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Inspection carried out on 11 July 2019

During a routine inspection

We carried out this announced inspection on 11 July 2019 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 provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

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

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

Exeter Orthodontic Practice is in Exeter and provides specialist orthodontic treatment to NHS and private patients.

Currently there is level access for people who use wheelchairs and those with pushchairs. However, accessible toilets are not currently available, although work to improve access is planned. Car parking spaces are available near the practice.

The dental team includes four orthodontists, seven dental nurses, two receptionists and a practice manager. The practice has four treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Exeter Orthodontic Practice is one of the partners.

On the day of inspection, we collected nine CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with all staff on duty. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 8am -12:45pm and 1:45pm – 6pm.

Friday 8am – 12:45pm and 1:45pm – 4pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies.
  • The provider had systems to help them manage risk to patients and staff.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Staff provided preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The provider had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.

There was an area where the provider could make improvements. They should:

  • Review the practice’s protocols to ensure clinical audits have documented learning points and the resulting improvements can be demonstrated.

Inspection carried out on 8 March 2012

During a routine inspection

People told us that they felt the staff at Exeter Orthodontic Practice were helpful and efficient. Some of the comments people told us when talking about their orthodontist were; �Very kind and supportive, they explain treatment really clearly�, �it�s really good because I get involved in the treatment and make the overall decisions�.

We spoke with five people who used the service. They told us they were given clear explanations about what treatment they required and knew what to expect. The orthodontists told us they would use visual aids, information leaflets, x-rays and verbal descriptions. This would help explain what people could expect from the course of treatment they were to receive and would enable them to make informed decisions on whether to go ahead with the treatment. The majority of people were NHS funded so did not need to pay fees. People who paid privately were given a letter which advised them on what the course of treatment would be, how much and what the benefits and negatives of the treatment. People we had spoken with felt that they were given the time and space to decide whether they would like to proceed with the course of treatment.

People who used the service told us that if they needed to cancel an appointment it was easy to reschedule. They said they were provided with an appointment in reasonable time.