We carried out an announced comprehensive inspection on 12 May 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

The Avenue Dental Clinic located in Ealing provides private dental treatment to patients of all ages.

Practice staffing consists of the principal dentist, two hygienists, one dental nurse and one receptionist.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. Registered persons 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 practice is open Monday 7am to 5pm, Tuesday 8am to 4.30pm, Wednesday 8am to 5pm, Thursday 7am to 7pm, Friday 7am to 1pm and occasional Saturdays 7am to 11am

The practice facilities include two treatment rooms, reception and waiting area, one office and a staff room/kitchen.

32 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• There were systems in place to ensure that all equipment was maintained in line with manufacturer’s guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.
• Rubber dam was being used for root canal treatment in line with national guidance
• The practice had not carried out an audit in the key area of infection prevention and control (IPC).
• Staff had little understanding the Mental Capacity Act (MCA) 2005 or Gillick Competence.

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

• Review its audit protocols to ensure infection control audits are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role. Including the Gillick competence.

We spoke with three patients who use the service. Patients said they were given a good explanation of the treatment required and received an estimate of treatment costs. One patient said "treatment planning is done thoroughly" and another said "good explanations are given on why treatment is needed". Patients we spoke with talked about their experience at the practice and were complimentary about their treatment and the outcome. One patient said they kept returning to the practice because they received good treatment and another said they were put at their ease during treatment and the dentist had an 'excellent attitude'.

Information was available at the clinic to support people to make decisions about their treatment. Assessment, planning and delivery of care were reflected in patient treatment plans. A schedule of training and practice meetings was in place. Staff had a development plan which identified training courses they needed to attend.

On the day of the inspection we found the practice to be clean and saw that a decontamination process was in place for the sterilization of dental instruments. A quality management system was in place to ensure the service was safe and care and treatment was regularly evaluated.