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Plymouth Orthodontics Limited

All reports

Inspection report

Date of Inspection: 13, 28 February 2014
Date of Publication: 20 March 2014
Inspection Report published 20 March 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 13 February 2014 and 28 February 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We sent a questionnaire to people who use the service, talked with people who use the service, talked with carers and / or family members and talked with staff. We reviewed information given to us by the provider.

Our judgement

Care and treatment was planned and delivered in a way that ensured people's safety and welfare.

Reasons for our judgement

We spoke with five people receiving or accompanying relatives for treatment at the practice. They all gave us positive feedback and comments included “very happy here….personal and friendly”, “dentist is very clear…verbal instructions about oral health and post treatment retainer clearly explained”, and “pleased with treatment and care”.

People confirmed they were asked about their medical history and it was checked for any changes on subsequent visits. We saw on patient records there were signed and dated medical histories. For the people who had been receiving treatment over an extended period of time, the medical history was updated annually and/or if there was any medical change between appointments. We also saw medical alerts recorded on patient records. This meant the dentist was alerted to take appropriate measures to prevent adverse reactions such as an asthma attack or an allergic reaction to latex.

We asked people about appointments. They told us that once they had started treatment, appointments were “fairly quickly”. We saw that the dairy was open for appointments to be booked up to four months in advance. We found for standard referral NHS patients there was about seven months waiting time for the initial appointment and about two years waiting list for treatment; urgent referrals were booked as soon as possible. This wait was due to the NHS contract which once it was filled, the dentist could not take any more NHS patients. There was no restriction on the numbers of private patients. A dental nurse showed us how the treatment waiting lists were monitored. The dentist recorded clinical notes and set a recall date. For example, a patient seen on the day of our visit had a 12 months recall date set. This meant a letter would be sent to the patient in December 2014 with an appointment for February 2015. We found young people’s ages were monitored and anyone reaching 17 years was given priority to be seen and treatment started before they reached their 18th birthday. This was important if they were to be treated as a NHS patient. Younger children started treatment in date order. If a patient was dissatisfied with the length of waiting time, they were offered a review and the option of being referred elsewhere was discussed.

For the young people we spoke with after school appointments were important and we observed staff were accommodating about booking these. Evening appointments were also available for private patients who preferred these. One person told us “I needed an emergency appointment when part of the brace broke and we got an appointment fairly quickly”. Breakages of fixed appliances were not charged for NHS patients, and private patients were charged only if it happened repeatedly. In these cases the appliance was removed and the patient discharged from treatment. We saw additional retainers were available for people to buy from the practice at NHS rates (the first one was provided free of charge to NHS patients) or at a private discounted fee. Dental hygiene products were also on sale at reception. These included mouthwash, toothbrushes, interdental brushes and “retainer brite”. We saw on patient’s records details about any leaflets given to the patient about oral health, and wearing an appliance or a retainer post treatment.

We looked at some examples of patient records. We saw these contained the letter from the referring dentist and letters to the referring dentist explaining proposed treatment plans after the first consultation. A full orthodontic assessment was completed at the first appointment with written clinical notes by the dentist as well as a record of options for treatment that had been discussed with the patient. Full orthodontic records, X-rays and study models (impressions of patient’s teeth) were taken when the patient started treatment. For private patients, notes of the visit were recorded by the dentist including risks, treatment options, types of discomfort that the patient cou