The Smile Studios: Richmond

We carried out this announced comprehensive inspection on 31 August 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.
• 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.
• Patients were treated with dignity and respect.
• 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 felt involved and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• Improvements were needed to the Information Governance policy to take account the General Data Protection Regulation (GDPR) 2018 requirements.
• There were ineffective systems to support continuous improvement.
• Improvements were needed to ensure that clinical staff kept up to date with current guidelines, and information related to patient care was suitably recorded within the dental care records.
• The leadership and oversight for the day-to-day management of the service needed improvements.

Background

The provider has 4 practices, and this report is about The Smile Studios: Richmond.

The Smile Studios: Richmond is in the London Borough of Richmond upon Thames and provides private dental care and treatment for adults and children.

There are 5 steps leading to the entrance of the practice so it is unsuitable for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The premises are within a listed building so the provider is unable to make substantial adjustments.

The dental team includes the principal dentist, 2 associate dentists, 1 specialist orthodontist, 3 dental nurses, 1 dental hygienist, 1 practice manager and 3 receptionists. Treatment under conscious sedation is provided occasionally by visiting sedationists. The practice has 4 treatment rooms.

During the inspection we spoke with the principal dentist, 1 dental nurse, 1 receptionist and the practice manager. Following the inspection we also spoke with a dentist who visited the practice to provide conscious sedation. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Wednesday & Friday from 8.30am to 6pm

Tuesday & Thursday from 8.30am to 7pm

Saturday from 8.30am to 4pm

Sunday from 9.30am to 6pm

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:

• Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.

• Improve the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.