The Ivy Clinic

We carried out this announced comprehensive inspection on 30 November 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 was supported by 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.
• The practice had infection control procedures which reflected published guidance.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children. Two staff members had not undertaken training at a level appropriate to their role. Following the inspection this was completed.
• 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.
• There was effective leadership and a culture of continuous improvement.
• 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.
• Staff knew how to deal with medical emergencies. However, not all of the life-saving equipment was available as per national guidelines. Following the inspection, the provider took timely action to rectify this.
• The practice had staff recruitment procedures which required some improvements.
• The practice had systems to manage risks for patients, staff, equipment and the premises. Improvements were required to ensure fire safety systems were maintained appropriately.

Background

The Ivy Clinic is in the London Borough of Richmond-upon-Thames and provides private dental care and treatment for adults and children. The premises are also used for physiotherapy, podiatry, acupuncture and beauty therapy services.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 3 dentists, 1 dental nurse, 1 trainee dental nurse, 1 dental hygienist, 1 practice manager and 2 receptionists. One of the receptionists and the practice manager are also qualified dental nurses. The practice has 2 treatment rooms used in the provision of dental care.

During the inspection we spoke with the principal dentist, 1 associate dentist, 1 dental nurse, 1 trainee dental nurse, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Thursday, Friday from 9am to 5pm

Tuesday, Wednesday from 9am to 6pm

Saturday from 9am to 2pm

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

• Take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Take action to implement any recommendations in the practice's fire safety risk assessment and ensure ongoing fire safety management is effective.
• Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Implement a system to ensure patient referrals to other dental or health care professionals are centrally monitored to ensure they are received in a timely manner and not lost.