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Inspection Summary


Overall summary & rating

Updated 9 August 2016

We carried out an announced comprehensive inspection on 21 July 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

Barnet Orthodontic Practice is located in the London Borough of Barnet and provides NHS and private orthodontic treatment to both adults and children. The premises are on the first floor and consist of two treatment rooms, a consultation room, an X-ray room and a reception area. The practice is open Monday to Thursday 8:30am – 5:00pm and Friday 8:30am – 4:30pm.

The staff consists of the principal dentist, an associate dentist, three dental nurses, an administrator and a receptionist.

The principal dentist 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.

We reviewed 50 CQC comment cards, the NHS Friends and Family test comment cards and spoke with three patients. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

  • We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
  • Patients were involved in their care and treatment planning so they could make informed decisions.
  • There were effective processes in place to reduce and minimise the risk and spread of infection.
  • The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
  • Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
  • Patients were treated with dignity and respect and confidentiality was maintained.
  • The practice had implemented clear procedures for managing comments, concerns or complaints.
  • Patients indicated that they found the team to be efficient, professional, caring and reassuring.
  • Patients had good access to appointments, including emergency appointments, which were available on the same day.
  • Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.
  • Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

  • There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.
Inspection areas

Safe

No action required

Updated 9 August 2016

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

The practice had systems in place for identifying, investigating and learning from incidents relating to the safety of patients and staff members. There were policies and procedures in place for the management of infection control, clinical waste segregation and disposal, management of medical emergencies and dental radiography. We found the equipment used in the practice was maintained and in line with current guidelines. Dental instruments were decontaminated suitably. Medicines and equipment were available in the event of an emergency and stored safely. X-rays were taken in accordance with relevant regulations.

Effective

No action required

Updated 9 August 2016

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

The practice provided evidence-based care in accordance with relevant, published guidance, for example, from the British Orthodontic Society (BOS), National Institute for Health and Care Excellence (NICE), Department of Health (DH) and the General Dental Council (GDC).

The practice monitored patients’ oral health and gave appropriate health promotion advice. Staff had completed continuing professional development to maintain their registration in line with requirements of the General Dental Council. Staff explained treatment options to patients to ensure they could make informed decisions about any treatment. The practice provided specialist services and followed up on the outcomes of referrals made to other providers. We saw examples of effective collaborative team working.

Caring

No action required

Updated 9 August 2016

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

We reviewed 50 CQC comment cards, the NHS Friends and Family Test comment cards and spoke with three patients. Patients were positive about the care they received from the practice. Patients commented they felt fully involved in making decisions about their treatment, they were listened to, were made comfortable and reassured. Patients told us they were treated in a professional manner and staff were very helpful.

We noted that patients were treated with respect and dignity during interactions at the reception desk and over the telephone. We observed that patient confidentiality was maintained.

Responsive

No action required

Updated 9 August 2016

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

There were systems in place for patients to make a complaint about the service if required. The practice reviewed patients’ comments and acted on them where necessary. Patients’ comments from the NHS Friends and Family test were reviewed on a regular basis. Information about how to make a complaint was readily available to patients. Patients had access to information about the service.

The practice provided friendly and personalised dental care. Patients had good access to appointments, including emergency appointments, which were available on the same day. In the event of a dental emergency outside of normal opening hours, patients were directed to the ‘111’ out of hour’s service and the contact details were available for patients’ reference.

Well-led

No action required

Updated 9 August 2016

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

The staff we spoke with described an open and transparent culture which encouraged candour. Staff said that they felt comfortable about raising concerns with the principal dentists. They felt they were listened to and responded to when they did so. Staff commented that the principal dentists were open to feedback regarding the quality of the care. Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

The practice had suitable clinical governance and risk management structures in place. Staff told us they enjoyed working at the practice and felt part of a team. Opportunities existed for staff for their professional development. Staff we spoke with were confident in their work and felt well-supported.