We carried out an announced comprehensive inspection on 11 November 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

The practice is located within a purpose adapted residential dwelling in Chelmsford, Essex and offers orthodontic treatments (dental treatment which involves the improvement of the appearance and position of mal-aligned teeth) by referral only.

The practice is open between 7.40am and 4.45pm on Mondays, Tuesdays and Wednesdays, between 7.40am and 5.15pm on Thursdays and between 7.40am and 1.40pm on Fridays.

The practice employs one specialist orthodontist, two orthodontic therapists, one qualified dental nurse and one trainee dental nurse. The dental team are supported by a practice manager, a treatment coordinator and a receptionist.

The practice is registered with the Care Quality Commission (CQC) as an organisation. The practice has a registered manager. 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 three treatment rooms, a combined waiting room and a reception area. Decontamination takes place in a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are brought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

We received feedback from 12 patients who completed CQC comment cards prior to our inspection visit. We also spoke with five patients during our inspection visit. Patients made positive comments about the excellent care and treatment that they received. They also commented positively about the cleanliness of the premises, the kindness and responsiveness of staff. Patients told us that staff explained treatment plans to them in a way that they could easily understand. Patients reported that they could access appointments that suited them including on the same day for emergency treatment.

Our key findings were:

• The practice had systems in place for investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults. Staff had undertaken training and were aware of their roles and responsibilities in relation to this.
• Risks to the health, welfare and safety of patients and staff were regularly assessed and managed. These included risks in relation to fire, legionella and risks associated with premises and equipment.
• The practice reviewed and followed guidance in relation to orthodontic dentistry.
• The practice had the recommended medicines and equipment for use in the event of a medical emergency and staff were trained in their use. Records were maintained in respect of the checks carried out for these medicines and equipment.
• Staff were supported, supervised and undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were treated with respect and that staff were polite and helpful.
• Patients were involved in making decisions about their care and treatments.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services. Learning from audits and reviews was shared with relevant staff and action plans were developed to secure improvements where these were identified.
• Patients' views were sought and these were used to make improvements to the service where these were identified.

Following our visit to the service we spoke with four parents of children who attended the practice for orthodontic treatment. Everybody we spoke with told us that they had received an excellent service from Orthoworld Chelmsford. They all told us that the staff were very polite and helpful.

All the people spoken with told us that they felt very involved in their care and treatment. The parents we spoke with all told us that the dentists took time to give their children a clear explanation and information about what was going to happen and ensured that their child understood the processes of their treatment and why they were receiving it.

All the people spoken with told us that they had always found the surgery to be clean and tidy on their visits.

Nobody had experienced any difficulties in getting an appointment. One person told us that the practice was very caring and responsive to seeing their child between routine treatment appointments. They also told us that the practice was very quick to respond to emergency treatment requests. Another person told us that they were very pleased to have received emergency treatment on the same day that it had been requested.