We carried out an announced comprehensive inspection on 2 September 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

Gants Hill Orthodontic Practice provides NHS and private orthodontic treatment (dental treatment which involves the improvement of the appearance and position of mal-aligned teeth) to patients of all ages in Gants Hill and the surrounding areas.

Practice staffing consists of the principal orthodontic specialist, who is also the owners/provider, two orthodontic therapists, three dental nurses, one receptionist and a practice manager.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual

registered person. 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.

The practice is open Monday Tuesday and Thursday 8.15am- 5.30pm, Wednesday 8.15am to 7pm,Fridays 9am to 4.30pm and Saturday 8am to 2pm

The practice facilities include two treatment rooms, an X-ray room, a reception and waiting area, a decontamination room and a staff room.

Forty-seven patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received and about the service. Patients told us that they were happy with the orthodontic treatment and advice they had received.

Our key findings were:

• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice investigated significant and safety events and cascaded learning to staff.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• There were systems in place to ensure that all equipment, including the suction compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment were maintained in line with manufacturer’s guidelines.
• The practice ensured staff were trained and that they maintained the necessary skills and competence to support the needs of patients.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients. The principal dentist told us that one complaint had been received about the service.
• The practice was well-led and staff felt valued, involved and worked as a team. Staff meetings were routinely held to help share information and learning.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical and non-clinical audits were carried out to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.

No patients were visiting at the time of our inspection so we were unable to seek anyone’s views on this occasion.

The surgery has a comments and suggestions box in the reception area and a clearly displayed sign on the notice board about how patients can make a complaint if they wish to.

We asked to see the records of four patients who had been examined by the orthodontist on the day prior to our visit. We found in each case that there were completed medical history updates and treatment plans.

The surgery operated a chaperone policy which required that the parent or guardian of each child that visits remained with them during their consultation and treatment.

We inspected the premises and noted that all areas of the practice, including the examination and treatment rooms were clean. All clinical staff were seen to be wearing clean uniforms.

We asked to see the records of maintenance checks for the x-ray machine, dental chairs, two autoclaves and ultrasonic bath. The records we looked at showed that the equipment had been routinely checked, maintained and kept safe for use.