Archived: Grosvenor Orthodontic Clinic

Updated 26 May 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 28 April 2016. The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

We reviewed information received from the provider prior to the inspection. During our inspection we reviewed policy documents and spoke with nine members of staff. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. One of the dental nurses demonstrated how they carried out decontamination procedures of dental instruments.

Two people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 26 May 2016

We carried out an announced comprehensive inspection on 28 April 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

Grosvenor Orthodontic Clinic is a dental practice located in the London Borough of Bromley. The premises are situated in a converted residential-building over three floors. There are five treatment rooms situated on the ground and first floors. There is also a dedicated decontamination room, an X-ray room, two reception areas, two patient toilets, a range of administrative offices and a staff room.

The practice provides NHS and private services to adults and children. The practice specialises in the provision of orthodontic treatments.

There are twenty-two members of staff including four orthodontists, three orthodontic therapists, eight dental nurses, a practice co-ordinator and a patient care co-ordinator, as well as a range of other support staff, such as laboratory or decontamination assistants, administrative, and reception staff. On the day of the inspection there was also a practice manager, who worked with nine practices owned by the same provider, and a health and safety advisor employed by the provider to work with a range of practices.

The practice opening hours are from 9.00am to 6.00pm on Monday, from 8.00am to 7.00pm Tuesday to Thursday, from 8.00am to 5.00pm on Friday and from 9.00am to 1.00pm on Saturday.

The principal orthodontist is registered with the Care Quality Commission (CQC) as an individual. 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 were informed that the practice had been taken over by Oasis Dental Care in February 2015 and changes to the registration with CQC were in progress at the time of the inspection.

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

Two people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• 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 effective systems 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 children living in vulnerable circumstances. However, not all of the clinical staff had completed safeguarding training.
• There were forms available to keep a record of any incident which could be used by the practice for shared learning. Staff were aware of these, but improvements could be made to ensure that all staff understood the process clearly.

• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced. However, we found that there were two air compressors which had not been serviced in the recommended time frames.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and the majority of staff told us they were well supported by the management team. However, further improvements could be made to ensure that all staff understood new management structures that had been put in place.
• There were governance arrangements in place, however further improvements could be made to the use of audits and risk management processes to monitor the quality and safety of the services.

There were areas where the provider could make improvements and should:

• Review the systems for checking and monitoring equipment to ensure that all equipment is well maintained.
• Review the practice’s safeguarding training ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice’s audit and risk assessment protocols for various aspects of the service to ensure that all risks are identified and minimised in a timely manner.
• Review staff understanding of governance and management structures to ensure that new systems are used effectively for monitoring and improving the quality of the service.