Updated 6 June 2019
We undertook a focused inspection of Osborne Orthodontics / Osborne Family Dentists – North Shields on 30 April 2019.
This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.
The inspection was led by a CQC inspector who was supported by a specialist dental adviser.
We undertook a comprehensive inspection of Osborne Orthodontics / Osborne Family Dentists – North Shields on 27 November 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care and was in breach of regulations 12, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can read our report of that inspection by selecting the 'all reports' link for Osborne Orthodontics / Osborne Family Dentists – North Shields on our website www.cqc.org.uk.
As part of this inspection we asked:
• Is it safe?
• Is it well-led?
When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvements were required.
Our findings were:
Are services safe?
We found this practice was providing safe care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breaches we found at our inspection on 27 November 2018.
Are services well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
The provider had made improvements in relation to the regulatory breach we found at our inspection on 27 November 2018.
Background
Osborne Orthodontics is in North Shields and provides NHS and private treatment to adults and children. Most of treatment provided within the practice is orthodontic although a small amount of general dentistry is also carried out. The dental practice is on the first floor of a shared building. Access to the first floor is via a staircase and this is made known to patients in the practice leaflet. Car parking spaces are available near the practice. There is one large treatment room with two dental chairs and an office area within. A decontamination and X-ray room are adjoined to the treatment room. There is a separate reception and waiting area.
The dental team consists of two principal dentists (one of whom is a specialist orthodontist), two dental nurses, a decontamination assistant, a practice manager who is also a qualified dental nurse, and two receptionists.
The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Osborne Orthodontics is one of the principal dentists.
During the inspection we spoke with one of the principal dentists, a dental nurse and the practice manager.
The practice is open for treatment between 9am and 8pm Monday to Saturday on a “by appointment only basis”.
We looked at practice policies and procedures and other records about how the service is managed.
Our key findings were:
- The practice had more efficient leadership in place.
- Medical emergency drugs and equipment were now available in accordance with national guidance.
- The systems to help manage risk to patients and staff had mostly improved. The provider had not implemented all of the recommendations from their fire risk assessment.
- The provider had improved their staff recruitment procedures. They needed to review their systems to make sure they undertook all required checks.
- The system to monitor staff training was not robust.
- Policies were re-written and updated where applicable.
- The practice had closed-circuit television (CCTV) on the premises; a policy had been created. There was no data protection impact assessment in place.
- Improvements were found in some of the practice’s audit and quality assurance processes; these were inconsistent.
- Most issues identified during our inspection on the 30 April 2019 were addressed promptly.
There were areas where the provider could make improvements. They should:
- Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.
- Review the practice’s protocols for ensuring that all clinical staff have adequate professional indemnity and immunity for vaccine preventable infectious diseases.
- Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.