Montrose Smile Studio

We carried out this announced comprehensive inspection on 4 May 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 broadly reflected published guidance.
• 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 appointment system worked efficiently to respond to patients’ needs.
• 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.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.
• Staff knew how to deal with medical emergencies. Improvements were required to ensure all life-saving medicines and equipment were available as per national guidelines.
• There were ineffective systems to support continuous improvement.
• The practice had ineffective systems to manage risks for service users and staff, and those arising from the use of equipment and the premises.

Background

Montrose Smile Studio is in Twickenham in the London Borough of Richmond-upon-Thames and provides private dental care and treatment for adults and children.

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

The dental team includes 2 dentists, 2 dental nurses, 1 dental hygienist, and 1 dental therapist. The practice has 3 treatment rooms.

During the inspection we spoke with the dentists, and the dental nurses. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Wednesday from 9am to 5pm

Friday from 9am to 1pm

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Take action to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
• Improve and develop staff awareness of autism and learning disabilities, and the requirements of the Mental Capacity Act 2005 and ensure all staff receive appropriate training.