We carried out an announced comprehensive inspection on 1 October 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 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.

Barnet Smiles Dental Care provides private, general dental services to patients of all ages. The team at the practice is led by a dentist. A practice manager supports the principal dentist to deliver the practice’s administration and clinical governance systems. There is a team of two associate part time dentists, two part time reception staff, four part time practice nurses, student dental nurse and a practice manager (who is also a qualified dentist).

The practice is open from Monday to Thursday 8:30am to 6:30pm and Friday 8:30am to 4:30pm (closed for lunch 1-2pm).

The practice is located in a converted house. There are three treatment rooms, a reception/patient waiting area, accessible patient toilet and a dedicated room where reusable dental instruments are washed and sterilised (a process known as decontamination). The practice is accessible to patients with restricted mobility as treatment can be carried out in the ground floor treatment room.

The dentist is also 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.

Forty eight people provided feedback about the service. All patients commented positively about the care and treatment they had received and the friendly, polite and professional staff. A number of patients commented on the discussions they had with the dentist about their care and treatment; and about how they felt listened to and were made to feel relaxed.

Our key findings were:

• The practice provided a clean, well equipped environment.
• Where mistakes had been made patients were notified about the outcome of any investigation and given a suitable apology.
• The practice had a systematic programme in place for auditing quality and safety including mandatory audits for infection control and radiography; but also additional audits for clinical note taking and health and safety.
• There was promotion of patient education to ensure good oral health.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• Some patients lived at a local care home for people with learning disabilities. The manager of the care home was positive about the kindness of reception staff at Barnet Smile Dental Care and about how dentists explained care and treatment.
• A large number of patients commented positively about staff interaction which helped ensure that they were relaxed and felt comfortable.
• The practice had an accessible and visible leadership team. Staff told us they felt supported by the dentist and practice manager.
• Governance and practice management systems were effective.
• In February 2015, Barnet Smiles Dental Care was awarded the ‘Investors in People National Standard.’ The practice manager spoke positively about how working towards the award had improved practice manage systems and the delivery of well led care and treatment.

Patients understood the care and treatment choices available to them. We spoke individually with two patients. They both spoke positively about how treatment options had been explained. A dentist we spoke with outlined how they explained treatment options to patients. This included use of computer animations, leaflets and hand drawings.

We looked at the training records of two dental nurses and saw that they had received training in medical emergencies and basic life support training for dental surgeries.

The dentist we spoke with demonstrated an understanding of safeguarding children and vulnerable adults. They were able to describe possible types of abuse and knew how and to whom, they would report a safeguarding alert.

There were effective systems in place to reduce the risk and spread of infection. The provider had a dedicated room for cleaning and sterilising dental instruments. Staff could explain the process to be followed to ensure that dental instruments were properly cleaned. During our inspection we saw that the perimeter areas of some treatment rooms were carpeted. The provider told us that the carpet was in the process of being replaced and we saw that a quote had been obtained.

Staff records and other records relevant to the management of the services were accurate and fit for purpose. During the course of our inspection, the dentist we spoke with was able to promptly locate policies, procedures and records.

People told us that they felt their privacy and dignity was respected. People told us that they were made aware of the treatment options available to them including the cost of treatment. One person told us that “the dentists went through everything with me and I have signed a consent form.”

People commented very positively on the care they received from their dentists. Comments included “I’m very happy with the service”. A person rated the quality of the service as “ten out of ten and always is“, and another person told us that their dentist was “the best dentist I’ve ever been to”. People commented that the dentists’ approach was “very personable and professional”.

We asked people using the service if they felt safe in the hands of their dentist. All commented that they felt safe and relaxed and that the dentists were always cheerful and were competent in their role.

People using the service commented that they felt that the cleanliness of the practice was good. Some comments included “very clean, couldn’t wish for better” and “it’s as clean as can be”.