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Inspection Summary


Overall summary & rating

Updated 19 September 2017

We carried out this announced inspection on 19 July 2017 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 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.

Background

U Smile Dental Practice is in Luton and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available in front of the practice, and road parking nearby.

The dental team includes one dentist, one dental nurse and one receptionist. The dental nurse and receptionist had very recently joined the practice at the time of our inspection. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 13 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with all of the staff. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Saturday from 9 am to 5 pm.

Our key findings were:

  • The practice was clean and well maintained.
  • The practice had infection control procedures which mostly reflected published guidance.
  • Most medicines and life-saving equipment were available in line with published guidance.
  • The practice had systems to help them manage risk, but was not always following the highlighted recommendations.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice did not have thorough staff recruitment procedures.
  • The 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.
  • The appointment system met patients’ needs.
  • The practice had effective leadership. Staff felt involved and supported and worked well as a team.
  • The practice asked staff and patients for feedback about the services they provided.

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

  • Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

  • Review the practices’ current Legionella risk assessment and implement the required actions taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

  • Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

  • Review the practice’s system for documentation of actions taken, and learning shared, in response to incidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
Inspection areas

Safe

No action required

Updated 19 September 2017

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

The dentist had received training in safeguarding; other staff had not. Staff knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed some essential recruitment checks.

Premises and equipment were clean. Some equipment was not properly maintained, improvements were made in this regard following the inspection. The practice mostly followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

Effective

No action required

Updated 19 September 2017

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

The dentists assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as caring, informative and considerate. The dentists discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

Caring

No action required

Updated 19 September 2017

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

We received feedback about the practice from 13 people. Patients were positive about all aspects of the service the practice provided. They told us staff were friendly, polite and professional. They said that they were given detailed information about dental treatment, and said their dentist listened to them and took the time to answer their questions. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dentist.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 19 September 2017

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice did not have access to interpreter services; however staff spoke five languages between them.

The practice took patients views seriously. They valued compliments from patients and had systems in place to respond to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 19 September 2017

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

The practice had some arrangements to ensure the smooth running of the service. There was a clearly defined management structure and the newly appointed practice team felt supported and appreciated.

The practice team kept complete patient dental care records which were, clearly written or typed and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.