Perfect Smile

We carried out this announced comprehensive inspection on 8 February 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 second inspector and had remote access to 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:

• The dental clinic appeared clean.
• Improvements were needed to manage infection prevention and control procedures.
• Staff knew how to deal with medical emergencies.
• Improvements were needed to manage medical emergencies. Specifically, the provision of appropriate life-saving equipment.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Improvements were needed to manage risks to patients and staff.
• The practice had staff recruitment procedures which reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff training was not monitored effectively.
• 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 felt involved and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice did not have appropriate quality assurance processes to encourage learning and continuous improvement.

Background

The provider is part of a dental group, with multiple practices. This report is about Perfect Smile Peach Street Dental Practice.

Perfect Smile Peach Dental Practice is in Wokingham 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. These include:

• A hearing loop
• Wheelchair accessible toilet
• Reading glasses
• A magnifying glass
• Step free access

The dental includes 4 dentists, 2 dental nurses, 1 dental hygienist, practice manager and receptionist. A student dental nurse started to work at the practice a couple of days before our visit so will not be included in any feedback about staff training.

The practice has 3 treatment rooms.

During the inspection we spoke with 2 dentists, 1 dental nurse, the registered manager and the practice manager.

We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

• Monday 8:30am – 18:00
• Tuesday 8:30am – 17:00
• Wednesday 8:30am – 17:00
• Thursday 8:30am – 17:00
• Friday 8:30am – 15:00
• Saturday 8:30am – 13:00
  
  

We identified regulations the provider was 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 was not meeting is at the end of this report.

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

• Implement protocols regarding the prescribing and recording of antibiotic medicines taking into account guidance provided by the Faculty of General Dental Practice in respect of antimicrobial prescribing.
  
  
• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.
  
  
• Take action to ensure hot running water is available in areas where employees are expected to wash their hands taking into account the Workplace (Health, Safety and Welfare) Regulations, 1992.

The registered manager accepted the shortfalls we raised and immediately started to address these.

Where evidence is sent that shows the relevant issues have been acted on, we have stated this in our report but we cannot say that the practice is compliant for that key question as this would not be an accurate reflection of what was found on the day of our inspection.