Smile Together Bodmin

We carried out this announced comprehensive inspection on 28 September 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 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 and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• 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.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved, supported 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 had information governance arrangements.

Background

The provider is part of a corporate group, Smile Together, and this report is about Smile Together Bodmin.

Smile Together Bodmin is in Bodmin and operates as an NHS urgent dental care hub providing urgent and emergency care, including out of hours, and routine (private) care, including direct access hygiene therapy treatments. The location also provides NHS special care, paediatric, orthodontic services and minor oral surgery, on referral.

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 at the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 5 dentists, 8 dental nurses, 2 trainee dental nurses, 1 dental therapist, 3 decontamination technicians, 1 location manager and 2 receptionists. The practice has 6 treatment rooms.

During the inspection we spoke with 2 dentists, 2 dental nurses, 1 decontamination technician, the quality assurance and compliance lead for Smile Together and members of the administrative, reception and marketing team. We looked at practice policies, procedures, and other records to assess how the service is managed.

The practice is open: Monday to Friday 8.30am – 5pm.

The practice had taken steps to improve environmental sustainability. For example, the practice was as paper free as possible, and there were recycling points in the practice, including for spent dental products. The provider had a staff cycle to work scheme. Oral health packs for patients were presented inside compostable bags and stickers for children awarded after seeing the dentist were biodegradable. There was a company sustainability policy, staff impact action group, and the provider is ‘B Corporation’ certified. This is a business sustainability and environmental impact award, which any business can apply to and be assessed for.

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

• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular in relation maintaining clear servicing records and the completion of any recommendations within said servicing reports.

• Take action to ensure clinical audits have documented learning points and the resulting improvements can be demonstrated. Audits of antimicrobial prescribing should be undertaken at regular intervals to improve the quality of the service.