The Care Quality Commission
  • Dentist
  • Dentist

Smile Dental Care

22 Meneage Street, Helston, Cornwall, TR13 8AB (01326) 569323

Provided and run by:
Smile Care (Cornwall) Ltd

All Inspections

27 October 2023

During an inspection looking at part of the service

We undertook a follow up inspection of Smile Dental Care – Helston on 27 October 2023. 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 who had access to a specialist dental adviser.

We undertook a comprehensive inspection of Smile dental Care - Helston on 16 August 2023 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 and was in breach of regulation 17 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 Smile Dental Care - Helston dental practice 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 (requirement notice only). We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

• Is it well-led?

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 breach we found at our inspection on 16 August 2023.

Background

The provider is part of a corporate group Smile Dental Care, and this report is about Smile Dental Care - Helston.

Smile Dental Care is in Helston and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 dentists, 1 part-time dental nurse, 3 trainee dental nurses, 2 receptionists and a practice manager. The practice has 4 treatment rooms.

During the inspection we spoke with 1 trainee dental nurse, 1 receptionist, the practice manager and the area business manager on behalf of Smile Dental Care.

The practice is open: Monday to Friday 9.00am – 5.00pm. The practice is closed between 1.00pm – 2.00pm.

16 August 2023

During a routine inspection

We carried out this announced comprehensive inspection on 16 August 2023 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 questions:

  • Is it safe?
  • Is it effective?
  • Is it caring?
  • Is it responsive to people’s needs?
  • Is it well-led?

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

Our findings were:

  • Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The practice had staff recruitment procedures which reflected current legislation.
  • Clinical staff provided patients’ care and treatment in line with current guidelines.
  • Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
  • Staff provided preventive care and supported patients to ensure better oral health.
  • The appointment system worked efficiently to respond to patients’ needs.
  • The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
  • Staff and patients were asked for feedback about the services provided.
  • Complaints were dealt with positively and efficiently.
  • The practice had information governance arrangements.
  • The practice infection control procedures were not effective.
  • Staff felt involved, but staff training and supervision was not effectively managed.
  • Staff knew how to deal with medical emergencies, but improvements should be made regarding monitoring of stock control of first aid and emergency medicines.
  • The practice had systems to manage risks for patients, staff, equipment and the premises, but improvements are recommended.
  • There was a new in post practice manager, who was working to prioritise areas for improvement at the practice.

Background

The provider is part of a corporate group Smile Dental Care, and this report is about Smile Dental Care - Helston.

Smile Dental Care is in Helston and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 dentists, 1 part-time dental nurse, 3 trainee dental nurses, 2 receptionists and a practice manager. The practice has 4 treatment rooms.

During the inspection we spoke with 3 dentists, 1 dental nurse, 3 trainee dental nurses, 1 receptionist, the practice manager, an area manager on behalf of Smile Dental Care, and the provider. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday to Friday 9.00am – 5.00pm. The practice is closed between 1.00pm – 2.00pm.

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

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

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

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

  • Implement an effective system for replenishing of out-of-date stock. In particular, for emergency medicines and first aid kits.
  • Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’
  • Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.
  • The practice should ensure that, where appropriate, clinical audits have documented learning points and that the resulting improvements can be demonstrated.

3 September 2019

During a routine inspection

We carried out this announced inspection on 3 September 2019 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 provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• 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 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 caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Smile Dental Care is in Helston, Cornwall and provides NHS and private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two dentists, one dental hygienist, three trainee dental nurses, one receptionist and a practice manager. The practice manager had been in post approximately two months. The practice has three treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Smile Dental Care is the provider.

On the day of inspection, we collected 33 CQC comment cards filled in by patients and spoke with two other patients. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, one qualified dental nurse (assisting from another of the provider’s practices for the day), one trainee dental nurse, the receptionist, the practice manager, another practice manager from one of the provider’s other practices and the provider’s area business manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am – 5pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The provider had systems to help them manage risk to patients and staff.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • Staff recruitment procedures were reviewed immediately following our inspection to ensure their robustness.
  • Improvements had commenced to ensure clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Further improvements were needed to ensure staff provided preventive care and supported patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The provider had effective leadership and a culture of continuous improvement.
  • The new practice manager had introduced systems to support staff and created a cohesive atmosphere of team working.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.

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

  • Review the practice protocols regarding audits for prescribing of antibiotic medicines, taking into account the guidance provided by the Faculty of General Dental Practice.
  • Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice (FGDP) when completing dental care records.
  • Take action to ensure the clinicians carry out patient assessments and ensure they are in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance.
  • Develop systems to ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff. Including the training, learning and development needs of individual staff members at appropriate intervals.
  • Take action to ensure all clinicians 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 (GDC). In particular, regarding the dental hygienist working without immediate chairside support.