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Bishops Stortford Orthodontic Practice

Inspection Summary


Overall summary & rating

Updated 8 June 2016

We carried out an announced comprehensive inspection on 26 April 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

Bishops Stortford Orthodontic Practice provides orthodontic treatment to adults and children. Orthodontics is the prevention and treatment of irregularly positioned teeth by means of braces.

The practice is situated over three floors of a converted house near the centre of Bishops Stortford. Treatment is provided by the NHS or paid for privately by patients.

The practice was first registered with the Care Quality Commission (CQC) in June 2011.

The practice’s opening hours are: 8.00 am to 5.00 pm Monday to Wednesday, 8.00 am to 7.00 pm on Thursday and 8.00 am to 4.00 pm on Friday.

Access for urgent advice or treatment for patients of the practice is by contacting a mobile phone which is held by the principal orthodontist, or by another practice orthodontist.

The principal orthodontist is registered with the Care Quality Commission (CQC) as an individual. 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.

The practice has three trained orthodontists, a dentist with a special interest in orthodontics, five orthodontic therapists, two orthodontic nurses, three further dental nurses, two trainee dental nurses, a treatment coordinator, a patient coordinator, a compliance officer, three receptionists, two decontamination technicians (one of whom also a laboratory technician) and a practice manager.

We received positive feedback from 44 patients (or their legal guardians) about the services provided. This was through CQC comment cards left at the practice prior to the inspection.

Our key findings were:

  • Patients were treated with dignity and respect, and patients commented that staff were friendly and knowledgeable.

  • Treatment options were explained in detail to patients, and a treatment plan was given to all patients to take away and consider before signing a consent form.

  • The practice met standards in infection control as outlined in the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05).

  • The practice had policies in place to ensure the smooth running of the service.

  • A legionella risk assessment had not been carried out on the premises to assess the level of risk, and ascertain an action plan to address that risk; however the practice was sending water samples for analysis annually.

  • Appropriate pre-employment checks were carried out on all staff to ensure that the practice was employing fit and proper persons.

  • There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

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

  • Review the need for a legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

  • Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.

  • Review the practice’s audit protocols for infection prevention and control giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

  • Review availability and appropriate storage of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
Inspection areas

Safe

No action required

Updated 8 June 2016

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

The practice had medicines and equipment to deal with medical emergencies in line with published guidance.

The practice met national standards in infection control, therefore patients could be assured that instruments were cleaned and sterilised in line with these standards.

The practice had systems in place to monitor and mitigate risks to patients, staff and visitors however they had not undertaken legionella risk assessment. This was completed shortly following the inspection.

Pre-employment checks on new staff were carried out in line with the requirements of the Health and Social Care Act 2008 Regulations 2014. Thus ensuring that fit and proper persons were employed.

Effective

No action required

Updated 8 June 2016

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

Clinicians used nationally recognised guidance in the care and treatment of patients.

Patients were educated in the importance of oral health, particularly when wearing a brace. This information was reinforced at every visit to the practice.

A comprehensive medical history form was sent to patients in advance of their first appointment at the practice. This was checked verbally at every visit, and re-signed every six months to ensure the information remained current.

Caring

No action required

Updated 8 June 2016

We found that this practice was providing caring services in accordance with the relevant regulations.

We were shown the suitable ways in which patients’ confidentiality was maintained at the practice.

We observed patients being treated in a courteous and friendly manner.

Patients informed us that they felt involved in their care, and clinicians always took the time to explain their treatment options in full.

Responsive

No action required

Updated 8 June 2016

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

Patients were seen within eight weeks of referral and, if ready, could start treatment immediately.

Patients commented that the practice were flexible and helpful when it came to arranging or re-arranging appointments.

The practice offered early morning appointments as well as one late evening a week in order to cater for the needs of individual patients particularly those undertaking examinations at school.

Well-led

No action required

Updated 8 June 2016

We found that this practice was providing well-led care in accordance with the relevant regulations.

The practice had policies in place to assist in the smooth running of the service; these had been recently reviewed to ensure they remained relevant and had been signed by all staff within the last year.

The practice held monthly staff meetings where complaints and significant incidents were discussed with staff to prevent their reoccurrence. The opinions of staff were obtained in these meetings, and suggestions to improve the service welcomed.

Clinical audits had been carried out to highlight areas which could be improved upon, however these were not always completed at the recommended frequency.