Archived: The Smart Clinics Brompton Cross

We carried out this announced inspection on 19 June 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 not 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

The Smart Clinics Brompton Cross is in the London Borough of Kensington and Chelsea and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Limited car parking spaces are available near the practice for a fee.

The dental team includes two dentists, (one of whom is the principal dentist) a trainee dental nurse, a receptionist and a practice manager. The practice has one treatment room.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at The Smart Clinics Brompton Cross is the practice manager.

We received feedback from nine patients.

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

The practice is open:

Our key findings were:

• The practice appeared clean and well maintained, however some cleaning equipment was in need of replacement.
• The provider had infection control procedures which reflected published guidance. However, a single use instrument was reportedly being reused on the same patient.
• The practice systems to help them manage risk to patients and staff needed improving. There was no legionella risk assessment and sharps risk assessment in place.
• Staff knew how to deal with emergencies. Appropriate medicines and most life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• 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.
• There was lack of effective leadership. The last infection control audit undertaken for continuous improvement was not appropriate for use in a dental practice.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had effective information governance arrangements

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

• Ensure that care and treatment is provided to patients in a way that is safe

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

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

• Review the practice's protocols for medicines management and ensure all medicines are dispensed safely and containers are clearly labelled with the practice details.