We carried out this announced inspection on 02 October 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 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 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

Beckenham Orthodontic Centre is based in the London Borough of Bromley and provides NHS and private orthodontic treatment to patients of all ages.

The practice is located on the ground, first and second floors of a converted building and has five treatment rooms. There is step-free access to the premises available via a portable ramp for wheelchair users. There is parking available for patients on the premises.

The dental clinical team includes two principal orthodontists, two associate orthodontists, five orthodontic therapists (one of whom was a locum at the time of the inspection), eight orthodontic nurses (some of whom also undertook receptionist and finance management duties), and two decontamination assistants. The dental clinical team is supported by a receptionist and information technology personnel, an administrator, an area manager, a practice coordinator, a patient care coordinator, two secretaries (one of whom also undertook receptionist duties), and a laboratory worker.

The practice is owned by an organisation 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 manager at Beckenham Orthodontic Centre was the practice coordinator.

On the day of inspection, we obtained feedback from 20 patients.

During the inspection we spoke with the area manager, the practice coordinator, the two secretaries, a receptionist, the principal orthodontists, an orthodontic therapist, and a decontamination assistant. We checked practice policies and procedures and other records about how the service was being managed.

The practice is open at the following times:

Mondays, Tuesdays, Thursdays and Fridays: 8am-6pm

Wednesdays: 8am-7pm

Saturdays: 9am-1pm once a month only

Our key findings were:

• The practice appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice had suitable information governance arrangements.

There are areas in which the practice could make improvements. They should:

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to staff commencing employment at the practice.
• Review staff training in medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team, and review the competence of non-clinical staff in setting up the for use oxygen in medical emergencies.