No 1 The Orthodontic Specialists

We carried out this announced comprehensive inspection on 8 November 2023 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 practice 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

No 1 The Orthodontic Specialists is in Derby and provides NHS and private orthodontic treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 2 orthodontists, 5 dental nurses, 3 orthodontic therapists (1 of whom is a trainee), 2 treatment coordinators, 2 receptionists and 1 practice manager. The practice has 3 treatment rooms.

During the inspection we spoke with 2 orthodontists, 3 dental nurses, 1 orthodontic therapist, 1 treatment coordinator, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday, Thursday and Friday from 8.30am to 3.30pm

Tuesday and Wednesday from 9am to 6pm

• We identified an area of notable practice in relation to providing person centred care. For example, following completion of a disability access audit, the provider identified that the majority of patients with additional communication requirements preferred to use bespoke applications to aid communication. The provider had purchased an additional iPad tablet and downloaded these applications to allow patients to communicate in their preferred manner.

• The practice had taken steps to improve environmental sustainability. For example, toothbrushes and mouthwash containers dispensed by the practice were mostly recyclable. Printing was kept to a minimum, lights were operated by sensors to reduce energy wastage and the packaging for instruments was separated into its paper and plastic components and both were recycled.