We carried out an announced comprehensive inspection on 22 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

Orchard Orthodontics is located in the London Borough of Croydon and provides orthodontic treatment to NHS and private patients. The practice opening hours were Monday 9.00 to 5.00pm, Tuesday 8.00 -6.00pm, Wednesday 8.00 -.5.00pm , Thursday 8.00 – 6.00pm and Friday 8.00- 5.00 pm and Saturdays by appointment 8.00- 4.00pm.

The premises consists of two treatment rooms which incorporate the decontamination facilities. The practice also had a waiting area.

The practice comprises of a principal dentist, two dental nurses, a trainee nurse, two orthodontic therapists, a business development manager, a private care executive manager and a receptionist.

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.

During the inspection we asked patients to complete CQC comment cards. We received 12 comment cards back from patients and spoke with three patients on the day of the inspection. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be caring, friendly and helpful and they were treated with care, dignity and respect.

Our key findings were:

• There were effective processes in place to reduce and minimise the risk and spread of infection.
• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE) .Patients were involved in their care and treatment planning.
• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
• Staff were trained in and there was appropriate equipment for them to respond to medical emergencies.
• Patients told us that staff were caring and treated them with dignity and respect.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• There were processes in place for patients to give their comments and feedback about the service including making complaints and compliments.
• There were good governance arrangements and an effective management structure.

There were areas where the provider could make improvements and should

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result

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People who use the service were given appropriate information and support regarding their treatment. People we spoke with confirmed they were involved in the discussions about their treatment and understood the treatment options available to them. One person told us, "Everything is explained. They gave me choices and showed me the different types of braces I could have."

We saw evidence that people’s needs were assessed in a variety of ways before treatment was delivered. People were satisfied with the standard of service delivered by the practice and with their treatment. People told us, "so far I'm happy with my treatment. I like that they send me a text to remind me about my next appointment." "They are good here. I'm happy."

We found there were effective systems in place to reduce the risk and spread of infection. Staff told us they felt supported by the management. We found that people were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

We reviewed several people's files, staff files and records relating to the management of the practice. We found the records were easily located, detailed, up to date and fit for purpose.