We carried out an announced comprehensive inspection on 22 June 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

Epsom Orthodontics is a specialist dental practice providing orthodontic treatment to children and adults mainly on a referral basis (Orthodontics is a specialist service of dentistry concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teethand their function). Orthodontic treatment is provided under NHS regulations for children except when the problem falls below the accepted eligibility criteria for NHS treatment. Private treatment is available for these patients as well as adults who require orthodontic treatment. The practice is situated in a converted listed building. The practice has a suite of six treatment cubicals and a separate decontamination room for cleaning, sterilising and packing dental instruments on the first floor of the building with a reception and waiting area on the ground floor. The first floor treatment area can be accessed by a lift for those patients and their carers who have mobility problems. Adjacent to the treatment area are two ‘safe haven rooms which are used for discussing treatment with patients prior to the commencement of treatment. These rooms can also be used by patients and staff to discuss matter of a rather sensitive nature therefore protecting the dignity and confidentiality of the patient.

The practice opening hours are 8.30am - 5.00pmMonday to Thursday and Fridays 8.30am – 12.30pm. The practice has five dentists providing orthodontic care and are supported by four orthodontic therapists, six dental nurses, a practice manager, a treatment co-ordinator and two administrative staff and two receptionists.

The practice manager 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 11 patients. These provided a completely positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

Our key findings were:

• We found that the practice ethos was to provide patient centred quality orthodontic care.
• Strong and effective clinical leadership was provided by the provider who was supported by an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared very clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• Staff understood how to report incidents and keep records for shared learning.
• The orthodontists provided care in accordance with current professional guidelines.
• The practice had fully embraced the concept of skill mix to assist in the delivery of effective orthodontic care to patients.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff recruitment files were organised and complete.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the management team.
• Staff we spoke with felt well supported by the management team and were committed to providing a quality service to their patients.
• Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.

We found that patients at this practice were treated with dignity and respect.

Patients all told us they fully understood the various stages of their orthodontic treatment and felt fully informed because the dentist had explained their treatment to them.

We observed the premises were fit for purpose and clean. All of the patients we spoke with told us the premises were clean.

We found the practice followed best practice in the decontamination of dental instruments so that patients can be confident that instruments are cleaned effectively.

Staff told us they were fully supported in obtaining the relevant training. We observed the staff training files which confirmed this.

Records were well maintained and stored securely so patients can be confident that their personal information is stored securely.