We carried out this announced inspection on 25 April 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Xen Smiles Limited is in Leeds and provides NHS and private treatment to adults and children.

There is ramp access for people who use wheelchairs and pushchairs. Car parking spaces are available on the road near the practice.

The dental team includes two dentists, two dental nurses, one receptionist and a practice manager who is also a qualified dental nurse. The practice has two 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 Xen Smiles Limited is the principal dentist.

On the day of inspection we received feedback from 42 patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday to Thursday from 8:45am to 5:00pm (Closed for lunch between 1:00pm and 2:00pm)

Friday from 8:45am to 1:00pm

Our key findings were:

• The practice was 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. These were not always followed.
• 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.
• 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 dealt with complaints positively and efficiently.

All the people we spoke with told us they were very satisfied with the care and treatment they received and no concerns were expressed about the treatment provided at the practice.

People said they were fully involved in decisions about their treatments and the dentist was very good at explaining the treatment they received. People told us the dentists gave them information about the treatment options and the costs were explained. They told us they felt comfortable to ask questions about the treatments available if they wished to do so. They all said that their confidentiality and dignity was always maintained and respected.

All the people we spoke with told us that they made routine check up and follow up appointments before they left the dentist. They also told us that there were very rarely waiting times to be seen by the dentist. However, if the dentist was running a little behind each person told us they were kept informed about the delays. People said that if they needed an emergency appointment they would be seen the same day. People we spoke with said they could talk to the dentists, practice manager and staff at any time and they were confident of using the complaints system if they needed to.

All three people told us that the practice was always clean, tidy and they had no concerns with the hygiene.