We carried out an announced comprehensive inspection on 20 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

Southover Orthodontics Limited is located in the London Borough of Barnet and provides NHS and private orthodontic treatment to both adults and children. The premises are on the ground floor and consist of a consultation room, two treatment rooms, an X-ray room, a reception area and a dedicated decontamination room. The practice is open Monday to Thursday 9:00am – 6:00pm, Friday 9:00am – 2:00pm and one Saturday per month 9:00am – 1:00pm.

The staff consists of the principal dentist, an orthodontic therapist, two dental nurses, a treatment coordinator and two receptionists.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

We reviewed 21 CQC comment cards, the NHS Friends and Family test and the practice patient satisfaction survey. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staffs understand how to minimise risks associated with the use of and handling of these substances.
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the protocols and procedures for use of X-ray equipment taking into account guidance notes on the Safe use of X-ray Equipment. 

People commented that they felt that the treatment had been explained to them and that they knew what to expect. People told us that “Dr Cooper is very good at managing expectations and explained how long the treatment would take and what it entailed”.

People commented very positively on the care they received from their orthodontist. People told us that staff were “very good” and that they were happy with the service they had received. One person told us that they were “9 ½ out of 10 happy with the service” and had no issues. Another person told us that the orthodontist was “very thorough” and that they would recommend the service to others.

A person using the service commented that they felt comfortable and that Dr Cooper made them feel at ease. People using the service commented that they felt they would be able to raise concerns if they needed to.

All areas of the practice were clean and hygienic during our visit. People commented positively on the cleanliness of the practice and described the standards as “very good” and “clean, very clean”.