We carried out an announced comprehensive inspection on 2 March 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

Heaton Mersey Orthodontic Centre is located in converted shop premises on Didsbury Road in the Heaton Mersey area of Stockport. The centre provides both NHS and private treatment to young people under 18 years of age and private treatment to adults. There are seven treatment rooms in total the three on the ground floor have wheelchair access. There is a consultation room where treatment options are discussed, a waiting area/reception, call centre, adapted toilet facilities, a separate waiting room for private patients, a dedicated decontamination room and an X-ray room on the ground floor. The remaining treatment rooms are located on the first floor of the building.

The staff team consists of two principal orthodontists (the owners), two orthodontic therapists, a head nurse/private treatment coordinator, six dental nurses, a lead receptionist/private treatment coordinator three receptionists, a sterilisation clerk and a practice manager.

One of the two principal orthodontists 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.

We received positive feedback about the service from 15 patients. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had an automated external defibrillator and medical oxygen available on the premises.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.
• Governance arrangements were in place for the smooth running of the practice.
• There was an effective complaints system.
• Infection control procedures were in accordance with the published guidelines.
• Staff had received safeguarding training, knew how to recognise signs of abuse and were aware of the reporting process.
• There was evidence of recent clinical audit being undertaken at the dental practice.
• Appropriate recruitment processes and checks were undertaken in line with the recruitment policy and procedure.
• It was practice policy to obtain a Disclosure and Barring Service check for all staff.
• There were clearly defined leadership roles within the practice and staff told us they felt supported and comfortable to raise concerns or make suggestions.
• There was a comprehensive staff appraisal system in place.
• Options for treatment were identified, explored and discussed with patients.
• Patients feedback indicated that staff were polite, caring and treated them with dignity and respect.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD).
• The practice is a member of the British Dental Association (BDA) Good Practice Scheme.
• There were areas where the provider could make improvements and should:
• Ensure all staff are fully aware of the procedures to follow in the event of a needle stick injury.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.