Grimsargh Smile Clinic

We carried out this announced inspection on 12 October 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.

We told the NHS England area team that we were inspecting the practice. We did not receive any information of concern from them.

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

Grimsargh Smile Clinic is based in the village of Grimsargh outside Preston, Lancashire and provides private treatment for adults and children.

There is provision for level access for people who use wheelchairs and pushchairs. Car parking spaces and public transport facilities are available outside the practice.

The dental team includes a practice manager, three dentists, one dental hygienist, three dental nurses and one receptionist. The practice has two 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 Grimsargh Smile Clinic was the principal dentist.

On the day of inspection we collected 29 CQC comment cards filled in by patients. This information gave us a very positive view of the practice.

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

The practice is open:

Monday 8.30am-5:45pm, Tuesday and Thursday 8.30am-5.30pm, Wednesday: 8.30am-6.45pm, Friday 8.30am-4pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Emergency equipment and medicines were available as described in recognised guidance; two items had been replaced but without subsequent disposing of the out of date items. The provider made arrangements for immediate disposal.
• The practice had systems in place to help them manage risk. Fire procedures were in place but regular fire drills had not been undertaken.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• The practice undertook audits of x-rays and clinical record keeping. Record keeping audits were not always completed for all clinicians and it was not clear what action and learning had taken place.
• The appointment system was flexible and 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.
• The practice dealt with complaints positively and efficiently.

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

• Review fire evacuation procedures and introduce regular fire evacuation drills for staff to ensure fire procedures are effectively followed.