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Archived: Orthodontics Exclusively

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Updated 7 June 2016

We carried out an announced comprehensive inspection on 23 March 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

Orthodontics Exclusively is an orthodontic dental practice which provides treatment under the NHS or privately. The practice is located in the Acocks Green area of Birmingham and is situated on the ground and first floor of a converted building. The practice has a reception and separate waiting room, two treatment rooms, an oral health education room, X-ray room and a decontamination room. The practice’s opening hours are: Monday 9am to 6pm, Tuesday and Thursday 9am to 5pm, Wednesday 9am to 1pm and Friday and Saturday by appointment only. The practice closes for lunch from 1 pm to 2 pm.

Orthodontics Exclusively has two part time orthodontists; one orthodontic therapist, a head dental nurse, two trainee dental nurses and a practice manager. 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.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from 29 patients who provided an overwhelmingly positive view of the service the practice provides. All of the patients commented that the quality of care was very good and that staff were helpful and informative.

Our key findings were:

  • There were systems in place to record accidents, significant events and complaints, and learning points were identified and were shared with staff.
  • There were sufficient numbers of suitably qualified staff to meet the needs of patients.
  • Patients spoke positively about their experiences of the orthodontic services they received.
  • Patients said they were treated with dignity and respect and their confidentiality was maintained.
  • Patients were involved in discussions about their care and treatment.
  • The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
  • The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.
  • Staff had been trained to deal with medical emergencies.
  • There were training opportunities for staff which allowed professional development within their role.
  • There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
  • Governance arrangements were in place for the smooth running of the practice.

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

  • Review the practice’s whistle blowing policy to ensure staff are provided with information about how to raise concerns both internally and with identified external agencies.
Inspection areas

Safe

No action required

Updated 7 June 2016

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

Systems were in place for recording significant events and accidents. Staff were aware of the procedure to follow to report incidents, accidents and Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR). All staff had received training in safeguarding vulnerable adults and children. Staff knew how to recognise the signs of abuse, and how to raise concerns when necessary. There were clear guidelines for reporting concerns and the practice had a lead member of staff to offer support and guidance over safeguarding matters.

Medicines for use in an emergency were available on the premises as detailed in the guidance on emergency medicines set out in the British National Formulary (BNF). Emergency medical equipment was also available and documentation demonstrated that checks were being made to ensure equipment was in good working order and medicines were within their expiry date. Staff had received training in responding to a medical emergency.

Recruitment checks were completed on all new members of staff. This was to ensure staff were suitable and appropriately qualified and experienced to carry out their role.

The practice had infection control procedures to ensure that patients were protected from potential risks. Regular audits of the decontamination process were carried out in accordance with published guidance. Equipment was maintained by a specialist company and regular checks were carried out to ensure equipment was working properly.

Effective

No action required

Updated 7 June 2016

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

All patients were clinically assessed by an orthodontist before any treatment began using the index of orthodontic treatment need. Patients completed a health questionnaire which was reviewed and updated at every appointment. Patients were asked to watch a film showing them how to maintain oral hygiene whilst wearing a brace and were given the opportunity to ask questions about orthodontic procedures.

Staff received professional training and development appropriate to their roles and learning needs. Qualified staff were registered with the General Dental Council (GDC) and were meeting the requirements of their professional registration.

The practice recorded patients’ consent before any treatment was started. Where the patient was a child, parental consent was also obtained.

Caring

No action required

Updated 7 June 2016

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

There were systems in place to help maintain patient confidentiality. Staff we spoke with were aware of the importance of confidentiality and were able to demonstrate how they achieved this. The waiting area was in a separate area to the reception desk and we were told that there was a separate area for discussions of a private nature.

Feedback from patients was positive. Patients said they received good orthodontic treatment and they were involved in discussions about their orthodontic care. Patients praised the staff and commented that they were professional, friendly and helpful.

Responsive

No action required

Updated 7 June 2016

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

Patients had good access to treatment and urgent care when required. Patients said they had no problem getting an appointment.

The practice had ground floor reception, waiting room and toilet which had been adapted to meet the needs of patients with a disability. Treatment rooms and the oral health education room were on the first floor. Alternative arrangements were in place for patients with restricted mobility.

The practice had developed a complaints procedure and information about how to make a complaint was available for patients to reference

Well-led

No action required

Updated 7 June 2016

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

There were good governance arrangements and a clear management structure. Staff were aware of their roles and responsibilities within the dental team, and knew who to speak with if they had any concerns.

Regular staff meetings were held and systems were in place to ensure all staff who were unable to attend the meeting received an update about topics of discussion. Staff told us they felt well supported enjoyed working at the practice and felt part of a team. Staff said that they could raise any issues or concerns with the provider.

The practice used regular clinical audit to highlight and improve areas of practice.