Archived: The Smile Rooms

We carried out this announced inspection on 18 May 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 and Healthwatch that we were inspecting the practice. They did not provide any information.

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

The Smile Rooms is in Malton and provides NHS treatment for children and private treatment adults.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes four dentists, eight dental nurses (two of which also work on reception), two dental hygienists, a dental hygienist therapist and two receptionists. The practice has four 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 11 CQC comment cards filled in by patients and spoke with six other patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday & Wednesday 8am – 5pm

Tuesday & Thursday 8am – 6pm

Friday 8am - 4pm

And the practice opens the first Saturday of the month.

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. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• 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 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.
• The practice dealt with complaints positively and efficiently.

We identified areas of notable practice through visible leadership within the practice; staff felt empowered and were happy and confident in their roles. A few examples of this include:

• We were told one nurse had video recorded decontamination processes for all staff to review and refresh their skills. Photos of each process were also available in the decontamination room as they found visual reminders reinforced messages more than written protocols. This method had been reviewed and all staff had fed back they felt a more consistent approach to decontamination was now in place. Further detailed training had been provided about the safe use of the equipment.

• We were shown a card given to patients so they could see their gum health grades from the last visit to their current visit; this included an explanation about what each code meant. All areas that required further care were highlighted to patients and treatment plans and supporting advice given to support the process.

• Nervous patients said staff were compassionate and understanding. Patients could choose whether they saw a male or female dentist. The practice had put a 360 video about the practice on the internet so patient could have a virtual tour of the practice before coming in. On their first visit they were offered an appointment with a treatment co-coordinator so they could discuss their needs before seeing a dentist. A detailed form was completed firstly by reception on making the appointment, and then by the treatment co-ordinator and all of this was provided to the dentist. The practice found this helped prevent patients having to repeat themselves at each stage and they were welcomed with information they had already provided. An examination protocol was used within the dental computer system which contained a pathology record, a dental examination and a periodontal examination record, which ensured consistency and appropriate aspects of the examination were covered.

• The practice had made reasonable adjustments to the practice and had implemented yellow paper for partially sighted patients as this was an easier format to read for them. We were also told an audio file could be sent to patients which covered all the information provided in the practice leaflet. Patients with hearing impairments could book appointments on line if they wished.

We felt these were areas of notable practice which should be shared.