The Avenue DP Ltd

We carried out this announced focused inspection on The Avenue DP Ltd 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 was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic was visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk to patients and staff.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved and 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 dental clinic had information governance arrangements.

Background

The provider has 12 practices and this report is about The Avenue DP Ltd.

The Avenue DP Ltd is in Colchester, Essex and provides NHS and private dental care and treatment for adults and children.

The practice is approached by a set of steps at the front of the building and is set out across four floors, level access to the practice for people who use wheelchairs and those with pushchairs is limited. There are treatment rooms on the ground floor. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with additional needs.

The dental team includes four dentists, five dental nurses (including two trainee dental nurses), two dental hygienists, two dental therapists, three receptionists, one practice manager, three support staff and one visiting clinician. The practice has five treatment rooms.

During the inspection we spoke with two dentists, three dental nurses (including one trainee dental nurse), one dental hygienist, one receptionist 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, Wednesday, Thursday and Friday from 8.30am to 5.30pm.

Tuesday from10am to 7pm.

The practice had taken steps to improve environmental sustainability. For example, where possible items were recycled, the practice were moving towards a paper light service, staff were instructed to turn the power off to equipment and lighting when not in use.

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

• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular assess the evacuation of a sedated patient in the event of an emergency, ensure patient group directives are in place for direct access to dental hygienists and therapists if working without a prescription from a dentist. Ensure medicines are stored in line with manufacturers guidance.
• 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 quality assurance logs for X-ray units and ensure systems are in place to alert people when X-ray units in treatment rooms are active.