Updated 29 February 2024
We carried out this announced comprehensive inspection on 11 January 2024 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.
- Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
- The practice had systems to manage risks for patients, staff, equipment and the premises. Improvements were needed in relation to reporting and dealing with significant events in accordance with dental guidelines. Improvements were needed so that the practice sedation risk assessment considered the specific risks associated with the use of multiple sedative medicines in sedation procedures.
- 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.
- There was effective leadership and a culture of continuous improvement. Improvements were needed so that audits included analysis and action plans.
- Staff felt involved, supported and worked as a team.
- Staff and patients were asked for feedback about the services provided.
- Complaints were dealt with positively and efficiently.
- The practice had information governance arrangements.
Background
Perfect Smile Reading Sedation Clinic is part of Perfect Smile, a group dental provider.
The practice is in Reading and provides NHS and private dental care 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 dental team includes 5 dentists, 2 visiting specialists who carry out sedation, 1 dental hygienist, and 5 dental nurses. The clinical team are supported by 1 practice manager and 2 receptionists.
The practice has 3 treatment rooms.
During the inspection we spoke with 1 dentist, 1 visiting sedationist, 2 dental nurses, the practice manager and 2 receptionists.
We looked at practice policies, procedures and other records to assess how the service is managed.
The practice is open between:
8am and 6pm on Mondays
8am and 5pm on Tuesdays to Thursdays
8am and 2pm on Fridays.
There were areas where the provider could make improvements. They should:
- Improve the practice protocols for conscious sedation, taking into account the guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015 and other related guidance. In particular, ensure that the practice sedation risk assessment considers and has arrangements to mitigate the risks associated with the use of multiple sedative medicines, including premises and equipment, and arrangements for access to emergency services.
- Improve the system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result. In particular, ensuring reversal medicines are only used in emergency situations during sedation, and where this occurs these are documented as significant events, reviewed, analysed and used to minimise recurrences.
- The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.