Updated 17 June 2022
We carried out this announced focused inspection on 11 May 2022 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 adviser.
To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:
• Is it safe?
• Is it effective?
• Is it well-led?
These questions form the framework for the areas we look at during the inspection.
Our findings were:
- The dental clinic was visibly clean and well-maintained.
- The practice had infection control procedures which did not always reflect published guidance.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were not always available.
- Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice’s staff recruitment procedures did not always reflect current legislation.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff provided preventive care and supported patients to ensure better oral health.
- The appointment system took account of patients’ needs.
- There was effective leadership and a culture of continuous improvement.
- Staff felt involved and supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- The dental clinic had information governance arrangements.
Background
The provider has one practice and this report is about Smile and Implant Centre.
Smile and Implant Centre is in Leicester and provides private dental care and treatment for adults and children.
The practice is accessed via a flight of stairs so is not accessible for people who use wheelchairs and those with pushchairs. Patients are informed of this and referred to a nearby practice if required. The practice is located on a busy street, so parking is not available. The practice has made some adjustments to support patients with additional needs.
The dental team includes three dentists, four dental nurses, three of whom are trainees, two dental hygienists, one receptionist and a practice manager. The practice has two treatment rooms.
During the inspection we spoke with three dentists, two dental nurses, one receptionist 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 to Thursday from 9am to 6pm
Friday: from 9am to 5pm
Saturday: from 9am to 1pm
The practice had taken steps to improve environmental sustainability. For example, they have implemented a sustainability policy aimed at reducing waste and promoting recycling. Heating is kept between 19 and 21 degrees Celsius. They have reduced the use of single use plastics and implemented a responsible purchasing policy.
There were areas where the provider could make improvements. They should:
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ . In particular, ensure single use items are not reused, manual cleaning of instruments follows current guidelines and items that have been through the decontamination process are stored in a sterile manner.
- Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, following guidelines for wearing face coverings in dental areas as a preventative measure for Covid transmission as per COVID-19: infection prevention and control dental appendix.
- Take action to ensure 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. Specifically, clear face mask for self-inflating bag sizes one to four.
- Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.