We carried out an announced comprehensive inspection on 20 August 2015 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.

Leamington Spa Orthodontics provides mainly NHS orthodontic treatment for children and young people up to the age of 18. They also provide private treatment for adults and children. The practice is situated in the centre of Leamington Spa in a five storey listed period property. The practice is approved as an outreach training centre by the University of Warwick, the General Dental Council and the National Examining Board for Dental Nurses and has Investors in People status. The practice is part of the British Dental Association Good Practice scheme. The business is operated by a private limited company which has one director who is also the registered manager with CQC. 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.

The practice has a large clinical team of orthodontists, orthodontic therapists, a dental hygienist and orthodontic nurses. The clinical team is led by the registered manager, an experienced and well qualified orthodontic specialist. They are supported by a team of practice co-ordinators and support staff. The practice has six treatment rooms with eight dental chairs and a decontamination room for the cleaning, sterilising and packing of dental instruments. The reception area and waiting room are on the ground floor. Access for patients with restricted mobility is available through the back entrance of the building and a ground floor treatment room is available for patients unable to go upstairs.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 38 completed cards and spoke with a young person and their parent during the inspection. Patients were complimentary about all aspects of the care and treatment they and their families received and many said they recommended the practice to other people.

Our key findings were:

• The practice had systems for dealing with significant events and accidents and staff understood their responsibilities for providing a safe service.
• The practice was visibly clean and had processes to help staff manage infection prevention and control effectively.

• The practice had systems, medicines and equipment for the management of medical emergencies and staff were trained to know how to deal with these. The practice had oropharyngeal airways, but did not keep these in the emergency oxygen kits. This had been recommended by their specialist external  medical emergencies trainer because staff were not sufficiently trained in how to use them.

• The practice had safeguarding processes and staff understood their responsibilities for safeguarding adults and children.

• The practice undertook the required employment checks on new staff.

• Clinical records included the essential information expected about patients’ care and treatment including treatment plans and consent to care and treatment.

• The practice was committed to staff education and development. Staff received training appropriate to their roles and were encouraged and supported in their continued professional development (CPD).

• The practice received very few complaints but had a clear system for handling and responding to these.

• Patients who completed Care Quality Commission comment cards were pleased with the care and treatment they or their family member received and were complimentary about the whole practice team.

• The practice had well organised governance and leadership arrangements and an open door policy which made staff feel valued and listened to.

• The practice had open and supportive leadership and staff were happy, professional and enthusiastic.

We found an area where the provider could make improvements and should:

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

On the day of our visit, we spoke with the principal dentist, dental nurses, reception staff, and other staff at the practice.

Following our visit, we spoke with four people by telephone who were registered with the practice to ask them about their experiences of the service.

People that used the practice were very positive about their experiences with the dental practice. They said they had been given the information needed to make an informed decision about treatment.