We carried out this announced inspection on 11 May 2017 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

Sweet Smiles Dental Practice is close to the centre of Liverpool and provides treatment to patients of all ages on a privately funded basis.

There is one step at the front entrance to the practice. There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs at the rear of the premises. Car parking is available near the practice.

The dental team includes four dentists, one of whom is a specialist orthodontist, and two dental nurses, one of whom also has a receptionist role. There is also a trainee dental nurse.The practice has two treatment rooms. There is a visiting anaesthetist who assists in the provision of sedation. The team is supported by the managing director and a deputy practice manager.

The practice is owned by a company and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Sweet Smiles Dental Practice is the managing director.

We received feedback from 14 people during the inspection about the services provided. We also received feedback from 3 people via the Share Your Experience facility on the CQC’s website. The feedback provided was positive about the practice.

During the inspection we spoke to the orthodontist, one dentist, dental nurses and the managing director. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open Monday to Friday 9.00am to 5.00pm, and alternate Saturdays 9.00am to 2.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.

• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.

• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• Staff knew how to deal with emergencies. Not all the recommended medical emergency medicines and equipment were available.
• The practice had staff recruitment procedures in place which needed minor improvements.

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

• Review the practice’s system for assessing, monitoring and mitigating the various risks arising from undertaking of the regulated activities, specifically in relation to staff working in a clinical environment where their immunity to the Hepatitis B virus is unknown.
• Review the protocol for maintaining accurate, complete and detailed records relating to employment of staff. This includes ensuring recruitment checks, including those in relation to references and qualifications are carried out and recorded.
• Review the practice’s protocols in relation to the use of closed circuit television to ensure patients are fully informed as to its purpose and their right to access footage.
• Review the practice’s protocols for monitoring and assessing quality and safety, specifically in relation to clinical matters.