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Inspection Summary


Overall summary & rating

Updated 5 August 2016

We carried out an announced comprehensive inspection on 21 June 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

Fresh Smiles Clinic is situated in Brighouse, West Yorkshire. It offers mainly private treatment to patients of all ages but has a small NHS contract. The services include preventative advice and treatment, routine restorative dental care and dental implants.

The practice currently has three surgeries, a waiting area, a reception area and an X-ray room. The reception area, waiting area and two surgeries are on the ground floor of the premises. The other surgery and the X-ray room are on the first floor of the premises.

There are four dentists (one of whom is the practice owner), two dental hygiene therapists, four dental nurses (including one trainee), a reception manager (who is also a qualified dental nurse) and a practice manager.

The opening hours are Monday from 9-00am to 5-30pm, Tuesday from 9-00am to 7-00pm, Wednesday from 9-00am to 5-00pm, Thursday from 8-30am to 5-00pm and Friday from 8-30am to 4-00pm. They are also open the first Saturday of each month from 9-00am to 1-00pm.

The practice owner 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.

During the inspection we received feedback from 15 patients. The patients were positive about the care and treatment they received at the practice. Comments included that the premises were safe and hygienic and that staff were welcoming, caring and friendly. Patients also commented that the dentists always listened to their concerns and provided detailed advice about treatments.

Our key findings were:

  • The practice appeared clean and hygienic.
  • The practice had systems in place to assess and manage risks to patients and staff including infection prevention, control and health and safety and the management of medical emergencies.
  • Staff were qualified and had received training appropriate to their roles.
  • Dental care records were detailed and showed that treatment was planned in line with current best practice guidelines.
  • We observed that patients were treated with kindness and respect by staff.
  • Patients were able to make routine and emergency appointments when needed.
  • The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
  • There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

  • Review the practice’s protocol for completing the X-ray audit.
  • Review the Legionella risk assessment and ensure all recommendations are completed.
  • Review the availability of a policy for the use of the cone beam computed tomography machine.
Inspection areas

Safe

No action required

Updated 5 August 2016

We found that this practice was providing safe care in accordance with the relevant regulations.

The practice had a policy in place for reporting of significant events. Staff told us they felt confident about reporting incidents and accidents.

Staff had received training in safeguarding at the appropriate level and knew the signs of abuse and who to report them to.

Staff were suitably qualified for their roles and the practice had undertaken the relevant recruitment checks to ensure patient safety.

Patients’ medical histories were obtained before any treatment took place. Staff were trained to deal with medical emergencies. All emergency equipment and medicines were in date and in accordance with the British National Formulary (BNF) and Resuscitation Council UK guidelines.

The decontamination procedures were effective and the equipment involved in the decontamination process was regularly serviced, validated and checked to ensure it was safe to use.

Effective

No action required

Updated 5 August 2016

We found that this practice was providing effective care in accordance with the relevant regulations.

Patients’ dental care records provided comprehensive information about their current dental needs and past treatment. The practice monitored any changes to the patient’s oral health and provided treatment when appropriate.

The dentists followed best practice guidelines when delivering dental care. These included Faculty of General Dental Practice (FGDP), National Institute for Health and Care Excellence (NICE) and guidance from the British Society of Periodontology (BSP).

Staff were encouraged to complete training relevant to their roles. The clinical staff were up to date with their continuing professional development (CPD).

Referrals were made to secondary care services if the treatment required was not provided by the practice.

Caring

No action required

Updated 5 August 2016

We found that this practice was providing caring services in accordance with the relevant regulations.

During the inspection we received feedback from 15 patients. Patients commented that staff were welcoming, caring and friendly. Patients also commented that the dentists always listened to their concerns and provided detailed advice about treatments.

We observed the staff to be welcoming and caring towards the patients.

Staff were fully aware of the importance of confidentiality. We observed privacy and confidentiality were maintained for patients using the service on the day of the inspection.

Responsive

No action required

Updated 5 August 2016

We found that this practice was providing responsive care in accordance with the relevant regulations.

The practice had an efficient appointment system in place to respond to patients’ needs. Patients commented they could access treatment for urgent and emergency care when required. There were clear instructions for patients requiring urgent care when the practice was closed.

There was a procedure in place for responding to patients’ complaints. This involved acknowledging, investigating and responding to individual complaints or concerns.

The practice had made reasonable adjustments to enable patients with limited mobility to access treatment.

Well-led

No action required

Updated 5 August 2016

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

There was a clearly defined management structure in place and all staff felt supported and appreciated in their own particular roles. The practice manager was responsible for the day to day running of the practice.

Effective arrangements were in place to share information with staff by means of monthly practice meetings and quarterly dentist meetings.

The practice regularly audited clinical and non-clinical areas as part of a system of continuous improvement and learning.

They conducted patient satisfaction surveys, were currently undertaking the NHS Friends and Family Test (FFT) and there was a comments box in the waiting room for patients to make suggestions to the practice.