Archived: Smile Dental Implants

We undertook a follow up desk-based review on 6 December 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of Smile Dental Implants on 10 May 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Smile Dental Implants dental practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breach we found at our inspection on 6 December 2019.

Background

Smile Dental Implants is in Worcester Park in the London borough of Sutton and provides private treatment to adults.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces Car parking spaces are available near the practice through local car parks and paid meter parking. There is a train station nearby and local buses.

The dental team includes a principal dentist, two associate dentists, a dental nurse (who is also the practice manager), two dental hygienists and a receptionist (who is a trainee dental nurse. 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.

We looked at practice policies and procedures and other records that the provider sent to us.

Our key findings were:

Systems and processes had been implemented to ensure good governance in accordance with the fundamental standards. In particular,

• A Disability access audit had been completed and systems were in place for this to be reviewed.

• Systems for routinely auditing various aspects of the service including infection control and radiography had been implemented

• Systems had been implemented to ensure completion of dental care records was in line with guidance.

• The practice were able to evidence suitable servicing and maintenance of the X-ray equipment and a suitable Radiation Protection Advisor had been appointed

• Fire and sharps risk assessments had been undertaken and suitably documented. Actions identified had been completed.

We carried out this announced inspection on 10 May 2019 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 not providing well-led care in accordance with the relevant regulations.

Background

Smile Dental Implants is in Worcester Park in the London borough of Sutton and provides private treatment to adults.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice through local car parks and paid meter parking. There is a train station nearby and local buses.

The dental team includes a dental nurse (who is also the practice manager), three dentists, a receptionist (who is a trainee dental nurse) and two dental hygienists. 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 17 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist, the dental nurse, one of the dental hygienists and the receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

9.30-4.00pm on Mondays, 9.30am to 4.30pm on Tuesdays 10.00am to 7.00pm on Wednesdays; 10.00am to 5.00pm on Thursdays; 9.30am to 1.00pm on Fridays. Saturdays are by appointment.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• Improvements were required to the practice's protocols for completion of dental care records
• Appropriate emergency medicines and life-saving equipment were available. Though some improvements were required.
• Improvements were required with regards to having systems in place to continuously manage risk to patients and staff.
• Risks from the use of X-ray equipment had not been suitably identified and mitigated.
• The practice had not undertaken any audits such as those for radiographs and infection prevention and control.

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 are at the end of this report.

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

• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular ensuring that fire and sharps risk assessments are completed and paperwork is available in a timely manner.