Teethinline - Milton Keynes

We carried out this announced comprehensive inspection on 30 October 2023 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 practice 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• There was scope for improvement in the practice systems to manage risks for for patients, staff, equipment and the premises. In particular in relation to ensuring a 5-year fixed wire electrical safety certificate was in place, safety alerts and waste processes.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Evidence was not always available to confirm that staff recruitment procedures reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

The provider has 2 practices, and this report is about Teethinline – Milton Keynes.

Teethinline is in Milton Keynes and provides NHS and private orthodontic treatment for adults and children.

The practice is accessed via stairs. The practice had a stair lift for people who are unable to manage the stairs. At the time of inspection, the stair lift was broken and awaiting repair which was due to be completed in December 2023. Patients who are unable to manage the stairs are directed to the providers other practice in Newport Pagnell. Car parking spaces, including dedicated parking for people with disabilities, are available outside the practice.

The dental team includes 3 orthodontists, 4 orthodontic therapists, 5 dental nurses, 2 receptionists, 1 treatment coordinator. The practice team are supported by a practice manager who supports remotely and visits every 6 weeks, and 2 directors. The practice has 3 treatment rooms, one room is an open plan layout with 2 dental chairs.

During the inspection we spoke with 2 orthodontic therapists, 2 dental nurses, 2 receptionists, 1 director and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Thursday from 8.30am to 5.30pm.

Friday from 8.30am to 4.30pm.

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

• Implement an effective system for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Improve the practice's systems for checking and monitoring equipment taking into account relevant guidance and ensure that all equipment is well maintained. In particular, ensure the practice has a satisfactory 5-year fixed wire electrical safety certificate.
• Improve the practice's waste handling protocols to ensure waste is segregated and disposed of in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01. Ensure that the storage bin outside of the practice is secured.