice.

The practice is based on the first floor. Patients are advised of this when they contact the practice. The practice website also includes this information.

The dental team includes five dentists, one oral surgeon, three dental nurses, one trainee dental nurse, one receptionist and an assistant practice manager.

The practice has four treatment rooms of which two are in use.

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.

The practice is open:

• Monday 8.00am – 7.00pm

• Tuesday and Thursday 8.00am – 8.00pm

• Wednesday and Friday 8.00am – 6.00pm

• Saturday 8.00am – 5.00pm

Our key findings were:

• Recruitment procedures were established to ensure only fit and proper persons are employed.

• Staff received the appropriate training necessary to enable them to carry out the duties.

We carried out this announced inspection on 17 October 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 not providing well-led care in accordance with the relevant regulations.

Background

Smile Rooms is in Windsor and provides private treatment to adults and children.

Car parking spaces, including some for blue badge holders, are available near the practice.

The practice is based on the first floor. Patients are advised of this when they contact the practice. The practice website also includes this information.

The dental team includes five dentists, one oral surgeon, three dental nurses, one trainee dental nurse, one receptionist and an assistant practice manager. The practice has four treatment rooms of which two are in use.

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 nine CQC comment cards filled in by patients and obtained the views of four other patients.

During the inspection we spoke with two dentists, two dental nurses, one trainee dental nurse, one receptionist and the assistant practice manager. The provider’s general manager was present to support the inspection

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 8.00am – 7.00pm
• Tuesday and Thursday 8.00am – 8.00pm
• Wednesday and Friday 8.00am – 6.00pm
• Saturday 8.00am – 5.00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance but these were not effective.
• Staff knew how to deal with emergencies but immediate life support training was not carried out for appropriate staff who supported sedation treatment.
• The provider had systems to help them manage risk to patients and staff but improvements were needed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures, but improvements were needed.
• 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 personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider and systems in place to deal with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

We identified regulations the provider was not complying with. They must:

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.
• Ensure staff are up to date with their mandatory training and their. In particular, immediate life support training for the dentist who supports the sedationist.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

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

• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Implement an effective system for identifying, disposing and replenishing of out-of-date stock. In particular, implementing an effective stock control system.
• Improve the practice's risk management for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, effective fire safety and Legionella risk assessments.