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Inspection Summary


Overall summary & rating

Updated 8 February 2019

We carried out this announced inspection on 30 January 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 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 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

Petts Wood Orthodontics is in Petts Wood, Orpington, and provides NHS and private orthodontic treatment to adults and children.

There is level access via a lift and a portable ramp for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes two specialist orthodontists, three dental nurses and a practice manager. The practice has one treatment room.

The practice is owned by a partnership between the two orthodontists, and as a condition of registration must have a person registered with the CQC 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 Petts Wood Orthodontics is one of the orthodontists.

On the day of inspection, we collected 32 CQC comment cards filled in by patients. We also obtained feedback from the practice’s practice surveys and thank you cards.

During the inspection we spoke with an orthodontist (the registered manager), the head dental nurse, and the practice manager. We checked practice policies and procedures and other records about how the service is managed.

The practice is open at the following times:

Our key findings were:

  • The provider appeared 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.
  • 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 were providing preventive care and supporting patients to ensure better oral health.
  • Staff received appropriate training and this was regularly reviewed.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system took account of patients’ needs.
  • The provider had made adjustments to accommodate patients with enhanced needs, such as wheelchair users, those with hearing difficulties, and patients who had problems with their vision.
  • The provider valued feedback from staff and patients about the services they provided. They had processes to enable them to deal with complaints positively and efficiently.
  • The provider had suitable information governance arrangements. Policies were suitable and regularly updated.
  • Staff felt involved and supported and valued, and worked well as a team.
  • The provider had effective leadership and a culture of continuous improvement.
Inspection areas

Safe

No action required

Updated 8 February 2019

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents to help them improve.

Staff received training in safeguarding people and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

Effective

No action required

Updated 8 February 2019

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

The orthodontists assessed patients’ needs and provided care and treatment in line with recognised guidance. The orthodontists discussed treatment with patients so they could give informed consent and recorded this in their records.

Patients described the service they received as professional, excellent and outstanding. They said staff explained things clearly and in an informative way.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

The provider supported staff to complete training relevant to their roles and had systems to help them monitor this.

Practice staff were involved in quality improvement initiatives such as a national ‘good practice’ certification scheme as part of its approach in providing high quality care. The practice participated in Peer Assessment Rating (a statutory requirement for NHS orthodontic providers developed by the British Orthodontic Society) to assess the standard of their orthodontic treatments; they had made improvements to the quality and effectiveness of their treatments.

The practice team kept complete patient dental care records which were, clearly written, or typed.

Caring

No action required

Updated 8 February 2019

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

We received feedback about the practice from 32 people. Patients were positive about all aspects of the service the practice provided. They told us staff were kind, caring, helpful and attentive. They commented that staff made them feel comfortable and confident. Parents told us staff were sensitive to the needs of their children who attended for treatment.

Patients said they were given clear information about their care and treatment, and said orthodontist listened to them.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 8 February 2019

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

The practice’s appointment system took account of patients’ needs. Patients could get an appointment quickly if they were experiencing a dental emergency.

Staff considered patients’ different needs. This included providing facilities for patients with impaired mobility, and families with children. The practice had access to interpreter services and had arrangements to help patients with sight or hearing loss.

The practice took patients views seriously. They valued compliments from patients and had arrangements in place to enable them to respond to concerns and complaints efficiently.

Well-led

No action required

Updated 8 February 2019

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided.

There was a clearly defined management structure and staff felt supported and appreciated.

The provider monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for, listening and responding to the views of patients and staff. They had carried out a wide range of audits which had led to improvements of the service.