Invisibrace

We carried out this announced inspection on 6 September 2021 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 provider 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 always ask the following three questions:

• 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:

Are services safe?

We found this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Invisibrace is in Surbiton in the London Borough of Kingston-upon-Thames and provides private dental care and treatment for adults and children.

The practice is located close to public transport links and car parking spaces are available near the practice.

The dental team includes a principal orthodontist, one dentist, one dental nurse, one trainee dental nurse, one hygienist, one orthodontic therapist, a business manager, a marketing coordinator, a receptionist and a practice manager. The practice has two treatment rooms.

The practice is owned by an individual who is the principal orthodontist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with the principal orthodontist, the dental nurse 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 – Saturday: 9:15pm - 5:30pm

(Open 2 Saturdays per month)

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff provided preventive care and supported patients to ensure better oral health.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had information governance arrangements.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvements were needed to ensure all staff undertook training as required.
• Staff knew how to deal with emergencies. Appropriate life-saving equipment and some medicines were available however, improvements were needed to ensure all medicines were available as recommended and the equipment was within the use-by date.
• Risks to staff and patients from undertaking of the regulated activities had not been suitably identified and mitigated.
• The provider had staff recruitment procedures. Improvements were needed to ensure that checks were carried out consistently for all staff at the time of recruitment and records available.
• There was ineffective leadership and a lack of management oversight for the day-to-day running of the service.
• There were ineffective systems to ensure facilities were safe and equipment was serviced and maintained according to manufacturers’ guidance.
• There were ineffective arrangements to monitor staff training and development needs and to ensure ‘highly recommended’ training was carried out.

We identified regulations the provider was not complying with. They must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice protocols regarding auditing patient dental care records to check that necessary information is recorded.
• Implement an effective system for identifying, disposing and replenishing of out-of-date stock.
• Take action to ensure the service takes into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.