We carried out this announced inspection on 18 February 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection in response to concerns we received and 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 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

Dr A Sharma t/a The Avenue is in the London Borough of Waltham Forest. The practice provides NHS and private treatment to patients of all ages.

The practice is located on the ground and first floor of the premises and there is step free access the practice via a ramp. The practice is located close to public transport bus and train services.

The dental team includes five dentists, two dental hygienists, three dental nurses and one trainee dental nurse. The clinical team are supported by a practice manager and three receptionists.

The practice is owned by an organisation 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 Dr A Sharma t/a The Avenue was the practice manager.

On the day of inspection we received feedback from 14 patients.

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

The practice is open between 9am and 7pm on Mondays, between 9am and 5pm on Tuesdays to Fridays and between 9am and 1pm on Saturdays.

Our key findings were:

• The practice appeared 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 practice was providing preventive care and supporting patients to ensure better oral health.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

There was one area where the provider could make improvements. They should:

Review the practice’s systems to monitor and track referrals to ensure that these are dealt with suitably.