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Queensway Orthodontic Clinic Also known as Queensway Dental Clinic

Inspection Summary


Overall summary & rating

Updated 2 August 2018

We carried out this announced inspection on 11July 2018 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 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 that this practice was providing safe care in accordance with the relevant regulations.

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

Queensway Orthodontic clinic is in Billingham and provides NHS and private orthodontic treatment to adults and children. The orthodontic clinic is a sister practice to Queensway Dental clinic which is spread across two buildings; the main building and opposing “Crown” building. Each building has it’s own reception, waiting area, a dedicated sterilisation suite and patient facilities.

Queensway Orthodontic clinic is located on the upper floor of the “Crown” building and has five treatment rooms. There is level access for people who use wheelchairs and pushchairs. Patients who are unable to ascend the stairs can be seen in their Queensway dental clinic’s ground floor treatment room. Car parking spaces are available, including a multi-storey car park opposite the practice.

The practice provides solely orthodontic treatment to patients – through internal or external referral.

The dental team includes three specialist orthodontists, four orthodontic therapists, an orthodontic service manager, four receptionists, nine dental nurses, three sterilisation technicians, a governance manager, a patient treatment co-ordinator and a business administrative team.

The practice is owned by a partnership 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 managers at Queensway dental clinic are the principal specialist orthodontist and the governance manager.

On the day of inspection, we collected eight CQC comment cards filled in by patients which gave us a positive view of the practice.

During the inspection we spoke with the governance manager, a specialist orthodontist, the treatment advisor, two dental nurses, a sterilisation technician and reception staff.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Friday8.30am to 5.30pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The practice had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
  • The practice had systems to help them manage risks.
  • The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
  • The practice had staff recruitment procedures. The process for undertaking Disclosure and Barring Service (DBS) checks, monitoring immunisation status and other essential recruitment processes required reviewing.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • The appointment system met patients’ needs.
  • The practice had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • Staff well-being was evidently a large priority to the partners of the practice. Numerous health and well-being options were available to staff.
  • The practice asked staff and patients for feedback about the services they provided.
  • The practice dealt with complaints positively and efficiently.
  • The practice had suitable information governance arrangements.
  • The practice was providing preventive care and supporting patients to ensure better oral health in line with current guidelines.
  • Oral health talks were given to various groups (schools, dementia clinics) throughout the region.

We identified areas of notable practice.

  • Staff well-being was evidently a priority. Various measures for team building and learning were in place, as well as free access to support groups. In addition, physical aids were provided and exercise events such as yoga and walking also took place.
  • Dental nurses involved in orthodontic nursing and assistance were provided with a comprehensive training programme led by a senior dental nurse. This involved one-to-one training and discussion of orthodontic procedures. We saw a training matrix covering a wide range of orthodontic subjects, including an introduction to orthodontics, use of cephalometrics, taking and developing occlusal radiographs, taking photos, intra-oral scanning, retainers and orthodontic record keeping. Each dental nurse was provided with a full one-to-one presentation and ensured sufficient time to understand and develop in the field.

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

  • Review the practice's recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.
Inspection areas

Safe

No action required

Updated 2 August 2018

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

The practice had systems and processes to provide safe care and treatment. They used learning from incidents and complaints to help them improve.

Staff received training in safeguarding and knew how to recognise the signs of abuse and how to report concerns.

Staff were qualified for their roles and the practice completed essential recruitment checks. We found certain pre-employment procedures were inconsistent between staff members including immunisation status and DBS checks.

Premises and equipment were clean and properly maintained. The practice followed national guidance for cleaning, sterilising and storing dental instruments.

The practice had suitable arrangements for dealing with medical and other emergencies.

Effective

No action required

Updated 2 August 2018

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

The dental professionals assessed patients’ needs and provided care and treatment in line with recognised guidance. Patients described the treatment they received as professional and excellent. The dental professionals discussed treatment with patients so they could give informed consent and recorded this in their records.

The practice had clear arrangements when patients needed to be referred to other dental or health care professionals.

We identified two areas of notable practice within Queensway Orthodontic clinic in aspects of staff support and training provision.

The practice supported staff to complete training relevant to their roles and had systems to help them monitor this.

The staff were involved in oral health projects, quality improvement initiatives and peer review with other dental professionals as part of its approach in providing high quality care.

Caring

No action required

Updated 2 August 2018

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

We received feedback about the practice from eight people. Patients were positive about all aspects of the service the practice provided. They told us staff were kind, professional and extremely friendly.

They said that they were given helpful, honest explanations about dental treatment, and said their specialist orthodontist or orthodontic therapist listened to them. Patients commented that they made them feel at ease, especially when they were anxious about visiting the dental practice.

We saw that staff protected patients’ privacy and were aware of the importance of confidentiality. Patients said staff treated them with dignity and respect.

Responsive

No action required

Updated 2 August 2018

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

The practice’s appointment system was efficient and met patients’ needs. Patients could get an appointment quickly if in pain.

Staff considered patients’ different needs. This included providing facilities for disabled patients and families with children. The practice had access to face to face interpreter services and had arrangements to help patients with sight loss.

The practice took patients views seriously. They valued compliments from patients and responded to concerns and complaints quickly and constructively.

Well-led

No action required

Updated 2 August 2018

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

The practice had arrangements to ensure the smooth running of the service. These included systems for the practice team to discuss the quality and safety of the care and treatment provided. There was a clearly defined management structure and staff felt supported and appreciated. Each member of staff had a specific role or responsibility within the practice. This helped to support patient care and also encouraged staff to be involved in all practice duties. It was evident the skill mix within the practice was conducive to improving the overall outcome for patients.

The practice team kept complete patient dental care records which were, clearly written or typed and stored securely.

The practice monitored clinical and non-clinical areas of their work to help them improve and learn. This included asking for and listening to the views of patients and staff.