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Inspection Summary


Overall summary & rating

Updated 12 July 2016

We carried out an announced comprehensive inspection on 22 June 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

Epsom Orthodontics is a specialist dental practice providing orthodontic treatment to children and adults mainly on a referral basis (Orthodontics is a specialist service of dentistry concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teethand their function). Orthodontic treatment is provided under NHS regulations for children except when the problem falls below the accepted eligibility criteria for NHS treatment. Private treatment is available for these patients as well as adults who require orthodontic treatment. The practice is situated in a converted listed building. The practice has a suite of six treatment cubicals and a separate decontamination room for cleaning, sterilising and packing dental instruments on the first floor of the building with a reception and waiting area on the ground floor. The first floor treatment area can be accessed by a lift for those patients and their carers who have mobility problems. Adjacent to the treatment area are two ‘safe haven rooms which are used for discussing treatment with patients prior to the commencement of treatment. These rooms can also be used by patients and staff to discuss matter of a rather sensitive nature therefore protecting the dignity and confidentiality of the patient.

The practice opening hours are 8.30am - 5.00pmMonday to Thursday and Fridays 8.30am – 12.30pm. The practice has five dentists providing orthodontic care and are supported by four orthodontic therapists, six dental nurses, a practice manager, a treatment co-ordinator and two administrative staff and two receptionists.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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 comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 11 patients. These provided a completely positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

Our key findings were:

  • We found that the practice ethos was to provide patient centred quality orthodontic care.
  • Strong and effective clinical leadership was provided by the provider who was supported by an empowered practice manager.
  • Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
  • The practice appeared very clean and well maintained.
  • Infection control procedures were robust and the practice followed published guidance.
  • The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
  • Staff understood how to report incidents and keep records for shared learning.
  • The orthodontists provided care in accordance with current professional guidelines.
  • The practice had fully embraced the concept of skill mix to assist in the delivery of effective orthodontic care to patients.
  • The service was aware of the needs of the local population and took these into account in how the practice was run.
  • Staff recruitment files were organised and complete.
  • Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the management team.
  • Staff we spoke with felt well supported by the management team and were committed to providing a quality service to their patients.
  • Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.
Inspection areas

Safe

No action required

Updated 12 July 2016

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

The practice had robust arrangements for essential areas such as infection control, clinical waste control, management of medical emergencies at the practice and dental radiography (X-rays). We found that all the equipment used in the dental practice was well maintained. The practice took their responsibilities for patient safety seriously and staff were aware of the importance of identifying, investigating and learning from patient safety incidents. There were sufficient numbers of suitably qualified staff working at the practice. Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Effective

No action required

Updated 12 July 2016

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

The orthodontic care provided was evidence based and focussed on the needs of the patients. The practice used current national professional guidance in relation to orthodontics including that from the British Orthodontic Society to guide their practice. We saw examples of positive teamwork within the practice and evidence of good communication with other dental professionals. The staff received professional training and development appropriate to their roles and learning needs. Staff were registered with the General Dental Council (GDC) and were meeting the requirements of their professional registration

Caring

No action required

Updated 12 July 2016

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

We collected 11 completed Care Quality Commission patient comment cards. These provided a completely positive view of the service the practice provided. All of the patients commented that the quality of care was very good. Patients commented on friendliness and helpfulness of the staff and the orthodontists were good at explaining the treatment that was proposed.

Responsive

No action required

Updated 12 July 2016

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

The practice had a system in place to schedule enough time to assess and meet patients’ needs. Patients were booked for longer appointments depending on their needs. Staff told us they treated everybody equally and where patients required additional assistance the practice would work together to assist patients.

The practice followed their complaints policy and procedures. Patients were informed about how to make a complaint. The practice acted with candour and apologised when things had not gone well.

Well-led

No action required

Updated 12 July 2016

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

The provider, practice manager and other staff had an open approach to their work and shared a commitment to continually improving the service they provided. The practice had robust clinical governance and risk management structures in place. Staff told us that they felt well supported and could raise any concerns with the practice owner and practice manager. All the staff we met said that they were happy in their work and the practice was a good place to work.