Sparklysmile

We carried out this announced inspection on 26 August 2021 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to follow up on information of concern we received and 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 Care Quality Commission (CQC) inspector who was supported by a CQC specialist dental advisor.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing 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:

Are services safe?

We found this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Sparklysmile is in the London Borough of Lewisham and provides private dental care and treatment for adults and children.

The dental team includes the principal dentist, one associate dentist, three visiting dentists, four dental hygienists and three dental nurses. The clinical team are supported by one receptionist, one administrative assistant and the practice manager. The practice has four treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 Sparklysmile is the principal dentist.

During the inspection we spoke with the principal dentist, one associate dentist, one dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice opening times are:

8.30am – 5.30pm Mondays to Fridays

Our key findings were:

• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines. Improvements were needed to ensure that detailed dental care records were maintained.
• Staff provided preventive care and supported patients to ensure better oral health.
• Infection prevention and control procedures were not followed in accordance with national guidance.
• The provider had ineffective arrangements to ensure that equipment was tested, serviced and maintained in accordance with relevant guidelines.
• Staff knew how to deal with emergencies. However, emergency equipment and medicines were not available in accordance with the Resuscitation Council UK 2021 guidelines.
• The provider had ineffective systems to help them manage risks to patients and staff and to monitor staff training and learning needs.
• The provider had ineffective recruitment procedures.
• The provider had ineffective governance systems to monitor the day to day running of the practice and an ineffective leadership to support a culture of openness and continuous improvement.

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 the duties.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely .
• Review the security of medicines in the practice and ensure there are systems in place to track and monitor their use.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.

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