Smile in London

We carried out this announced focused inspection on 22 July 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 appeared to be visibly 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 help them manage risk to patients and staff.
• 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.
• 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.
• There was strong 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 two practices and this report is about Smile in London - Wanstead.

Smile in London is in the town of Wanstead, in the London Borough of Redbridge, and provides NHS and private dental care and treatment for adults and children.

There is access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice. The practice has made reasonable adjustments to support patients with additional needs, for instance, an access ramp is available to make it easier for people that use wheelchairs. In addition, the treatment room is spacious which allows for those using mobility equipment to manoeuvre freely.

The dental team includes two principal dentists, a prosthodontist, three associate dentists, two dental hygienists, two dental nurse and a head dental nurse. They were supported by a practice administrator, a practice coordinator and a practice manager. The practice has three treatment rooms, a staff room and a separate decontamination room.

During the inspection we spoke with a dentist, a dental hygienist, two dental nurses, the practice coordinator and administrator 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 Friday 9am to 5.30pm and Saturday 9am to 1pm. Outside of these hours, arrangements are in place for patients requiring urgent care and treatment.

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

• Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.
• Take action to ensure all clinicians are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.