West Face Orthodontics

Updated 18 May 2016

We inspected West Face Orthodontics on 17 March 2016. The inspection was led by a CQC inspector who was accompanied by a specialist advisor.

Before the inspection, we reviewed all the information we held. This included the last inspection report dated May 2012, at which a legal requirement was made. The practice had provided an action plan demonstrating that staff had since received training about safeguarding procedures. Pre-inspection information was sent by the principal orthodontist and included details to confirm that no written complaints had been received, and provided staff information and the current statement of purpose outlining the aims of the service.

We informed NHS England area team that we were inspecting the practice. They confirmed that this practice was not an outlier (needing closer monitoring) and they had received no concerning information about it.

The methods that we used at this inspection included: talking to six people using the service, their relatives / friends, interviewing staff, observations, review of documents and 49 comment cards from patients.

The practice provides both private and NHS orthodontic services.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 18 May 2016

We carried out an announced comprehensive inspection on 17 March 2016 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 regulation.

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

CQC inspected the practice on 22 May 2012 and asked the provider to make improvements in the training provided to staff about safeguarding vulnerable adults and children. We checked these areas as part of this comprehensive inspection and found this had been resolved.

West Face Orthodontics, is a private dental practice which also treats NHS patients.  The practice receives self referrals and referrals from dental professionals such as a patient's own dentist, for second opinion or treatment planning. The practice specialises in orthodontics treating patients with bite problems and improvement of teeth aesthetic and appearance. The orthodontist works with other dental specialists to move teeth to the correct position to accommodate prosthetics such as implants and bridges to replace missing or absent teeth. The practice is situated in a converted domestic dwelling situated in the centre of St Austell, Cornwall. The practice has two dental treatment rooms, an x-ray room and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The practice operates over two floors. The provider is the only orthodontist working at the practice and is supported by two dental nurses, and a receptionist. The practice’s opening hours are 8.30 am  to 1 pm and 2pm to 4 pm Monday to Thursday.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual.

A registered manager is a person who is registered with the Care Quality Commission 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 collected 49 completed cards and obtained the views of six patients on the day of our visit. These provided a positive view of the services the practice provides. All of the patients commented that the quality of care was good.

We carried out an announced comprehensive inspection on 17 March 2016 as part of our planned inspection of all dental practices. Our inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• The practice ethos was to provide high quality patient centred care at all times.
• Staff had been trained to handle emergencies and appropriate medicines were readily available in accordance with current guidelines.

• The practice was clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a dedicated safeguarding lead professional and effective safeguarding process in place for safeguarding adults and children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The orthodontist and dental nurses provided specialised orthodontic services in accordance with current professional guidelines.
• 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, urgent and emergency care when required.
• The practice had an orthodontist who provided a range of more specialised orthodontic services, which is a special part of dentistry that deals with straightening teeth and influencing bone growth.  There were enough supporting staff to deliver the services on offer.
• Staff had received training appropriate to their roles and were supported in their continuing professional development.
• Staff we spoke with felt well supported by the practice owner who was committed to providing a quality service to their patients.
• Information from 49 completed CQC comment cards and six patients who were asked for their views of the service on the day of our visit gave us a positive picture of a friendly, caring and professional service.

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

• Review availability of equipment such as an automated external defibrillator (AED), to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure data sheets are obtained so that staff understand how to minimise risks associated with the use of and handling of these substances.
• Review and update the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

A month after the inspection the provider sent us evidence demonstrating that all of the above issues had been addressed.