We carried out this announced inspection on 24 January 2019 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 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 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

Kent Smile Studio is in Maidstone and provides NHS and private treatment to 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 at the rear of the practice.

The dental team includes eight dentists, six dental nurses, three student nurses, two dental hygiene therapists, a clinical dental technician and reception is staffed by registered dental nurses and one receptionist. One of the dental nurses is also the treatment coordinator. The practice has four treatment rooms.

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.

On the day of inspection we collected 50 CQC comment cards filled in by patients and spoke with five other patients.

During the inspection we spoke with two dentists, three dental nurses, and the treatment coordinator. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 manage risk.
• The practice staff 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

The inspection was carried out by one Inspector over three hours. During this time we talked with people who had come in for treatment; viewed the premises; talked with staff as well as with the principal dentist, and viewed documentation.

People expressed their confidence in the dentists and the other dental staff who gave them care and treatment. Some of their comments included “This is a very well run practice with very friendly staff”; “It is always very good here, I am given first class treatment”; and “I have been coming here for years, and I am very happy with the treatment I am given.”

We found that people were given appropriate information about the practice and their own dental needs, and were able to make their own decisions about their treatment.

The staff were given appropriate training and support, and had opportunities to develop their own professional portfolios. We saw that regular training courses included training in safeguarding children and vulnerable adults, and how to apply the Mental Capacity Act 2005 for people who lacked the mental capacity to make their own decisions.

The premises were visibly clean in all areas, and we found that there were reliable procedures in place to provide effective infection prevention and control.

The practice carried out surveys and monitoring programmes to assess the quality of the care and treatment given. We saw that action was taken to improve any areas that were identified.