Orchard Dental Care - Elm Avenue

We carried out this announced comprehensive inspection on 31 October 2023 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 practice 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 had remote access to a specialist dental advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.
• Improvements were required to the practice’s infection control procedures, especially as regards storage of sterilised dental instruments to ensure they were in line with current national guidance.

Background

Orchard Dental Care - Elm Avenue is in Ruislip, in the London Borough of Hillingdon, and provides NHS and private dental care and treatment for adults and children.

The practice is not accessible to people who use wheelchairs and those with pushchairs. The practice had systems in place to communicate this to new patients before booking and they signposted people with mobility issues to nearby practices. Car parking spaces are available near the practice.

The dental team includes the principal dentist, 2 associate dentists, 1 visiting prosthodontist, 1 visiting endodontist, 1 qualified dental nurse, 1 trainee dental nurse, 2 dental hygienists and 2 receptionists. The practice has 3 treatment rooms.

During the inspection we spoke with the principal dentist, the qualified dental nurse, 1 dental hygienist and 2 receptionists. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Thursday from 8.30am to 5.30pm

Friday from 8.30am to 1.30pm

Saturday by appointment only.

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

• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular, ensure there are systems in place to monitor the storage time of sterilised dental instruments.
• Improve the practice`s recruitment policy and procedures to ensure that the necessary recruitment checks are carried out.
• Improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular ensure that elector-mechanical servicing of the radiation equipment is carried out in line with the manufacturer`s guidance or annually and rectangular collimators are used with the intraoral X-ray units.
• Improve and develop staff awareness of autism and learning disabilities and ensure all staff receive appropriate training in this.
• Take action to ensure audits of infection prevention and control, record keeping and antimicrobial prescribing are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.