We carried out this announced inspection on 31 October 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.

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

Avant Garde New Eltham is in the Royal Borough of Greenwich and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Limited car parking spaces are available near the practice and the practice also has some parking permits for patients to use.

The dental team includes three dentists, two dental nurses, a trainee dental nurse and a receptionist. The practice has two treatment rooms.

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 inspection we received feedback from 49 patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday- Wednesday 9.00am - 6.00pm

Thursday- 9.00am - 8.00pm

Friday- 9.00am - 6.00pm

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.
• 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.

At our inspection at Avant Garde New Eltham we checked to see if the provider had made improvements following our previous inspection on 16 December 2013 in relation to cleanliness and infection control. We found that the provider had made improvements to how the surgery was cleaned; actions had been taken to implement findings from a previous infection control audit; cleaning equipment such as buckets and mops were colour coded and appropriately stored; and staff wore appropriate personal protective equipment when decontaminating used instruments.

People who used the service we spoke with were complimentary about Avant Garde New Eltham. People told us that the appointment system was effective. One person told us that “I called this morning and they were able to give me an appointment straight away”. Another person told us that “my experience is generally very good to excellent”. People said staff were “friendly” and made them relax when they were anxious. People told us that they were involved in their treatment plan and they were given opportunity to make choices. All the people we spoke with said they were provided with enough information and felt the surgery was visibly clean.

We found that people were involved in planning their care and treatment and were able to make decisions that suited their needs. People's needs were assessed prior to receiving treatment from the dentist and the provider had arrangements in place to deal with foreseeable emergencies. The provider had policies and procedures in place to safeguard vulnerable adults and children and we found that staff knew about abuse and their responsibility to report any concerns of abuse. We also found that the provider maintained appropriate records and this included staff records and treatment plans. However, we found some shortfalls in cleanliness and infection control which included decontamination procedures.