We carried out this announced inspection on 14 May 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

Orthodontics For You (Bromsgrove) Limited is in Bromsgrove and provides NHS and private orthodontic treatment to adults and children. Orthodontics is a specialist dental service concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teeth and their function. Orthodontic treatment is provided under NHS referral 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.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including several for blue badge holders, are available near the practice.

The dental team includes two dentists who are both specialist orthodontists, an orthodontic therapist who is also a qualified dental hygienist, three dental nurses, two receptionists, a treatment co-ordinator, a nurse manager and a practice manager. The practice has two treatment rooms. The provider also owns a practice in Solihull and the management team and principal dentist split their hours between both practices.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Orthodontics For You (Bromsgrove) Limited is the principal dentist.

On the day of inspection, we collected 26 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses, one orthodontic therapist, one receptionist, the nurse manager and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 8.30am to 5.30pm.

Tuesday from 8.30am to 5.30pm.

Wednesday from 8.30am to 5.30pm.

Thursday from 8.30am to 5.30pm.

Friday from 8.30am to 4.30pm.

Our key findings were:

• Effective leadership was provided by the principal dentist and an empowered management team.
• Staff we spoke with felt well supported by the principal dentist, nurse manager and practice manager. They were committed to providing a professional, friendly and high-quality service to their patients.
• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff. There was scope to strengthen the recording and monitoring of patient safety alerts.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Several team members including the safeguarding lead were trained to level three in safeguarding.
• The provider had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health. They routinely referred patients to their dental hygienist and orthodontic therapist through a clear care pathway.
• The appointment system took account of patients’ needs. The practice offered extended hours appointments opening early Monday to Friday from 8.30am.
• The provider had effective leadership and culture of continuous improvement. In-house training in basic life support and online core training were provided by the principal dentist.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided. Information from 26 completed Care Quality Commission (CQC) comment cards gave us an extremely positive picture of a professional, friendly, caring and high-quality service.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.