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Inspection Summary


Overall summary & rating

Updated 7 April 2017

We carried out an announced comprehensive inspection on 14 February 2017 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

Mr Alan Davey is a specialist orthodontics practice providing NHS and private treatment for both adults and children. The practice is based in Oxford city centre.

The practice has three dental treatment rooms of which one is based on the ground floor and a separate decontamination area used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility via the rear of the building.

The practice employs two specialist orthodontists, onedentist, one orthodontic therapist, two nurses, one receptionist and two practice managers.

The practice’s opening hours are between 8.30am and 5.30pm from Monday to Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an on call dentist and an out-of-hours service, via 111.

A specialist orthodontist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 36 patients. These provided a 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.

We obtained the views of 11 patients on the day of our inspection.

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 empowered practice managers.
  • 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 effective 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.

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

  • Consider providing an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

  • Review the availability of hearing loops for patients who are hearing aid wearers.

  • Review the systems around fire safety ensuring that the fire drill is timed and revisit the practice fire safety risk assessment with a view to reviewing emergency lighting and the fire door in the basement.

  • Review staff recruitment procedures to ensure that references of prospective employees are followed up.
Inspection areas

Safe

No action required

Updated 7 April 2017

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 its responsibilities for patient safety seriously and staff were aware of the importance of identifying, investigating and learning from patient safety incidents.

Staff had received safeguarding training and were aware of their responsibilities regarding safeguarding children and vulnerable adults.

Effective

No action required

Updated 7 April 2017

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.

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.

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.

Caring

No action required

Updated 7 April 2017

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

We obtained the views of 36 patients prior to our visit and 11 patients on the day of our visit. These provided a positive view of the service the practice provided.

All the patients commented that the quality of care was very good. Patients commented on friendliness and helpfulness of the staff and dentists were good at explaining the treatment that was proposed.

Responsive

No action required

Updated 7 April 2017

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

The service was aware of the needs of the local population and took these into account in how the practice was run.

Patients could access treatment and urgent and emergency care when required. The practice provided patients with access to telephone interpreter services when required.

The practice had one ground floor treatment room and level access into the building for patients with mobility difficulties and families with prams and pushchairs via a rear entrance to the practice.

Well-led

No action required

Updated 7 April 2017

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

Effective leadership was provided by senior clinicians and empowered practice managers. The clinicians and practice manager had an open approach to their work and shared a commitment to continually improving the service they provided.

There was a no blame culture in the practice. The practice had robust clinical governance and risk management structures in place.

We saw evidence of systems to identify staff learning needs which were underpinned by an appraisal system and a programme of clinical audit. Staff working at the practice were supported to maintain their continuing professional development as required by the General Dental Council.

Staff told us that they felt well supported and could raise any concerns with the senior clinicians 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.