Mona Lisa Smiles

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We found this practice was providing effective care in accordance with the relevant regulations and had taken into consideration appropriate guidance.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Assessing needs is based on the latest evidence we assessed for the Effective key question.

Patients told us they were given clear information to help them make an informed choice about their treatment and any associated costs. One patient told us, ‘I have been treated with good care and respect and I feel the dentist always goes out of his way to ensure that he provides a high quality, caring and efficient service.’ They were involved in decisions about their care. One patient said, ‘Everything was explained in a way that I could easily understand, and I have been taken through each step’. Patients told us that when they were prescribed medicines, sufficient information was given.

The provider had systems to ensure that people who used the service received person-centred care and treatment that was appropriate, met their needs and was reflective of their personal preferences. The dentists confirmed, where applicable, they referred patients to a range of specialists in primary and secondary care for treatment the practice did not provide. Staff told us how they kept up to date with current evidence-based practice. The practice provided preventive care and supported patients to ensure better oral health. Staff felt the practice supported them to develop and enabled them to take on lead roles and responsibilities. Staff worked together and with other health and social care professionals to deliver effective care and treatment. Staff demonstrated their understanding of the need to obtain patients’ consent to care and treatment in line with legislation and guidance. They understood their responsibilities under the Mental Capacity Act 2005.They described how they involved patients’ relatives or carers when appropriate and made sure they had enough time to explain treatment options clearly.

Staff had the skills, knowledge and experience to carry out their roles. The practice had systems to keep dental professionals up to date with current evidence-based practice. Staff obtained full consent, kept detailed records and had access to the appropriate equipment for the placement of implants. The practice offered conscious sedation for patients. The practice’s systems included checks before and after treatment, emergency equipment requirements, medicines management, sedation equipment checks, and staff availability and training. Intravenous sedation was provided by a visiting medical doctor who used multiple drugs for sedation. We discussed with the provider the importance of having risk assessments in place, which consider all of the specific risks associated with the use of multiple sedative medicines, including the risk of oversedation, risks associated with the use of reversal medicines, and risk of delayed response by local emergency services. In addition, the risk assessment should take into consideration the practice premises and facilities, access to emergency services in accordance with current guidelines. The provider confirmed that they already had these risk assessments and the required arrangements in place. The practice had an onsite dental laboratory which was registered with the Medicines and Healthcare products Regulatory Agency. We looked at 6 patient care records and 2 sedation records. The information recorded in these patient care records was in line with recognised guidance. Staff obtained patients’ consent to care and treatment in line with legislation and guidance. They understood their responsibilities under the Mental Capacity Act 2005. We saw evidence the dentists justified, graded and reported on the radiographs they took. The practice had systems for the safe handling and prescribing of medicines. NHS prescription pads were kept securely, and a log was in place to monitor and track their use.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.