We carried out this announced inspection on 21 March 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 Care Quality Commission 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

The Smile Clinic is in the London Borough of Hounslow. The practice provides NHS and private dental treatment to patients of all ages. The practice provides dental implants and offers conscious sedation to patients who are suitable and may benefit from this.

The practice is located on the ground and first floor level in a purpose adapted premises. There is step free access to the practice and one treatment is located on the ground floor.

The practice is located close to public transport bus and train services.

The dental team includes the principal dentist who owns the practice, six associate dentists, one dental hygienist and three dental nurses. The clinical team are supported a practice manager and two receptionists.

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 our inspection we received feedback from 44 patients.

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

The practice is open between 9am and 5.30pm on Mondays and Fridays, between 9am and 6pm on Tuesdays and Wednesdays and between 9am and 6.30pm on Thursdays.

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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 emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

During our inspection on 12 July 2013 we found that effective recruitment and selection processes had not been followed by the provider. No written references from previous employers had been sought for any of the staff employed by the service. During this

inspection we found the provider had in place two written references for each member of staff and therefore effective recruitment and selection processes were being followed.

During our inspection we spoke with three people who use the service and four members of staff. People told us that they had no concerns and were happy with the service provided. One person said “I have never needed to make a complaint, I am very satisfied with the staff and the service.” Another said “this is my second visit to this dentist, they are very friendly and put me at ease.”

We saw testimonials from people, comments included, “my experience of DNA Dental has been fantastic” and “thank you so much for your expert service you have given me and my family for many years.”

People said they had been given the information needed to make an informed choice about the treatment options available. One person said “it’s the first time a dentist has explained my treatment so thoroughly.” Another said “they explain everything.”

People told us the dental practice was always clean and tidy and effective systems were in place to reduce the risk and spread of infection.

We viewed seven personnel files and found some recruitment checks were in place. However there was no evidence that written references had been requested for all staff before they commenced employment with the service. This meant that the provider could not demonstrate that appropriate recruitment checks were carried out to ensure that only suitable applicants were selected to work with people using the service.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.