TLC 4 Smiles Ashbourne

We carried out this announced focussed inspection on 19 May 2021 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 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 asked the following three questions:

• 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 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 providing well-led care in accordance with the relevant regulations.

Background

TLC 4 Smiles is in Ashbourne and provides mostly NHS dental care and treatment for adults and children.

There is ramped access to the practice for people who use wheelchairs and those with pushchairs. A car parking space for blue badge holders is available on site at the practice. Roadside car parking is also available near the practice.

The dental team includes two dentists, one dental hygiene therapist, four dental nurses including one trainee dental nurse, and two receptionists. The practice has three treatment rooms, one of which is on the ground floor.

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 TLC 4 Smiles Ashbourne is the dental hygiene therapist.

During the inspection we spoke with one dentist, three dental nurses, one dental hygiene therapist, and two receptionists We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Wednesday and Friday: 8:30am to 5pm

Tuesday and Thursday: 8:30am to 6pm

Our key findings were:

• The practice appeared to be visibly 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 safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• 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.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider had information governance arrangements.

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

• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the practice protocols regarding audits for prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.