We carried out this announced inspection on 30 January 2018 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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

Regent Orthodontics is in Bradford and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and pushchairs. The practice has a dedicated car park for patients and staff.

The dental team includes two orthodontists, five dental nurses, one orthodontic therapist, two receptionists and a practice manager. The practice has a four chair clinic, two treatment rooms, a discussion room, a photo room and an X-ray room.

The practice is owned by an individual who is the principal orthodontist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 50 CQC comment cards filled in by patients or their parents / guardians. This information gave us a positive view of the practice.

During the inspection we spoke with one orthodontist, four dental nurses, two receptionists 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 to Thursday from 8:00am to 5:00pm

Friday from 8:00am to 1:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures. Improvements could be made to the process for storing clean instruments.
• Staff had completed training in how to deal with medical emergencies. The process for checking emergency equipment could be improved.
• The practice’s approach towards risk management of sharps and Legionella could be improved.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Not all staff had completed level two safeguarding training.
• The practice’s staff recruitment procedures could be improved.
• 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.
• The appointment system met patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the system for identifying and disposing of out-of-date equipment.
• Review the safeguarding training of staff ensuring they are trained to an appropriate level.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice's recruitment policy and procedures to ensure Disclosure and Barring Service (DBS) are requested and recorded suitably.