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Inspection Summary


Overall summary & rating

Updated 28 January 2019

We undertook a follow up focused inspection of Vistara Smiles on 16 January 2019.

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 led by a CQC inspector.

We had undertaken a comprehensive inspection of Vistara Smiles on 7 June 2018 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 in accordance with the relevant regulations 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 Vistara Smiles 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.

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 of 7 June 2018.

Background

Vistara Smiles is in Islington, London, and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes two dentists and a trainee dental nurses.

The practice has three treatment rooms.

The practice is open from Monday to Saturday by appointment

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.

Our key findings were:

The provider had made improvements to the management of the service.

The practice had arrangements to ensure the smooth running of the service.

At the previous inspection we had found that this practice was providing safe care in accordance with the relevant regulations but told them there were things they should do. We found that the provider had taken action to address the issues we said they should look at. We found that:

• The practice had a system for the documentation of actions taken and learning shared in response to incidents, with a view to preventing further occurrences and ensuring improvements are made as a result. Staff were aware of the procedures regarding documenting and learning from these events.

• The practice had appropriate infection control procedures and protocols in place that took into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

At the previous inspection we had found that this practice was providing effective care in accordance with the relevant regulations but told them there were things they should do. We found that the provider had taken action to address the issues we said they should look at.

We found that:

• The practice had protocols in place for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

Inspection areas

Safe

No action required

Updated 6 July 2018

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

The practice had systems and processes to provide safe care and treatment.

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

Staff knew how to recognise the signs of abuse of children and vulnerable adults, and knew how to report concerns.

The premises and equipment appeared clean and properly maintained.

Effective

No action required

Updated 6 July 2018

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as being of a high standard.

The dentists discussed treatment with patients so they could give informed consent and documented this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

Caring

No action required

Updated 6 July 2018

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

We received feedback about the practice from 18 patients; they were positive about all aspects of the service the practice provided. They told us staff were professional, caring and respectful.

They said they were given helpful, detailed and clear explanations about dental treatment and said their dentist listened to them. Patients commented that staff made them feel at ease.

Staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 6 July 2018

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if they were experiencing dental pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had arrangements to help patients with hearing loss and visual impairment.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 28 January 2019

We found that this practice was providing well-led care in accordance with

the relevant regulations.

The provider had made improvements to the management of the service.

The practice had arrangements to ensure the smooth running of the service. These included systems to assess, monitor and discuss the quality and safety of the care and treatment provided.

The practice team kept complete patient dental care records which were, clearly written or typed and stored securely.