We carried out an announced comprehensive inspection on 21 July 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 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

Barnet Orthodontic Practice is located in the London Borough of Barnet and provides NHS and private orthodontic treatment to both adults and children. The premises are on the first floor and consist of two treatment rooms, a consultation room, an X-ray room and a reception area. The practice is open Monday to Thursday 8:30am – 5:00pm and Friday 8:30am – 4:30pm.

The staff consists of the principal dentist, an associate dentist, three dental nurses, an administrator and a receptionist.

The principal dentist is the registered manager. 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.

We reviewed 50 CQC comment cards, the NHS Friends and Family test comment cards and spoke with three patients. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.
• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

People who used the service understood the care and treatment choices available to them. Written treatment plans were provided as well as video animations for younger patients. We saw that patient care was assessed and documented. New patients were asked to complete a confidential medical history questionnaire which was updated every six months or before a treatment.

Staff knew the names of local child protection safeguarding contacts and were able to describe possible signs of abuse. Treatment rooms had guidance leaflets to help staff recognise child abuse and take appropriate steps if child abuse or neglect was suspected.

There were effective systems in place to reduce the risk and spread of infection. We saw that the reception area, treatment rooms and decontamination areas were clean and clutter free. All the people we spoke with were positive about the cleanliness of the surgery. Staff attended annual infection control and prevention training which enabled them to provide care and treatment to patients safely and in a way that minimised infection risks.

None of the people we spoke with expressed concerns about the accuracy or confidentiality of patient records. The provider told us that consent forms were obtained for new courses of treatment and for x rays.