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Archived: Brighton Smile Clinic


Inspection carried out on 6 May 2015

During a routine inspection

Brighton Smile Clinic is a general dental practice in Brighton offering both NHS and private dental treatment. The practice treats adults and children.

The premises consists of a waiting area adjacent to the reception area and one treatment room. There is also a separate decontamination area.

The staff structure of the practice consists of the provider (who works part time at the practice), an associate dentist and two dental nurses. The practice sometimes receives support from an ‘interim’ practice manager who is based at the provider’s sister practice in Brighton.

We spoke with one patient on the day of our inspection and reviewed 21 comment cards that had been completed by patients which reflected very positive views about the care and treatment they had received. Patients felt the dentists (in particular the associate dentist who treated most of the patients seen at the practice) took a lot of time to explain care and treatment options in a way they understood. Common themes were patients felt they received excellent care in a calm and clean environment by friendly and caring staff.

Our key findings were:

We found that this practice was providing safe, effective, caring and responsive care in accordance with the relevant regulations. However we found that this practice was not providing well-led care in accordance with the relevant regulations.

  • The practice provided care and treatment in a clean, hygienic, calm and welcoming environment.

  • The practice had systems to assess and manage risks to patients for infection prevention and control and the management of medical emergencies.

  • Patients told us through comment cards they were treated with kindness and respect by staff. The practice ensured there was always enough time to explain fully the care and treatment they were providing in a way patients understood.

  • Patients were able to make routine and emergency appointments when needed. There were clear instructions for patients regarding out of hours care.

  • Records we reviewed showed dentists did not always record oral health assessments and planned treatment.

  • There were not clearly defined leadership roles within the practice. Although staff told us they felt able to raise concerns or make suggestions. It was unclear who these should be directed to or who was responsible for the day to day running of the practice.

We identified regulations that were not being met and the provider must:

  • Establish and implement a process to regularly identify, assess and manage risks to the health, welfare and safety of patients, staff and visitors to the practice.

  • Assess, monitor and improve the quality and safety of the services provided.
  • Ensure a full and accurate clinical record is kept in respect of each patient's care and treatment.

You can see full details of the regulations not being met at the end of this report

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

  • Ensure the infection control policy is updated with current guidance.
  • Ensure all staff are familiar with the Mental Capacity Act 2005 and its relevance to dental practice.
  • Establish a process to record and monitor decisions made at staff meetings and during informal discussions about how the service could be improved.
  • Ensure all staff are familiar with their responsibilities under the Reporting of Injuries and Dangerous Occurrences Regulations 2013 (RIDDOR).
  • Ensure the practice always follows the provider’s recruitment and selection procedures when employing new staff members.
  • Consider the guidance issued in the Department of Health publication ‘Delivering Better Oral Health; a toolkit for prevention’ when providing preventive oral health care and advice to patients.
  • Undertake an assessment of the practice compliance with the requirements of the Disability Discrimination Act 2005.
  • Ensure there are clear and established lines of accountability and responsibility in the practice.

Inspection carried out on 19 July 2013

During a routine inspection

We spoke with all three patients who used the service during our inspection. We also spoke with two dentists, one of whom was the provider, the manager, dental nurse and receptionist.

Patients were supported to give informed consent for their treatment. A patient said, �I was shown x-rays and kept involved. It was all my own choices.�

Patients had a thorough oral assessment and treatment was given in accordance with their agreed plan. Patients were satisfied with the service. One said, �It�s really friendly, really nice. They made me feel really relaxed; it�s not a stressful place.� Another said, �We have a good relationship, I feel like I�m being treated like a human being.�

We found staff were aware of their responsibilities in child protection and the safeguarding of vulnerable adults. One said, �I know where the policy is to make sure I�m following the right procedure.�

The practice was clean and hygienic and all relevant government guidance on infection control was being followed. A patient said, �It�s really clean, sparkling.�

Staff were appropriately skilled and qualified to do their jobs, and checks were made that they were of good character. A patient said, �My actual treatment is really good, I feel like I�m in safe hands.�

Patients were able to give feedback, and actions were taken in the light of comments made. The provider ensured the practice was safe.

We found records were comprehensive, current, fit for purpose and stored securely.