We carried out this announced inspection on 5 December 2018 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

Smilecare is in Slough and provides NHS and private treatment to patients of all ages.

There is level access, via a portable ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available in the public pay and display car park at the rear of the practice.

The dental team includes 15 dentists, four dental nurses, five trainee dental nurses, one dental hygienist, four receptionists and the practice manager.

The practice has 11 treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Smilecare is a dentist.

On the day of our inspection we collected 17 CQC comment cards filled in by patients and obtained the views of a further eight patients.

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

The practice is open 8am to 6pm Monday to Friday and 9am to 5pm Saturday.

Our key findings were:

• The practice 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 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 appointment system met patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The practice had systems to deal with complaints positively and efficiently.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• Improvements were required to a number of areas of the practice. All of these have been addressed since our inspection.

One staff member told us, “We treat all patients the same. We don’t treat private patients better than NHS patients.” This meant people who used the service were treated with consideration and respect.

People told us about the appointment system. One person said: "It’s very easy, I am seen when I need it.” Another person told us, “It’s one of the good things, if I have a problem I am seen fairly quickly.” This meant people were able to get to see the dentist when they needed to.

Staff were able to explain the different forms of abuse and what they would do if they had concerns. This showed staff members understood what procedures to follow should they suspect abuse.

Staff files held fully completed application forms, job references, identity verifications, hepatitis B checks and criminal bureau checks (CRB) now known as disclosure barring service (DBS), proof of registration with the dental council. This showed there effective recruitment and selection processes in place.

We saw appropriate action was taken to address to the complainants satisfaction. These meant complaints were investigated people’s satisfaction.