We carried out this announced inspection on 30 October 2017 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.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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

Dolphin Orthodontics is in Cosham and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including for patients with disabled badges, are available near the practice.

The dental team includes one orthodontist, one dental nurse and one receptionist. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 20 CQC comment cards filled in by patients and spoke with 8 other patients. This information gave us a positive view of the practice.

During the inspection we spoke with one orthodontist, One dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am to 5:30pm.

Our key findings were:

• The practice was 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 risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough 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 appointment system met patients’ needs.
• The practice had effective leadership. 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 dealt with complaints positively and efficiently.

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

• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as record keeping and infection prevention and control are undertaken at regular intervals to help improve the quality of service. The practice should also ensure, that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

At our last inspection of this service on 2 October 2013 we found that the provider could not be assured that their decontamination room and procedures followed the guidance set out in the Department of Health guidance on decontamination in dental services, HTM01-05. This guidance aimed to raise the quality of decontamination in dental primary care.

We carried out this visit to confirm the improvements that the provider told us about had been made.

During this visit we spoke with the dentist and the practice nurse. We looked at the decontamination room and records relating to daily and monthly checks made of cleaning the surgery, instruments and equipment.

The provider had completed an action plan which outlined the improvements that had been made and we saw that patients were protected from the risk of infection because appropriate guidance had been followed.

People told us they were satisfied with the care and treatment they received. One person commented, "I am very pleased with this dentist, I have been pleased with my orthodontic treatment so far.”

People said the dentist consulted with them before proceeding with any treatment. One person told us that they were informed of all the options available to them regarding their treatment.

Patients commented on the cleanliness of the practice. We found the practice very clean and tidy and free from clutter. One patient said "I can't fault the cleanliness". We spoke with ten patients and nine of them told us they would recommend the practice to their family or friends. One patient said "I would definitely recommend the practice to anyone". However, another patient told us they were not happy with the treatment and would not recommend this orthodontist.