Orthodontics Exclusively

We carried out this announced focused inspection on 28 April 2022 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 adviser.

To get to the heart of patients’ experiences of care and treatment, we usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic was visibly 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 mostly available. The provider sent us evidence they had ordered the missing items following our inspection.
• The practice had systems to help them manage risk to patients and staff.
• 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.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff 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.
• There was effective leadership and a culture of continuous improvement. However, the infection prevention control and radiography audits were not completed every six months as required.
• Staff felt involved and 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 dental clinic had information governance arrangements.

Background

Orthodontics Exclusively is in Birmingham and provides NHS and private orthodontic dental care and treatment for adults and children.

There is level 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 additional needs, taking into consideration the limitations of the building. For example, a portable ramp is available for the entrance steps and a rear access to a downstairs surgery with a single step if required.

The dental team includes one dentist, one specialist, one orthodontic therapist, three qualified dental nurses, two trainee dental nurses and one receptionist. The practice has three treatment rooms.

During the inspection we spoke with one dentist and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday from 9am to 1pm and from 2pm to 6pm
• Tuesday to Thursday from 9am to 1pm and from 1.45pm to 5.30pm
• Friday by appointment only
• Saturday Closed

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

• Take action to ensure the availability of equipment in the practice to manage medical emergencies considering the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Take action to ensure audits of radiography and infection prevention and control are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.