Evolution Orthodontics

We carried out this announced inspection on 18/02/2020 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 Care Quality Commission, (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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Evolution Orthodontics is in the London Borough of Redbridge and provides private orthodontic dental care and treatment for adults and children. The practice previously held an NHS contract to provide orthodontic treatment. They had some patients who were currently completing NHS treatment.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including one dedicated parking space for people with disabilities are available near the practice.

The dental team includes four orthodontists, one dental nurse and three trainee dental nurses. The clinical team were supported by a receptionist and a practice manager. The practice has three treatment rooms, one of which is located on the ground floor.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 41 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, one dental nurse, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between:

8:30 am and 5:30 pm Monday to Fridays

Occasional Saturdays: 9.00 am to 1.00 pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.

• The provider had infection control procedures which reflected published guidance.

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with exception of child adhesive pads for use with the automated external defibrillator. The self- inflating reservoir was past its use by date. These items were ordered on the day the inspection and were available shortly after.

• The provider had systems to help them manage risk to patients and staff.

• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.

• The provider had staff recruitment procedures which reflected current legislation.

• 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 supported patients to ensure better oral health.

• The appointment system took account of patients’ needs.

• The provider had effective leadership and a culture of continuous improvement

• Staff felt involved and supported and worked 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 information governance arrangements.

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

• Improve the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the frequency of checks of medical emergency equipment taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.

• Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular review and address the areas for improvement identified in the report from the five-year electrical installation inspection.