The Care Quality Commission
  • Dentist
  • Dentist

iSmile Dental Practice

1 The Lodge, Mount Pleasant Avenue, Tunbridge Wells, Kent, TN1 1QY (01892) 547286

Provided and run by:
Dr Simon Azimi Fard

Important: The provider of this service changed. See old profile

All Inspections

15 March 2022

During an inspection looking at part of the service

We undertook a follow up focused inspection iSmile dental Practice on 15 March 2022. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of iSmile Dental Practice on 05 January 2022 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe, effective and well led care and was in breach of regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for iSmile dental practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it effective?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 05 January 2022

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 05 January 2022.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 05 January 2022.

Background

iSmile Dental Practice is in Tunbridge Wells and provides private treatment for adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes two dentists, two trainee dental nurses, and a practice manager. The practice has two treatment rooms.

During the inspection we spoke with one dentist, one trainee dental nurse, 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 Thursday 8.30am to 5.15pm
  • Friday – closed
  • Saturday 10am to 4.30pm

Our key findings were:

  • The practice appeared to be visibly clean and maintained including the decontamination room
  • The provider had infection control procedures which reflected published guidance
  • Staff knew how to deal with emergencies and all of the required medicines and equipment were available.
  • The provider had systems to help them manage risks to patients and staff
  • The provider had safeguarding processes and staff were aware of their responsibilities for safeguarding vulnerable adults and children.
  • The provider had recruitment procedures which reflected current legislation
  • Dental care records had improvements with recording some information, but further improvements were required.
  • Clinical governance had improved, but further improvements were required in relation to auditing patient dental care records and antimicrobial prescribing.

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

  • Take action to ensure the clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.

  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

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

  • Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular, ensure a five year electrical safety check is conducted and certificate is obtained.

05 January 2022

During an inspection looking at part of the service

We carried out this unannounced focused inspection on 05 January 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 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.

To get to the heart of patients’ experiences of care and treatment, we always ask the following three questions:

• 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 practice appeared to be visibly clean and maintained.
  • The provider had infection control procedures which did not reflect published guidance.
  • We were not assured staff knew how to deal with emergencies, some staff had not completed training. Some of the appropriate medicines and life-saving equipment were available.
  • The provider had systems to help them manage risk to patients and staff. However, this needed some improvement.
  • The provider did not have safeguarding processes and staff were not aware of their responsibilities for safeguarding vulnerable adults and children.
  • The provider had staff recruitment procedures which did not reflect current legislation.
  • 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.
  • Staff provided preventive care and supported patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • Staff felt involved and supported and worked as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had information governance arrangements.

Background

iSmile Dental Practice is in Tunbridge Wells and provides private dental care and treatment for adults and children.

There is level 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 dental team includes two dentists, two trainee dental nurses and a practice manager. The practice has two treatment rooms.

During the inspection we spoke with both dentists, both trainee dental nurses 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 Thursday 8.30am to 5.15pm
  • Friday closed
  • Saturday 10am to 4.30pm

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

  • Care and treatment must be provided in a safe way for service users.
  • Systems or processes must be established and operated effectively to ensure compliance with the requirements of the fundamental standards as set out in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
  • Comply with requirements in relation to staffing.

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

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

  • Implement an effective system for identifying, disposing and replenishing of out-of-date stock.
  • Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’
  • Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.

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

19 April 2016

During an inspection looking at part of the service

We carried out an unannounced focused inspection on 19 April 2016 to follow up on previous inspections carried out on 23 and 29 September 2015 to ask the practice the following key questions; Are services safe, effective, responsive and well-led?

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 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

CQC inspected the practice on 23 and 29 September 2015 and asked the provider to make improvements regarding Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment, Regulation 15 HSCA (RA) Regulations 2014 Premises and equipment and Regulation 17 HSCA (RA) Regulations 2014 Good governance. We checked these breaches as part of the focused inspection on 19 April 2016.

Ismile Dental Practice provides private dental treatment and facial aesthetics from their practice in Tunbridge Wells, in Kent. The majority of the dental treatment provided is general dentistry. The practice mostly provides treatment for adults but has a very small number of patients that are children.

Practice staffing consisted of the principal dentist who is also the owner and registered manager, , one dental nurse, one receptionist and a practice manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

The practice opening hours are 8.30am to 5.15pm Monday, Tuesday, Thursday and Friday and 8.30am to 7.00pm on Wednesday.

Our key findings were:

  • The practice had systems and processes in place to assess risks to the health and safety of patients, staff and visitors.
  • The practice had carried out audits in key areas, such as infection control, record keeping and the quality of X-rays.
  • There were systems in place to check all equipment had been serviced and maintained regularly, including the steriliser and the X-ray equipment.
  • Dental care records were consistent and contained accurate information of the treatments provided to patients.
  • Staff followed the appropriate decontamination process of instruments according to national guidelines.
  • There was a process in place to assess the risks in relation to the Control of Substances Hazardous to Health (COSHH) 2002 regulations.
  • Staff had received further training appropriate to their roles and were supported in their continued professional development (CPD).

23 and 29 September 2015

During a routine inspection

We carried out an announced comprehensive inspection on 23 September 2015 and 29 September 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was not 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 not providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

iSmile Dental Practice provides general dentistry, such as treating tooth decay, gum disease and restorative dentistry. The practice provides private services for patients in Tunbridge Wells, Kent and the surrounding areas.

The practice staff includes one dentist, one person working as a hygienist / dental therapist / dental nurse as well as two receptionists. Dental services are provided Monday to Friday between the hours of 8.30am and 5.15pm.

The dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Twelve people provided feedback about the service. We looked at ten patient comment cards where all comments were positive about the service patients experienced at iSmile Dental Practice. Patients indicated that they felt the practice offered an excellent service and staff were professional, helpful and kind. They said that staff treated patients with dignity and respect. Patients had sufficient time during consultations with staff and felt listened to as well as safe.

Our key findings were:

  • There were systems to check equipment had been serviced regularly, including the compressor, autoclave, oxygen cylinder and the X-ray equipment.
  • Patients were provided with information and were involved in decision making about the care and treatment they received.
  • The practice had a monitoring system to help ensure staff maintained their professional registration.
  • There were meetings held in order to engage staff and involve them in the running of the practice.

We identified regulations that were not being met and the provider must:

  • Ensure the content and quality of dental care records are in line with national guidance.
  • Ensure that the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (medical Exposure) Regulation (IRMER) 2000.
  • Ensure the practice’s recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to help ensure necessary employment checks are carried out for all staff and the required specified information in respect of persons employed by the practice is held.
  • Ensure there is a system that monitors and records the hepatitis B status of clinical staff.
  • Ensure systems are introduced for the proper and safe management of medicines.
  • Ensure the practice has an effective system to assess, monitor and mitigate the risks arising from the undertaking of the regulated activities.
  • Ensure that there are appropriate governance arrangements for the safe running of the service by establishing systems to monitor and assess the quality of the service.
  • Ensure audits of various aspects of the service are undertaken at regular intervals to help improve the quality of the service. The practice should also ensure that all audits have doicumented learning points and the resulting improvements can be demonstrated.

You can see full details of the regulations not being met at the end of this report.

There were areas where the provider could make improvements and should:

  • Review the practice’s protocols for the use of rubber dams for root canal treatment, giving due regard to guidelines issued by the British Endodontic Society.