Practice Policies

The Smile Studios Dental Group Practice Policies

Medical history forms
The importance of obtaining an accurate medical history of patients cannot be stressed too highly. It should always be ascertained whether there has been any change in medical circumstances ahead of commencing treatment, particularly where drugs may be an element of the treatment plan to be followed. Intolerance or allergy will occasionally manifest with no previous history.

Medical history form should be filled in by the patient once every 12 months and verbally updated by the Dentist every visit.

Download our Medical Form

Chaperone
This practice is committed to providing a safe, supportive environment for patients. All patients will have a chaperone present for every consultation, examination or procedure. Usually, this will be a member of staff but it may also be a family member or friend. The role of a chaperone includes:

• Providing emotional comfort and reassurance to patients
• To act as an interpreter
• To provide protection to healthcare professionals against unfounded allegations of improper behavior.

Safeguarding vulnerable adults and children

Child Safety
The Smile Studios is committed to create and maintain a safe environment for children and young people. This practice recognizes the complexity of laws regulating childminding and has created this policy to ensure that the staff members are not given the responsibility to look after the children of patients.
Whilst on the practice premises, children and young people must be accompanied by an adult carer at all times. As the staff members are not registered childminders, they are unable to accept the responsibility for looking after young children whilst their carer is having dental treatment.

Child and Vulnerable Adult Protection
There is an effective process for identifying and responding appropriately to signs and allegations of abuse. There is an effective process for preventing abuse before it occurs and minimizing the risks of further abuse once it has occurred.
A child is defined as a person under the age of 18. A vulnerable adult is any person aged 18 or over who is or may be in need of health or social care services by reason of a mental, physical or learning disability, age or illness and who is or may be vulnerable to take care of him or herself, or unable to protect him or herself against significant harm or serious exploitation.
Where staff are likely to engage with a child or vulnerable adult on a one-to-one basis, the staff member is appropriately trained in issues related to child and vulnerable adult protection.
The leads for child and vulnerable adult protection are Dr Manoj Bhardwaj and Mr Sidonio Costa. Every team member knows the name of the lead person for child and vulnerable adult protection. All suspicions and allegations of abuse will be taken seriously and responded to swiftly and appropriately. All staff have a responsibility to report concerns to the appropriate lead member of staff.

All team members are required to undergo an enhanced DBS check every three years. The Smile Studios will not employ anyone who has been barred by the Independent Safeguarding Authority (ISA).

Good practice guidelines
A chaperone is always present when treating a child or vulnerable adult.
Physical force is never used against a patient unless it constitutes reasonable restraint to protect him/her or another person or to protect property. If it is necessary to restrain a patient because they are an immediate danger to themselves or others or to property the minimum amount of force is used for the shortest amount of time.
Any problems are referred to the child and vulnerable adult protection lead.

GDPR
From May 2018 Europe’s data protection rules will undergo their biggest changes in two decades. Since they were created in the 1990s, the amount of digital information we create, capture, and store has vastly increased. Simply put, the old regime was no longer fit for purpose.
The solution is the mutually agreed European General Data Protection Regulation (GDPR), which will come into force on May 25th, 2018 It will change how businesses and public-sector organisations can handle the information of customers.
GDPR means that we at The Smile Studios will be more accountable for handling of people’s personal information and as such we have updated our data protection policies.
Data Protection Code of Practice
Our data protection code of practice lays out our procedures that ensure The Smile Studios and our employees comply with The Data Protection Law, 2001 and The General Data Protection Regulation (GDPR) (Regulation (EU) 2016/679)
What personal data do we hold?

In order to provide you with a high standard of dental care and attention, we need to hold personal information about you. This personal data comprises:

• your past and current medical and dental condition; personal details such as your age, national insurance number/NHS number, address, telephone number and your general medical practitioner
• radiographs, clinical photographs and study models
• information about the treatment that we have provided or propose to provide and its cost
• notes of conversations/incidents that might occur for which a record needs to be kept
• records of consent to treatment
• Any correspondence relating to you with other health care professionals, for example in the hospital or community services.

Why do we hold information about you?
We need to keep comprehensive and accurate personal data about patients to provide you with safe and appropriate dental care. We will ask you yearly to update your medical history and contact details.
Retaining information
We will retain your dental records while you are a practice patient and after you cease to be a patient, for at least eleven years, or for children until age 25, whichever is longer.
Security of information
Personal data about you is held in the practice’s computer system and in a locked manual filing system. The information is only accessible to authorized team members. Our computer system has secure audit trails and we back up information routinely.
Disclosure of information
To provide proper and safe dental care we may need to disclose personal information about you to:

• Your general medical practitioner
• Dental Services i.e. Kings/GST/Special care dental
• Other health professionals caring for you
• NHS business service authority
• Private dental schemes of which you are a member
• Medical Specialist Group
• Agents and Third parties as required by legal and law

Disclosure will take place on a ‘need-to-know’ basis. Only those individuals/organizations who need to know to provide care for you and for the proper administration of Government (whose personnel are covered by strict confidentiality rules) will be given the information.
In very limited circumstances or when required by law or court order, personal data may have to be disclosed to a third party not connected with your health care. In all other situations, disclosure that is not covered by this Code of Practice will only occur when we have your specific consent. Where possible you will be informed of these requests for disclosure.
Access to your records
You have the right of access to the data that we hold about you and to receive a copy. Parents may access their child’s records if this is in the child’s best interests and not contrary to a competent child’s wishes. Formal applications for access must be in writing to The Smile Studios.

The first request is for free but any repeated requests might be charged at a fee for access of up to £10 (for records held on the computer) or £50 (for those held manually or for computer-held records with non-computer radiographs). We will provide a copy of the record within 40 days of receipt of the request and fee (where payable) and an explanation of your record should you require it.
If you do not agree
If you do not wish personal data that we hold about you to be disclosed or used in the way that is described in this Code of Practice, please discuss the matter with your dentist. You have the right to object, but this may affect our ability to provide you with dental care.

Data Protection
The practice is committed to complying with the Data Protection Act 1998 by collecting, holding, maintaining and accessing data in an open and fair way
The practice will only keep relevant information about employees for the purposes of employment, or about patients to provide them with safe and appropriate dental care. The practice will not process any relevant ‘sensitive personal data’ without prior informed consent. As defined by the Act ‘sensitive personal data’ is that related to political opinion, racial or ethnic origin, membership of a trade union, physical or mental health or condition, religious or other beliefs of a similar nature. Sickness and accident records will also be kept confidential.
All manual and computerized records will be kept in a secure place; they will be regularly reviewed, updated and destroyed in a confidential manner when no longer required. Personnel records will only be seen by appropriate management.
Patients’ records will only be seen by appropriate team members. To facilitate patients’ health care the personal information about them may be disclosed to a doctor, health care professional, hospital, NHS authorities, the Inland Revenue, the Benefits Agency (when claiming exemption or remission from NHS charges) or private dental schemes of which the patient is a member. In all cases, the information shared will be only that which is relevant to the situation. In very limited cases, such as for identification purposes, or if required by law, information may have to be shared with a party not involved in the patient’s health care. In all other cases, information will not be disclosed to such a third party without the patient’s written authority.

Modern Slavery Act 2015 Policy

Modern slavery is a crime and a violation of fundamental human rights. This Policy underlines our commitment and actions to ensuring modern slavery is not taking place anywhere in and around our organization.

This Policy is made on behalf of The Smile Studios pursuant to section 54(1) of the Modern Slavery Act 2015 and constitutes our slavery and human trafficking Policy.

Our supply chains:

The Smile Studios supply chain consists of multiple suppliers, the majority of whom are primarily based in the UK. Our suppliers include:

Professional services – accountants, legal advisors, recruitment agents;

• Self-employed clinicians;
• Dental laboratory, material and product suppliers;
• Marketing and advertising services;
• Repairs and maintenance services;
• IT and communication systems;
• General office and practice suppliers;

Accessing our supply chains:

Our Anti-Slavery Policy reflects our commitment to acting ethically and with integrity in all our business relationships, and implementing and enforcing effective systems and controls to prevent slavery and human trafficking practices in our supply chains.

To help identify any potential risks within our supply chains (including in respect of new suppliers and commercial arrangements), we undertake a due diligence assessment taking into consideration the following factors:

• The geographical location of the business or manufacture/supply of goods;
• Industry sector – we recognize that certain sectors suffer greater exposure to slavery and human trafficking practices;
• Value of the contract / commercial arrangement;
• Supplier’s dependency upon our business;
• The supplier’s own commitment to ethical practices, e.g. commitment to equal opportunities and diversity in the workplace, anti-slavery practices, compliance with the national minimum wage and national living wage, anti-bribery practices etc.

In the event that any supplier / commercial arrangement is considered to be a potential risk, we will undertake further due diligence until we are satisfied that we have achieved compliance with the law and ethical practices.

For all new suppliers or business partners, we will not engage their services unless they share our values demonstrated in this Policy. Should any supplier fail to meet these standards, we will offer to help them identify the steps they will need to take to comply.

We are advising suppliers that we are adopting a zero-tolerance approach to modern slavery and human trafficking, and should any supplier or business partner not comply with The Smile Studios approach, or be prepared to sign our Code of Conduct, we will cease to trade with their company until they have provided us with adequate reassurance of compliance.

General due diligence processes to combat slavery and human trafficking.

We have also put in place systems, procedures and best practices to help combat anti-ethical practices and modern slavery within our supply chains and general business operations. For example, we:

• Continually monitor potential risk areas in our supply chains;
• Protect whistle-blowers to ensure that they are not discouraged from raising any concerns relating to unethical or illegal practices;
• Ensure supplier adherence to our values and ethics;
• Adopt robust recruitment processes in line with UK employment laws, including: ‘right to work document checks; contracts of employment and checks to ensure everyone employed is 16 and above;
• Collaborate with suppliers to help them understand and work towards their own obligations under the Modern Slavery Act 2015;
• Engage with reputable businesses and individuals with a proven track record of legal compliance and good ethical standards;
• Have robust policies in place to ensure the new joiner has the Right to Work in the UK, and have confirmed their identity prior to the commencement of their placement;
• Adopt a supply chain compliance program, which consists of reviewing each new supplier in line with the principles of this Policy;
• Train our colleagues and business partners on their obligations under the applicable laws and regulations. Completion of our anti-slavery training module will form part of our annual training program;
• Will develop a procedure to monitor how our suppliers comply with our supplier Code of Conduct;
• Pay and reward our employed colleagues in accordance with market rates, which are reviewed annually and bench-marked;
• Promote and encourage transparency within our supply chains.

We have a dedicated team that is responsible for ensuring that we comply with the principles and commitments set out in this Policy.

Our effectiveness in combating slavery and human trafficking within our organization and supply chain is measured by reference to the number of reports received from employees, the public, or law enforcement agencies to indicate that modern slavery practices have been identified.

Disability
The Smile Studios recognizes that discrimination on the grounds of disability is illegal. Through this policy, through training and by example, the practice wishes to demonstrate that it does not tolerate discrimination by anyone working at the practice.

Patients

The practice and its staff will not treat a disabled person less favorably than another person because of a disability. Less favorable treatment includes:

• Refusing to treat a disabled patient
• Giving a disabled patient a lower standard of service or treating him or her in a worse manner than an able-bodied patient
• Offering a disabled patient less favorable terms.

The following exceptions may occur when in the dentist’s opinion

• Health and safety reasons exist where either the patient or someone else would come to some harm if the dentist did not refuse treatment
• A disabled patient is unable to understand that treatment must be paid for, where appropriate
• The situation would mean negating or no longer providing the service

The practice will do its best to change or remove policies, practices and procedures, provide auxiliary aids and overcome physical features that make it very difficult or impossible for a disabled patient to use the practice.

Employees

The practice

• Will not unjustifiably treat a disabled employee less favorably for a reason that relates to a disability.
• Will comply with a duty of reasonable adjustment to any physical feature of the premises or to working arrangements unless the adjustment would be of no substantial benefit.

The practice will not discriminate against a disabled person

• In the arrangements made for determining who should be offered employment
• In the terms on which the disabled person is offered employment
• By refusing to offer or deliberately not offering the disabled person employment
• In the opportunities that are afforded to an employee for promotion, a transfer, training or receiving any other benefits
• By refusing to afford, or deliberately not affording, any such opportunity
• By dismissal or any other detriment.

The practice will undertake to provide support, assistance and, if necessary, counseling to members of the practice who are victims of violence and aggression in the course of their work. In appropriate cases, a discretionary period of sick leave on full pay will be granted

Evidence-based Dentistry
The practice is committed to complying with the current guidelines on using an evidence-based approach. We endeavor to keep our knowledge and skills current by:

• Following and keeping up-to-date with evidence-based guidance
• Using relevant local referral protocols
• Using standard care pathways, where appropriate
• Applying the principles of research governance
• Sharing information, skills and clinical experience at regular practice meetings

Equality & Diversity Statement
The practice is committed in the care we provide to all our patients. We ensure that all those using our services receive the highest possible standard of service irrespective of ethnicity, race, marital status, gender, sexual orientation, age, disability, religion, beliefs, civil partnership status or chronic illness.
The staff at The Smile Studios are fully committed in providing equality in all of our services and our equal opportunities policy has been developed to ensure this. We continue to monitor and apply our equal opportunities policy to ensure it meets and reflects our diverse patient base.
We ensure that these same standards will be received by all those employed by The Smile Studios.

Equipment
The Smile Studios makes sure that equipment:

• Is suitable for its purpose
• Is available
• Is properly maintained
• Is used correctly and safely
• is validated, tested and inspected as required

Fee’s, Payment and Refund

This policy is to clarify and outline details in respect of payments and deposits taken by The Smile Studios.

The prompt collection of fees is crucial to maintaining cash flow and keeping the practice operational. All members of the dental team are responsible for ensuring that patients are fully informed about the fees that they are likely to pay and when those payments will be due.

Information on fees

We are committed to ensuring that patients are given sufficient information about the costs associated with their care to allow them to make informed decisions. Where changes to treatment are agreed upon with a patient, we ensure that any cost implications are explained. An indicative price list of treatments available at the practice is displayed in the reception area, practice leaflet and published on the practice website.

Estimates and bills

Before any treatment is undertaken, the treatment options and associated costs are explained in full to the patient in a way that the patient understands. The patient is allowed time to consider the information provided and to ask questions. A written treatment plan and estimate of the costs are provided for all dental treatments. Details of any fees incurred and payments made are recorded in the patient’s clinical records and checked at each visit. Payments that remain outstanding are also recorded. Where appropriate, patients are given an itemized bill.

Payments

All payments must be made on the day of treatment unless stipulated otherwise by the dental treatment plan. Payment can be made by cash, credit/debit card or finance if approved.

We do not accept cheque payments.

Deposits

The deposit paid for appointment booking confirmation will remain in credit on accounts and will be deducted from the treatment value.

The non-refundable deposit cannot be refunded due to payments being made in advance to suppliers, laboratories and other such parties.

When booking your appointment, we will normally seek a deposit from you, the payment of which is your confirmation of your commitment to attend your appointment. Our deposits are normally fully refundable providing sufficient notice of cancellation is given (48 hours).

NHS practices in England and Wales: NHS patients who are not exempt from fees can be asked to pay the Band 1 fee when they book the appointment. If they subsequently fail to attend the payment must be refunded in full.

Cancellation by the Patient

You may cancel a course of treatment for which you have booked an appointment and be fully refunded all fees for treatment not yet performed; provided you give The Smile Studios a minimum of 48 hours prior notice. If 48 hours prior notice is not received, The Smile Studios reserves the right to withhold a proportionate amount of money, based upon the length of the appointment, to cover overheads.

Refunds

The Smile Studios will refund the money to patients who wish to discontinue treatment or require a refund. Refunds will be processed via cheque by the second week of each month.

This may occur in additional administration charges.

Outstanding payments

A regular check of the treatments provided against the payments received is undertaken by the Dentist/Reception and reminders are sent to patients who have missed payments.

If no payment is received within seven days a reminder will be sent inviting the patient to contact the practice regarding payment options.

If, following the second reminder, no payment is received, a final reminder letter will be sent and the patient advised that further failure to make a payment may result in the practice instructing a debt collection agency or taking legal proceedings. Details of the agency will be provided to ensure that the patient knows who may contact them at a later date.

If, following the final reminder, no payment is received the Practice Manager will consider how to progress the matter. Action may include the engagement of a reputable debt collection agency or formal legal action.

In extreme circumstances and at the sole discretion of the practice owner and/or practice manager the debt may be written off.

The patient will be informed that, for the purposes of collecting the debt, their details may be passed to a third party.

Fitness to Practice
Healthcare professionals within this Practice are required to maintain their levels of competence within all aspects of their appointed role. This is achieved through continued professional development, private study, attending conferences/seminars, and taking part in shared learning initiatives within the Practice or through an independent provider. The performance of the professional is reviewed on a regular basis – through performance review or appraisal and patient or co-worker feedback. Where the standard of performance is called into question or is seen to have fallen below acceptable levels, for example as a direct result of a patient complaint, that professional may face professional body intervention and investigation in addition to practice investigation. The professional body may provide advice or guidance for that professional or place practicing restrictions on him/her. As a final resort, it could lead to de-registration. No action is taken by the professional body before a full and thorough investigation is conducted.

Infection Prevention and Control Policy
Statement of intent
Infection control is of prime importance in this practice. Every member of staff will receive training in all aspects of infection control, including decontamination of dental instruments and equipment, as part of their induction program and through regular update training, at least annually.

Decontamination of instruments and equipment

Single-use instruments and equipment must be identified and disposed of safely, never reused. All re-usable instruments must be decontaminated after use to ensure they are safe for reuse. Gloves and eye protection must be worn when handling and cleaning used instruments.

Before being used, all new dental instruments must be decontaminated fully according to the manufacturer’s instructions and within the limits of the facilities available at the practice. Those that require manual cleaning must be identified. Wherever possible, the practice will purchase instruments that can withstand automated cleaning processes using a washer-disinfector or an ultrasonic cleaner.

At the end of each patient treatment, instruments should be transferred to the decontamination area for reprocessing. Used instruments should be only transferred between surgery and decontamination room in a closed container labeled ‘Used instrument’.

Staff will be appropriately trained to ensure they are competent to decontaminate existing and new reusable dental instruments. Records of this training are kept.

Cleaning

Used instruments should be cleaned using the ultrasonic cleaner (unless this is incompatible with the instrument), following the manufacturer’s instructions for use. If heavily soiled, you should immerse the instruments briefly in cold water (with detergent) before ultrasonic cleaning.

When placing instruments in the ultrasonic cleaner, you should:

• Open fully all instrument hinges and joints and disassemble, if appropriate.
• Place instruments in the suspended basket and immerse it fully in the cleaning solution (made up according to manufacturer’s instructions).
• Avoid overloading the basket or overlapping instruments.
• Do not place instruments on the floor of the ultrasonic cleaner.

Rinse instruments thoroughly by immersion using freshly distilled water and dry them using non-linting cloths.

Where instruments are cleaned manually, you must follow the practice policy for manual cleaning.

Inspection

After cleaning, inspect instruments for residual debris and check for any wear or damage using task lighting and a magnifying device. If present, residual debris should be removed by hand and the instrument re-cleaned.

Thoroughly rinse instruments prior to sterilization.

Sterilization

Where instruments are to be stored for use at a later date, they should be wrapped or put in pouches prior to being sterilized in the autoclave, following the manufacturer’s instructions for use. Storage should not exceed 365 days, after this, instruments must be reprocessed. Instruments for same-day use do not require wrapping.

Work surfaces and equipment

The patient treatment area should be cleaned after every patient using Continue Disinfectant wipes/spray even if the area appears uncontaminated.

Between patient treatments, the local working area and items of equipment must be cleaned using Continue Disinfection wipe/spray. This will include work surfaces, dental chairs, inspection lights and handles, hand controls, delivery units, spittoons, aspirators, and if used, x-ray units and controls. Other equipment that may have become contaminated must also be cleaned.

In addition, cupboard doors, other exposed surfaces (such as dental inspection light fittings) and floor surfaces within the surgery should be cleaned daily.

Impressions and laboratory work

Dental impressions must be rinsed until visibly clean and disinfected by spraying using an Impressive spray and labeled as ‘disinfected’ before being sent to the laboratory. Technical work being returned to or received from the laboratory must also be disinfected and labeled.

Hand hygiene

The practice policy on hand hygiene must be followed routinely. The full policy is in the practice policy folder; a summary is included here.

Nails must be short and clean and free of nail art, permanent or temporary enhancements (false nails) or nail varnish. Nails can be cleaned using a blunt ‘orange’ stick.

Wash hands using liquid soap or hand disinfection lotion between each patient treatment and before donning and after removal of gloves. Follow the hand washing techniques displayed at each hand wash sink. Scrub or nail brushes must not be used; they can cause abrasion of the skin where microorganisms can reside. Ensure that paper towels and drying techniques do not damage the skin.

Antibacterial-based hand rubs/gels can be used instead of hand-washing between patients during surgery sessions if the hands appear visibly clean. They should be applied using the same techniques as for hand washing. The product recommendations for the maximum number of applications should not be exceeded. If hands become ‘sticky’, they must be washed using liquid soap.

At the end of each session and following hand washing, apply the hand cream provided to counteract dryness. Do not use hand cream under gloves; it can encourage the growth of micro-organisms.

Personal Protective Equipment

Training in the correct use of PPE is included in the staff induction programs, which can be found in the induction program. All staff receives updates on its use and when new PPE is introduced into the practice.

PPE includes protective clothing, disposable clinical gloves, plastic disposable aprons, face masks, and eye protection. In addition, household gloves must be worn when handling and manually cleaning contaminated instruments Footwear must be fully enclosed and in good order.

Immunization
Staff involved in decontamination and clinical work have evidence of current immunization for Hepatitis B
Items sent to the laboratory and equipment sent for repair
All items dispatched to the laboratory are washed and disinfected after removal from the mouth and items received from the laboratory are washed and disinfected prior to fitting. Equipment is decontaminated before being sent for repair
Legionella control
The practice takes all reasonable measures to minimize the risk of exposure of staff, patients and visitors to legionella in accordance with existing guidance. The practice carries out regular legionella risk assessments, water tests and audits. Flushing of hot and cold water outlets is routinely undertaken by the practice. Records of all legionella control activities are maintained and reviewed at the Annual Management Review
Spillage
Clinical staff are trained in how to manage an accidental spillage of a hazardous substance and how to follow our emergency arrangements
Waste
Waste is carefully handled and disposed of by appropriate carriers according to current regulations
Water quality
Dental unit waterlines undergo disinfection, flushing and maintenance to minimize the risk of biocontamination. Practice water is inspected and tested as necessary to maintain water quality
Training
Each member of the team undergoes regular training and review and has a responsibility to ensure a safe working environment for all. Training includes the principles of infection prevention, the use of decontamination equipment and materials, the daily inspection and testing of equipment and the maintenance of records
Audit
We audit and review infection prevention procedures every year with the aim of a continual improvement in standards and to update this policy and procedures as necessary
Medical Emergencies
People who use our services receive care, treatment and support and we ensure that equipment required for resuscitation or other medical emergencies is available and accessible for use as quickly as possible. The Smile Studios has a defibrillator and all clinical staff are trained in its use.
No-smoking
The practice is committed to complying with the Health Act 2006 and to protecting all team members, patients and visitors from exposure to second-hand smoke. Smoking is prohibited at practice premises. In addition, team members are not allowed to smoke whilst wearing their clinical attire or in the immediate vicinity of the practice. Team members are expected to follow this policy and to support its implementation.
Notification of other incidents
People who use services can be confident that important events that affect their welfare, health and safety are reported to the Care Quality Commission so that, where needed, action can be taken. This is because providers who comply with the regulations will notify the Care Quality Commission about incidents that affect the health, safety and welfare of people who use services, including:

• Injuries to people
• Making an application to deprive someone of their liberty
• Events that stop the registered person from running the service as well as they should
• Allegations of abuse
• A police investigation.

Patient Care
The practice is committed to offer high standards of care and service to our patients, we:

• Operate a quality assurance program to ensure
• Effectiveness of our infection control
• Consistent quality of provided treatment
• Compliance with health and safety legal requirements
• Safe use of x-ray equipment
• Compliance with the GDC requirements for the Continuing Professional Development of our team members
• Ensure that all of our treatments are evidence-based and follow NICE intervention procedures and guidance
• Having a policy of minimum intervention, this means we do the least treatment possible to achieve the best results for our patients
• Do not refuse treatment on the grounds of race, gender, age, disability, sexual orientation or religious beliefs

Our private fees are designed to be fair and to enable us to offer patients the freedom of choice to have advanced treatments. We operate a robust patient complaints procedure. All comments and suggestions are welcomed and taken very seriously because they help us to continually improve our services to patients. Contemporaneous records are maintained on Computer records. Patient Consent The practice follows the GDC guidelines ‘Principles of Patient Consent’. All clinical team members providing treatment requiring consent are adequately trained and ensure that the patient has:

• Enough information to make a decision (informed consent)
• Made a decision (voluntary decision-making)
• The ability to make an informed decision (ability)

The nature of treatment (NHS or private) and all charges are clarified to the patient before it commences and s/he is provided with a written treatment plan and cost estimate. All team members are aware that once the consent has been given it may be withdrawn at any time and they will respect the patient’s decision. If the team member is uncertain about the patient’s ability to give informed consent, they will consult their dental defense organization for advice.
No person may provide consent for treatment of another adult and all healthcare professionals, including dentists, must have regard to the Mental Capacity Act Code. There is always a legal presumption of capacity and in order to give consent a person must be able:

• To understand relevant information
• To retain that information
• To use/weigh it up in the decision-making process
• To communicate decisions (speech, sign language or any other means)

Personal Development and Training
The practice is committed to providing planned training and development opportunities for team members to enable them to realize their potential and so make the best possible contribution toward delivering a high standard of treatment and service to patients. Each employee has a Training Record, which is reviewed during the annual staff appraisal meeting. During the meeting, further training needs are established based on the GDC guidelines, individual aspirations, performance and the development plan for the practice as a whole.
Recalls
When treating patients, the practice follows the National Institute for Health and Clinical Excellence (NICE) intervention guidance. Patient recall periods are documented and individually designed.
Referral
There are processes for referral of patients to other providers if it is in the best interests of the patients. All practitioners fully explain the reasons for and implications of a referral. A referral is made when the practitioner is unable to undertake treatment. Practitioners only carry out treatment if they have been trained and are competent to do it.
Requests for treatment are always clear and the referral colleague is provided with all of the appropriate information.
If a practitioner is asked to provide treatment or clinical advice, the treating practitioner will ensure that they are clear about what they are being asked to do. GDC guidelines on referral are followed.
Staff are trained in its use and the implementation of the policy is monitored. There are processes in place to accept patients from referring practitioners.
There are robust arrangements to make sure that information-sharing systems comply with the Data Protection Act 1998. See Data Protection.
The following treatments may be referred to outside specialists when required:
Complicated endodontic treatment/orthodontic treatment/oral surgery/periodontal surgery/patients who need to be treated under general anesthesia, inhalation and intravenous conscious sedation and implants.
Risk Management
The practice is committed to ensuring the safety of our patients and all team members. To this effect, we have introduced this policy to identify all risks to them. All inquiries regarding this policy must be addressed to the Health and Safety Manager. We make the best endeavour to remove risk and when this is not possible to reduce the risk to its minimum with appropriate control measures. Our risk management includes but is not limited to:

• Health and Safety
• COSHH
• Infection control
• Clinical waste
• Water regulations
• Staff training and development
• Continuing professional development
• The safe use of X-ray equipment
• Clinical audit
• Financial risks such as controlling cash flow and private fee levels
• Violence and Aggression at Work
• Welfare at the workplace
• Employment conditions, contracts and documentation
• Patient complaints

Safe Use of X-ray Equipment
The practice is committed to ensuring the safety of our patients and all team members and to complying with all current regulations including IRME(R) 2000 and IRR99 for the safe use of radiographic equipment. All inquiries regarding this policy must be addressed to the Health and Safety Manager. Team members only operate x-ray equipment if properly trained and authorized to do so.

Lone Working Policy

All members of the team have a responsibility to take care of themselves and others affected by their work.

There may be occasions when members of the dental team will be required to work by themselves. We assess the risk of lone working in a systematic and ongoing way and have put safety systems in place to reduce the risk as far as is reasonably practicable. We will provide support and training, where necessary and encourage all team members to report any adverse incidents.

Lone workers include those working at their main place of work where they:

• Are the only person working on the premises
• Work separately from others, for example, in different locations
• Work outside normal office hours, for example, cleaning staff.

When assessing the risks associated with working alone, we consider both patient and staff safety.

Patient safety

All members of the dental team will be appropriately supported when treating patients. Medical emergencies can happen at any time so, wherever possible, we will ensure that at least one other appropriately-trained person is available within the working environment to assist with a possible medical emergency when treating patients. In exceptional circumstances, the second person may be a receptionist or a person accompanying the patient.

However, there may be times when this is not possible, for example:

• Treating patients outside of normal working hours
• Providing treatment as part of a public health program
• Unavoidable unforeseen circumstances.

If you are faced with working alone, you should assess the possible risk to the patient of continuing treatment and act in the patient’s best interests.

Staff safety

If you are required to work alone, we will assess the possible risks and identify appropriate control measures, which are likely to include:

• Personal security – doors and windows should be closed and secured as appropriate, to restrict access to the practice
• In an emergency situation (for example, an attempted break-in, feeling unwell, or fire), you should summon the relevant emergency services
• For cleaning and reception staff – we will provide training on the potential hazards within the practice (for example, contaminated dental instruments, equipment and hazardous waste) and display cautionary information where relevant
• We will provide a contact telephone number of a responsible member of staff to ensure that you have access to advice
• Assessing the need for personal safety equipment
• Provision of first-aid training.

Reporting incidents

You must always report incidents and near-misses, including incidents where you feel threatened, to The Management Team/Dr Manoj Bhardwaj. you must seek help and advice if you are concerned about any aspect of safety.

Statement of Purpose

Aims and Objectives

As a practice, we will:

• Wherever possible, see patients on time and give an apology and an explanation if we run late by more than ten minutes
• Use good quality modern materials and techniques
• Support continuing staff training and development
• Spend sufficient time with patients
• Charge fair and reasonable prices and offer a choice of payment methods
• Promote a culture of good and open communication with patients so they can help shape our service provision.

Patients can help us achieve these aims by:

• Attending appointments on time and giving adequate notification of cancellation
• Understanding the need for change to sustain a good quality service
• Attending the practice regularly and listening to the professional advice given
• Paying fees promptly
• Providing feedback on all aspects of the service in a friendly and courteous manner.

This practice is registered with the Care Quality Commission for the provision of general dental care.

Legal Status
Practice Owner Dr Manoj Bhardwaj
Regional Practice Manager is Sidonio Costa

Regional Compliance Manager is Tanya Anders
All professional members of staff who are providing dental advice/treatment to patients will maintain full registration under the GDC guidelines including medical indemnity insurance. All clinical and non-clinical staff will have up-to-date DBS checks & photographic identification i.e. passport/driving licence.
Sustainable development
The practice is committed to promoting the conservation, sustainable management and improvement of the environment and to minimizing the environmental impact of its activities. The practice aims to achieve this by:

• Taking sustainable development into account in its policies, plans and decisions
• Encouraging its staff to work in an environmentally responsible manner and to play a full part in developing new ideas and initiatives
• Encouraging its visitors and patients to take responsible action in terms of environmentally sustainable best practice
• Minimizing its consumption of natural resources.
• Reduce carbon emissions where possible such as using low-energy ways in which to interact with its partners
• Seeking to reduce reliance on the private car
• Choosing sustainable goods and services

The practice, working with its staff and suppliers, will:

• Reduce emissions from its buildings through energy management such as turning off lights and equipment, reducing the temperature of the heating and using good standards of insulation
• Maximise recycling arrangements
• Minimise waste by reducing and reusing non-clinical products where appropriate
• Reduce where possible clinical waste
• Raise awareness of sustainable development at the practice
• Reduce the printing of paper forms and records
• Reduce business travel by promoting telephone consultation
• Reduce water consumption
• Comply with all environmental legislation and codes of practice

Other resources
The practice aims to minimize its consumption of other resources, including dental materials, gas, paper, tissues, paper towels and other consumables.
Recycling
The practice will encourage its staff members to use the appropriate internal and external recycling facilities provided for paper, cardboard, glass and plastics.
Mercury Management
The practice will ensure that all water from dental equipment passes through an efficient mercury trap.
Suppliers
The practice will prefer suppliers who have sustainable policies and procedures.

Zero Tolerance Policy

Abusive or Violent Behaviour

Please note that this dental practice operates a “Zero Tolerance” policy and any patient who commits an act of violence against any member of staff or other patient, or behaves in such a way that any such person fears for their safety. Any such incidents will be reported to the police immediately, the patient’s treatment will be terminated and if applicable the Primary Care Trust will be informed.

Expected Standards of Behaviour

The Smile Studios has a duty to provide a safe and secure environment for staff, patients and visitors. Violent or abusive behavior will not be tolerated and decisive action will be taken to protect staff, patients and visitors.

The following are examples of unacceptable behavior on Practice Premises:

• Violence
• Excessive noise, e.g. recurrent loud or intrusive conversation or shouting
• Threatening or abusive language involving swearing or offensive remarks
• Derogatory racial or sexual remarks
• Malicious allegations relating to members of staff, other patients or visitors
• Taking alcohol or drugs on practice premises
• Drug dealing on practice premises
• Wilful damage to practice property
• Theft
• Threats or threatening behaviorPatient Complaints
  Practice Policy for Complaints
  In this practice, we take complaints very seriously indeed and try to ensure that all our patients are pleased with their experience of our service. When patients complain, they are dealt with courteously and promptly so that the matter is resolved as quickly as possible. This procedure is based on these objectives.

Our aim is to react to complaints in the way in which we would want our complaint about a service to be handled. We learn from every mistake that we make and we respond to customers’ concerns in a caring and sensitive way.

• The person responsible for dealing with any complaint about the service which is provided is Regional Manager.
• If a patient complains on the telephone or at the reception desk, we will listen to their complaint and try to resolve it immediately.
• if the complaint can not be resolved over the phone or at the reception desk we will ask you to make a written complaint that will be passed on to the Dentist or Regional Manager.
• If the Regional Manager is not available at the time, then the patient will be told when they will be able to talk to the dentist and arrangements will be made for this to happen. The member of staff will take brief details of the complaint and pass them on. If we cannot arrange this within a reasonable period or if the patient does not wish to wait to discuss the matter, arrangements will be made for someone else to deal with it.
• If the patient complains in writing the letter will be passed on immediately to the Regional Manager.
• If a complaint is about any aspect of clinical care or associated charges it will normally be referred to the dentist, unless the patient does not want this to happen.

We will acknowledge the patient’s complaint in writing and enclose a copy of this code of practice as soon as possible, normally within three working days. We will seek to investigate the complaint within ten working days of receipt to give an explanation of the circumstances which led to the complaint. If the patient does not wish to meet us, then we will attempt to talk to them on the telephone. If we are unable to investigate the complaint within ten working days, we will notify the patient, giving reasons for the delay and a likely period within which the investigation will be completed. The patient will be sent an update on the ongoing investigation every 10 days until it has been completed.

• We will confirm the decision about the complaint in writing immediately after completing our investigation.
• Proper and comprehensive records are kept of any complaint received.
• If patients are not satisfied with the result of our procedure then a complaint may be made to: The Dental Complaints Service (08456 120 540) for complaints about private treatment. The General Dental Council, 37 Wimpole Street, London, W1M 8DQ (the dentists’ registration body)

Policies in the full version are available in every branch of The Smile Studios.