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Healthy Smiles Dental Practice

Inspection Summary


Overall summary & rating

Updated 24 February 2017

We carried out an announced comprehensive inspection on 20 January 2017 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.

Healthy Smiles Dental Practice is a general dental practice close to Leagrave railway station offering private dental treatment to adults and children on Fridays (or other times by appointment only). The principal dentist has a special interest in endodontics (root canal treatment) and accepts referrals from other practices on that basis.

The premises are located all on ground level in converted residential premises and has parking available. The practice consists of one treatment room, a reception and waiting area. There is also a designated decontamination room.

The staff at the practice consists of the principal dentist and two dental nurses (who also work part time at the provider’s other practice in Leagrave). The principal dentist 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.

Our key findings were:

  • There was an induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.
  • The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
  • There were effective systems in place to reduce the risk and spread of infection. We found the treatment room and equipment were visibly clean.
  • There were systems in place to check equipment had been serviced regularly, including the autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.

  • We found the dentist regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

  • Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

  • Patients received clear explanations about their proposed treatment, its costs, benefits and risks and were involved in making decisions about it.

  • Patients were treated with dignity and respect and confidentiality was maintained.

  • The appointment system met the needs of patients.

  • Although the practice had not received any complaints, they had an appropriate complaints procedure in place.

  • Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

  • At our visit we observed staff were caring, friendly and professional.

  • We received feedback from 11 patients who reported they received clear explanations of their treatment options from caring, friendly and professional staff.

  • There was an effective system in place to act on feedback received from patients and staff.

  • There were systems in place to assess, monitor and improve the quality of service provided.

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

  • Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society

  • Review the practice protocols for mitigating risks associated with Legionella by ensuring the practice undertakes a Legionella risk assessment and implements the required actions giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum01-05: 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.

  • Review the practice protocols for the maintenance of the dental air compressor to ensure it is serviced in line with the manufacturer’s instructions.

Inspection areas

Safe

No action required

Updated 24 February 2017

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

The practice had systems in place for the management of infection control, clinical waste segregation and disposal, management of medical emergencies and dental radiography. The practice had not undertaken a Legionella risk assessment; however they were minimising the risks by maintaining dental unit water lines and monitoring water temperatures. We found the equipment used in the practice was maintained and in line with current guidelines. An exception to this was the dental air compressor which had not been appropriately serviced.

The practice did not use rubber dam in accordance with guideline issued by the British Endodontic Society when providing root canal treatment; however, the risks to patients were mitigated by using local anaesthetic instead of sodium hypochlorite (bleach) as an irrigant and by using rotary instruments.

There were systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members. The staffing levels were adequate for the provision of care and treatment.

Effective

No action required

Updated 24 February 2017

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

The practice provided evidence based dental care which was focussed on the needs of the patients. We saw examples of effective collaborative team working. The staff were up-to-date with current guidance and received professional development appropriate to their role and learning needs. Staff, who were registered with the General Dental Council (GDC), had frequent continuing professional development (CPD) training and were meeting the requirements of their professional registration.

Caring

No action required

Updated 24 February 2017

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

Patients told us they had positive experiences of dental care provided at the practice. Patients felt they were listened to and were involved with the discussion of their treatment options which included its risks, benefits and costs. We observed the staff to be caring, friendly and professional. Staff spoke with enthusiasm about their work and displayed a genuine empathy for patients.

Responsive

No action required

Updated 24 February 2017

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

The practice provided friendly and personalised dental care. Patients could access routine treatment and urgent or emergency care when required. The practice offered emergency appointments enabling effective and efficient treatment of patients with dental pain. Staff demonstrated that they knew and supported patients’ individual support needs.

Well-led

No action required

Updated 24 February 2017

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

The dental practice had effective clinical governance and risk management structures in place. Staff told us the provider was always approachable and the culture within the practice was open and transparent. Staff were aware of the practice ethos and philosophy. They told us they felt well supported and able to raise any concerns where necessary. Staff told us they enjoyed working at the practice and would recommend it to a family member or friends.