The Orthodontic Centre

Updated 3 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

During the inspection we spoke with one specialist Orthodontist, four dental nurses, one receptionist, the decontamination assistant, the practice manager and the area regulatory officer. To assess the quality of care provided we looked at practice policies and protocols and other records relating to the management of the service.

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 3 November 2016

We carried out an announced comprehensive inspection on 27 September 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

The Orthodontic Centre is part of the IDH group and is located in central Doncaster. It provides specialist NHS and private orthodontic care to children and adults. It consists of a team of Specialist Orthodontists supported by orthodontic therapists a dental hygienist and orthodontic dental nurses. The practice is visited by an implantologist twice a month.

The practice has a large reception and waiting area on the ground floor, staff changing facilities, an office, a private treatment planning room and a small kitchen. There are two surgeries on the first floor, one of which has six dental chairs, two further offices, a decontamination and sterilisation room and a separate room for the Orthopantomogram (OPG) machine (an OPG machine produces a panoramic scanning dental X-ray of the upper and lower jaw). On the second floor there is a three chair surgery and a large staff area with kitchen facilities.

There are two specialist Orthodontists, three orthodontic therapists, one dental hygienist, 18 dental nurses, a decontamination assistant, a lead receptionist, a treatment co-ordinator and a practice manager. The regional regulatory officer was also present during the inspection.

The practice is open between the hours of 8:15am and 7:30pm; opening and closing hours varying from day to day throughout the week.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

On the day of inspection we received 40 CQC comment cards providing feedback and we spoke with two patients. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be very pleasant and helpful, the practice had a happy and safe environment; staff were friendly and communicated well. Patients commented they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and uncluttered.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• The Orthodontist carried out an assessment in line with recognised guidance from the British Orthodontic Society (BOS).
• Orthodontic treatment was well planned and provided in line with current guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.

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

• Review the staff’s awareness of the use of medical emergency oxygen.
• Review the staff’s awareness on the Mental Capacity Act 2005, Gillick competence and Caldicott principles.
• Review the practices record keeping procedures to bring them in line with British Orthodontic Society (BOS) guidelines.
• Review the practices procedures for the recording and the justification of radiographic requirements to bring them in line with the National Radiological Protection Board (NRPB) guidelines.