Archived: Brighton Smile Clinic

Updated 25 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection was carried out on 6 May 2015 by an inspector and a dental specialist advisor. We reviewed information received from the provider prior to the inspection. On the day of our inspection we looked at practice policies and protocols, ten clinical patient records and other records relating to the management of the service. We spoke to the interim practice manager, the associate dentist, two dental nurses and one patient. We reviewed 21 comments cards completed by patients.

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?

This informed our view of the care provided and the management of the practice.

Updated 25 June 2015

Brighton Smile Clinic is a general dental practice in Brighton offering both NHS and private dental treatment. The practice treats adults and children.

The premises consists of a waiting area adjacent to the reception area and one treatment room. There is also a separate decontamination area.

The staff structure of the practice consists of the provider (who works part time at the practice), an associate dentist and two dental nurses. The practice sometimes receives support from an ‘interim’ practice manager who is based at the provider’s sister practice in Brighton.

We spoke with one patient on the day of our inspection and reviewed 21 comment cards that had been completed by patients which reflected very positive views about the care and treatment they had received. Patients felt the dentists (in particular the associate dentist who treated most of the patients seen at the practice) took a lot of time to explain care and treatment options in a way they understood. Common themes were patients felt they received excellent care in a calm and clean environment by friendly and caring staff.

Our key findings were:

We found that this practice was providing safe, effective, caring and responsive care in accordance with the relevant regulations. However we found that this practice was not providing well-led care in accordance with the relevant regulations.

• The practice provided care and treatment in a clean, hygienic, calm and welcoming environment.

• The practice had systems to assess and manage risks to patients for infection prevention and control and the management of medical emergencies.

• Patients told us through comment cards they were treated with kindness and respect by staff. The practice ensured there was always enough time to explain fully the care and treatment they were providing in a way patients understood.

• Patients were able to make routine and emergency appointments when needed. There were clear instructions for patients regarding out of hours care.

• Records we reviewed showed dentists did not always record oral health assessments and planned treatment.

• There were not clearly defined leadership roles within the practice. Although staff told us they felt able to raise concerns or make suggestions. It was unclear who these should be directed to or who was responsible for the day to day running of the practice.

We identified regulations that were not being met and the provider must:

• Establish and implement a process to regularly identify, assess and manage risks to the health, welfare and safety of patients, staff and visitors to the practice.

• Assess, monitor and improve the quality and safety of the services provided.
• Ensure a full and accurate clinical record is kept in respect of each patient's care and treatment.

You can see full details of the regulations not being met at the end of this report

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

• Ensure the infection control policy is updated with current guidance.
• Ensure all staff are familiar with the Mental Capacity Act 2005 and its relevance to dental practice.
• Establish a process to record and monitor decisions made at staff meetings and during informal discussions about how the service could be improved.
• Ensure all staff are familiar with their responsibilities under the Reporting of Injuries and Dangerous Occurrences Regulations 2013 (RIDDOR).
• Ensure the practice always follows the provider’s recruitment and selection procedures when employing new staff members.
• Consider the guidance issued in the Department of Health publication ‘Delivering Better Oral Health; a toolkit for prevention’ when providing preventive oral health care and advice to patients.
• Undertake an assessment of the practice compliance with the requirements of the Disability Discrimination Act 2005.
• Ensure there are clear and established lines of accountability and responsibility in the practice.