Smiles and Smiles Limited

We carried out this announced focused inspection on 29 June 2022 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 practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The practice had infection control procedures which reflected published guidance.
• The dental clinic was generally clean. However, improvements could be made in regard to the cleaning of the decontamination room.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided
• The dental clinic had information governance arrangements.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• Staff knew how to deal with medical emergencies. However, improvements were required in regard to the practice having appropriate medicines and life-saving equipment available.
• The practice some systems help them manage risk to patients and staff; however, improvements were required in regard to risks associated with fire and legionella.
• Safeguarding processes were in place, however not all staff had completed safeguarding training.
• There was lack of evidence that all staff had undertaken suitable training in radiography, infection prevention and control and fire safety.

Background

The Marylebone Dental Practice is in Westminster and provides private dental care and treatment for adults and children.

The practice is not accessible for people who use wheelchairs and those with pushchairs. Staff referred patients to other local practices if they were unable to access the building. Car parking spaces are available near the practice.

The dental team includes four dentists, three dental nurses, a dental hygienist and two practice managers. The practice has four treatment rooms.

During the inspection we spoke with two dentists, two dental nurses and both of the practice managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9am to 5.30pm.

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

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

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

• Ensure persons employed in the provision of the regulated activity receive the appropriate support, training, professional development, supervision and appraisal necessary to enable them to carry out their duties

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

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

• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.