Blanche Smile Studio

We undertook a follow up focused inspection of Blanche Smile Studio on 6 November 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was accompanied by a specialist dental adviser.

We undertook a comprehensive inspection of Blanche Smile Studio on 1 July 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe or well led care and was in breach of regulations 12 safe care and treatment, 17 good governance and regulation 19 HSCA (RA) Regulations 2014 Fit and proper persons employed (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Blanche Smile Studio on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 1 July 2019.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 1 July 2019.

Background

Blanche Smile Studio is in the City of Westminster in London and provides private treatment to adults and children.

Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes a dentist and a dental nurse. The practice has one treatment room that incorporates a decontamination area.

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 requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Blanche Smile Studio is the principal dentist.

Our key findings were:

• Work outlined in the legionella risk assessment had been carried out.

• The practice had a system in place to receive safety alerts.

• There were appropriate medication and equipment to manage medical emergencies.

• The Control of Substances Hazardous to Health (COSHH) file had been reviewed and updated

• The practice had a health and safety risk assessment

• Disability access audit had been undertaken.

• Infection control audits were undertaken at six monthly intervals

• Radiographic audits had been undertaken

• A recruitment process was in place; however improvements were still required.

The practice had also made the following improvements:

• Improvements had been made in regard to recording information related to patient assessments, use of rubber dam and preventative advice given.

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

• Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

We carried out this announced inspection on 1 July 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 not 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 not providing well-led care in accordance with the relevant regulations.

Background

Blanche Smile Studio is in the City of Westminster in London and provides private treatment to adults and children.

Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes a dentist and a trainee dental nurse. The practice has one treatment room that incorporates a decontamination area.

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 Blanche Smile Studio is the principal dentist.

On the day of inspection, we collected 19 CQC comment cards filled in by patients. [DA1]There were no patients to speak with on the day of the inspection.

During the inspection we spoke both with the dentist and the trainee dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice appeared clean and well maintained.
• 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 asked staff and patients for feedback about the services they provided.
• Staff knew how to deal with medical emergencies. However not all medicines and life-saving equipment were available on the premises.
• The practice had not established effective systems to help them manage risk to patients and staff.
• The dentist was not up to date with key training such training in conscious sedation.
• At the time of the inspection the provider did not have a staff recruitment procedure in place.
• Improvements were required to the system to audit non-clinical and clinical processes.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider was not meeting are at the end of this report.

There were areas where the provider could make improvements.

They should:

• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping. This relates specifically to recording information in relation to patient assessments, use of rubber dam and preventative advice given.