We carried out this announced inspection on 7 February 2019 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

Avenue Dental Surgery is in Torquay and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs via a side entrance. Car parking spaces are available at and near the practice.

The dental team includes five dentists, one foundation dentist (in their first year after graduating), four dental nurses, one trainee dental nurse, one dental hygienist, one dental hygiene therapist, two receptionists and a practice manager. The practice has four treatment rooms.

The practice is owned by a company 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 Avenue Dental Surgery was the practice manager.

On the day of inspection we collected five CQC comment cards filled in by patients and spoke with two other patients. This gave us a positive view of the practice.

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

The practice is open: Monday to Friday 8.30am – 5pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 and is reviewing some areas of risk management.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice was reviewing staff recruitment procedures to ensure they are robust.
• 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 leadership demonstrated a culture of continuous improvement.
• Staff felt involved and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Consider the development of audit systems to monitor record keeping for assessment of implant procedures/written treatment plans and antimicrobial prescribing, in conjunction with the development of a practice sepsis policy.

• Review the practice's responsibilities to consider the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. In particular, by developing a plan of action as a result of audit.

• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term. In particular, by considering sector specific training for the registered manager.