We carried out an announced comprehensive inspection on 27 February 2017 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.

Cygnet Orthodontics is an orthodontic referral centre in Staines, Middlesex providing NHS and private orthodontic care and treatment. The practice is situated in a converted The practice is situated in a converted (domestic) grade II listed commercial property on the ground and first floor. It consists of three treatment rooms and a separate room which houses the panoramic dental and cephalometric X-ray machine.

The staff at the practice consist of two principal specialist orthodontists (one of whom is the registered manager), two associate specialist orthodontists, an orthodontic therapist, a trainee orthodontic therapist, a treatment co-ordinator, five dental nurses, three receptionists and a book-keeper.

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.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the orthodontists and orthodontic therapist took X-rays at appropriate intervals.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• During our visit we observed staff were positive, friendly, supportive and put patients at their ease.

• We reviewed 42 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection and were very positive. Common themes were patients felt they received excellent, friendly and informative care in a relaxed and hygienic environment from staff who were very caring, polite and very happy to answer any questions.

• There was an effective system in place to act on feedback received from patients and staff.
• There were systems in place to assess, monitor and improve the quality of service provided.

We carried out an inspection at Cygnet Orthodontics to look at the care and treatment provided to patients who used the service. During the visit we interviewed three patients and observed three treatment sessions. We spoke with four members of staff who worked at the practice and reviewed six patient's records.

The patients we spoke with were very happy with the practice. They told us “They are very good here.” They told us staff ensured they had given their consent to care and treatment in advance.

People told us that the premises were always clean and that staff were seen to wear gloves when they carried out procedures.

None of the people we spoke with had any complaints about the practice. They told us they felt they could speak to the staff if they needed to.