We carried out this announced inspection on 22 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 and a second CQC inspector.

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

Smiles 4U Dental Surgery is in Birmingham 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 are available near the practice. There are no dedicated spaces for blue badge holders but staff told us they would ensure that the driveway was clear for patients with mobility issues.

The dental team includes four dentists, five dental nurses (two of whom are trainees), one practice manager and one receptionist. The practice has three 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 13 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two 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 between 9am and 5pm from Monday to Friday.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. All staff apart from two trainee dental nurses had completed training in safeguarding.
• The provider had staff recruitment procedures. Improvements were needed to ensure complete immunisation records were available for all clinical staff members.
• 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 were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well 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 suitable information governance arrangements.

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

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Review staff training to ensure that all the staff including trainee dental nurses have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.

During our inspection we spoke with a trainee dentist, two dental nurses and the practice manager. We looked at the records of ten people who had used the service.

Following our visit we spoke with five people over the telephone so that we could get their views of the service provided. All the people we spoke with were positive about their experiences. They felt they were given enough information about their treatment options and were always asked about their medical history. One person told us, “No problems, I get everything I need”.

There were procedures in place to identify, assess and manage risks relating to the health, welfare and safety of people. Appropriate risk assessments and maintenance of equipments were in place to protect people from unsafe care and treatment.

There were infection prevention procedures in place to minimise the risk of infection. Decontamination procedures were followed to ensure instruments were being hygienically cleaned.

Staff had received appropriate training and development to enable them to deliver treatment to people safely and to an appropriate standard.

There were procedures in place to monitor quality of service and identify improvements where necessary.