17 October 2017
During a routine inspection
We carried out this announced inspection on 17 October 2017 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 provider 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.
We told the NHS England area team and Healthwatch that we were inspecting the practice. NHS England provided information which we took into account.
To get to the heart of patients’ experiences of care and treatment, we always ask the following five 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:
Are services safe?
We found that this practice was providing safe care in accordance with the relevant regulations.
Are services effective?
We found that this practice was providing effective care in accordance with the relevant regulations.
Are services caring?
We found that this practice was providing caring services in accordance with the relevant regulations.
Are services responsive?
We found that this practice was providing responsive care in accordance with the relevant regulations.
Are services well-led?
We found that this practice was providing well-led care in accordance with the relevant regulations.
Background
Key 2 Smiles is located in Leyton, in the London Borough of Waltham Forest. The practice provides NHS and private dental treatments to patients of all ages.
The practice is located on the first floor of a purpose adapted residential premises. The practice has two treatment rooms. The practice is conveniently located close to public transport links.
The dental team includes the principal dentist and one associate dentist, one dental hygienist, one qualified dental nurse, two trainee dental nurses and one receptionist.
The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.
We received feedback from 13 patients via CQC comment cards and speaking with patients. This information gave us a positive view of the practice.
During the inspection we spoke the principal dentist, one trainee dental nurse, the dental hygienist, a locum dental nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open between 9am and 6pm on Mondays, Tuesdays, Wednesdays and Thursdays.
The practice is closed between 1pm and 2pm for lunch.
Our key findings were:
- The practice was clean and well maintained.
- The practice had infection control procedures which reflected published guidance.
- Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to help them assess and manage risk.
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
- The practice had thorough staff recruitment procedures.
- The clinical staff provided patients’ care and treatment in line with current guidelines.
- Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
- The appointment system met patients’ needs.
- The practice had effective leadership. Staff felt involved and supported and worked well as a team.
- The practice asked staff and patients for feedback about the services they provided.
- The practice dealt with complaints positively and efficiently.
There were areas where the provider could make improvements. They should:
- Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
- Review the practice’s protocols for handling needles and other dental sharps taking into account the European Council Directive 2010/32/EU (the Sharps Directive) and other published guidance.