We carried out this announced inspection on 28 June 2018 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 not 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 not providing well-led care in accordance with the relevant regulations.

Background

Luxmedica Ealing is an independent clinic in the London Borough of Ealing and provides private primary medical and dental healthcare services. Services are available to any feepaying patient. The dental care services are provided only to adult patients. The service-users at Luxmedica Ealing are predominantly Polish patients.

The dental team includes four dentists, two dental nurses and four receptionists. There were also two owners, a registered manager and an operation manager that oversee the running of the medical and dental services.

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 Luxmedica Ealing is the practice manager.

On the day of inspection, we collected 13 CQC comment cards filled in by patients. All of the comment cards we received were positive about the service. Patients said they were satisfied with the standard of care received and said the staff was approachable, committed and caring.

During the inspection we spoke with the two owners, the registered manager, one dentist, one dental nurse and one of the receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Saturday 9am to 9pm

• Sundays 10am to 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff were aware of infection control procedures which reflected published guidance.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The appointment system generally met patients’ needs.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice asked patients for feedback about the services they provided.
• The practice’s systems to help them manage risk required improvements.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• Staff felt involved and supported and worked well as a team.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. All staff except one of the dentists had completed medical emergencies training.
• The practice had a suitable safeguarding policy. All staff except one of the dentists had received up to date safeguarding training.
• The practice had staff recruitment procedures in place, though improvements were required to ensure recruitment records were maintained suitably.
• Risks associated with recruitment of staff, Legionella infection, and medical emergencies and safeguarding training had not been suitably identified and mitigated.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.
• 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.