Buckingham Gate Orthodontics

We carried out this announced inspection on 9 March 2020 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Buckingham Gate Orthodontics is in Westminster and provides private orthodontic dental care for adults and children.

There is lift access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice.

The dental team includes one principal dentist, 20 dentists, and two dental nurses, and two receptionists. The practice has seven treatment rooms.

The practice is owned by a company 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 Buckingham Gate Orthodontics is one of the practice owners.

On the day of inspection, we collected 31 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, both the dental nurses, one of the practice owners (who was the registered manager) and the practice compliance consultant. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open

Monday -Friday 10.00am – 7.00pm

Saturday 10.00am – 2.00pm

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance. However, improvements were required in regards to the use of protective equipment.
• 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 safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines. However, improvements were required in regards to record keeping.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Implement protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
• Take action to ensure the clinicians take into account the guidance provided by the Faculty of General Dental Practice when completing dental care records.
• Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ in particular in regards to the cleaning of instruments.
• Take action to ensure audits of radiography and infection prevention and control have documented learning points and the resulting improvements can be demonstrated.