Christchurch Orthodontics

Updated 18 January 2017

We carried out an announced, comprehensive inspection on 17 November 2016. Our inspection was carried out by a lead inspector, a second inspector and a dental specialist adviser.

During our inspection visit, we reviewed policy documents and staff training and recruitment records. We obtained the views of 11 members of staff.

We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. We were shown the decontamination procedures for dental instruments and the systems that supported the patient dental care records. We obtained the views of 15 patients on the day of our inspection.

Patients gave positive feedback about their experience at the practice.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 18 January 2017

We carried out an announced comprehensive inspection on 17 November 2016 to ask the practice the following key questions;

Are services safe, effective, caring, responsive and well-led?

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

Christchurch orthodontics is a dental practice providing NHS and private orthodontic treatment for both adults and children. The practice is based in a former domestic dwelling in Christchurch, a town situated in Dorset.

The practice has four dental treatment rooms; one of which is based on the ground floor and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility.

The practice employs four orthodontic practitioners, one orthodontic therapist, five dental nurses, one decontamination room assistant, two reception staff and a practice manager.

The practice’s opening hours are between 8.30am and 6pm Monday to Wednesday, 8.30am and 5pm Thursday and 8.30am and 4pm Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.

The provider, Mr David Tehrani Yeganeh, shares the practice facilities with another dentist who is separately registered with CQC. Facilities are shared and patients can register with either of the dentists. The dental nurses and support staff are employed jointly by both dentists.

Mr David Tehrani Yeganeh is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

We obtained the views of 15 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide high quality patient centred orthodontic care in a relaxed and friendly environment.
• Effective leadership was provided by senior clinicians and an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• The orthodontist provided orthodontic care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
• Staff we spoke with felt well supported by the senior clinicians and practice manager and were committed to providing a quality service to their patients.
• Information from 42 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

There were areas where the provider could make improvements and should:

• Review the practice fire safety risk assessment and the requirements of the Regulatory Reform (Fire Safety) Order 2005. Ensure all practice fire safety checks are carried out in accordance with legal requirements
• Review its responsibilities to the needs of disabled people and the requirements of the Equality Act 2010 and the Disability Discrimination Act audit undertaken for the premises. Specifically, the provision of a foot operated bin in the disabled toilet and the availability of hearing loops for patients who are hard of hearing.
• Consider the addition of General Dental Council (GDC) registration numbers of dentists working at the practice on the external name plate in accordance with GDC guidance issued in March 2012.
• Review all dentists and clinician personnel recruitment files and ensure that documentation is obtained and retained in relation to Schedule 3, Health and Social Care Act 2008.
• Review the recommendations of the January 2016 gas safety check provided in accordance with the Specifically the installation of a carbon monoxide detector.