The patients we spoke with were happy with the treatment they received from the practice. They said they had been given the information needed to make an informed decision about treatment. People had received the aftercare advice they needed. We were given positive feedback about the approach of all of the staff.

We carried out an announced comprehensive inspection on 14 February 2017 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

Mr Alan Davey is a specialist orthodontics practice providing NHS and private treatment for both adults and children. The practice is based in Oxford city centre.

The practice has three dental treatment rooms of which one is based on the ground floor and a separate decontamination area used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility via the rear of the building.

The practice employs two specialist orthodontists, one dentist, one orthodontic therapist, two nurses, one receptionist and two practice managers.

The practice’s opening hours are between 8.30am and 5.30pm from Monday to Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an on call dentist and an out-of-hours service, via 111.

A specialist orthodontist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 36 patients. These provided a positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

We obtained the views of 11 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred quality orthodontic care.
• Strong and effective clinical leadership was provided by the provider who was supported by empowered practice managers.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared very clean and well maintained.
• Infection control procedures were effective and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• Staff understood how to report incidents and keep records for shared learning.
• The orthodontists provided care in accordance with current professional guidelines.
• The practice had fully embraced the concept of skill mix to assist in the delivery of effective orthodontic care to patients.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff recruitment files were organised and complete.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the management team.
• Staff we spoke with felt well supported by the management team and were committed to providing a quality service to their patients.
• Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.

There were areas where the provider could make improvements and should:

• Consider providing an annual statement in relation to infection prevention control required under The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the availability of hearing loops for patients who are hearing aid wearers.

• Review the systems around fire safety ensuring that the fire drill is timed and revisit the practice fire safety risk assessment with a view to reviewing emergency lighting and the fire door in the basement.

• Review staff recruitment procedures to ensure that references of prospective employees are followed up.