Trinity Gate Orthodontics

We carried out this announced comprehensive inspection on 1 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. The system of checks of medical emergency equipment and medicines were not effective.
• 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

Trinity Gate Orthodontics is in Worcester and provides NHS and private dental care and treatment for adults and children.

The provider was unable to provide step free access to the practice due to building constraints. However, staff had made reasonable adjustments, including a stairlift to access the accessible toilet and a radiography suite on the lower ground floor for patients with access requirements. Staff had carried out a disability access audit and had formulated an action plan to continually improve access for patients.

The dental team includes 1 orthodontist, 1 dentists, 2 dental nurses (including 1 trainee nurse), 1 orthodontic therapist, 1 practice manager, 1 receptionist and 1 administrator. The practice has 3 treatment rooms.

During the inspection we spoke with 1 orthodontist, 1 dentist, 1 orthodontic therapist, 1 nurse and the receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open: Monday to Thursday from 9am to 5pm and Friday from 8.30am to 4.30pm.

There were areas where the provider could make improvements. They should:

• Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK).
• Take action to ensure audits of record keeping are undertaken at regular intervals to improve the quality of the service.