We carried out an announced comprehensive inspection on 18 March 2016 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 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.

Aestcom – Harpenden, known locally as Harpenden Smiles Dental Studio is a general dental practice in central Harpenden, Hertfordshire offering private dental treatment to adults and children.

The premises are located on the first floor above commercial premises two floors and consist of three treatment rooms, a reception area and a waiting area. There is also a designated decontamination area.

The staff at the practice consist of a practice manager, a principal dentist, three associate dentists, two trainee dental nurses and a dental hygienist/therapist. The principal 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.

Our key findings were:

• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were caring and professional.

• We received feedback from three patients who reported they received excellent care from dedicated and friendly staff in a relaxing environment.

• There was an effective system in place to act on feedback received from patients and staff.

• There were systems in place to assess, monitor and improve the quality of service provided.

• The practice had promoted good oral health and developed links with the local community by sponsoring a local rugby team and participating in local community and charity events.

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

• Replace the clinical waste bin in the decontamination room in accordance with current guidance.

• Review the protocol for testing and validating the ultrasonic cleaning bath.

• Review the fire safety signage in the practice to ensure that staff and patients are clear about escape routes and where to assemble in the event of a fire.

We visited the Aestcom Harpenden Smiles Studio, on 23 April 2013, People attending the practice told us that they had travelled from a distance to see this dentist because they were, “pleased with the service” and the way the dentist worked with them. We found that the provider gave people information about their procedures and was happy to provide people with alternatives. We saw that people’s privacy and dignity was respected and staff were professional and well trained in supporting people who used the service.