We carried out an announced comprehensive inspection on 19 January 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 Brace Place is an orthodontic dental practice based in Crosshills, North Yorkshire providing a specialist orthodontic service. The treatments, both NHS and private range from fixed aesthetic braces to clear aligner treatments. The service is provided by one orthodontist, an orthodontic therapist, three dental nurses and a receptionist. The practice has a ground floor surgery and a first floor surgery, a reception area, a waiting room on each floor, a decontamination room, an X-ray room and an easy accessible toilet. The staff room and office are located in the basement of the practice.

The practice is open:

Monday, Wednesday and Thursday 09:00 – 17:00

Tuesday 09:00 – 19:30

Friday 09:00 – 14:30

On the day of inspection we received 21 CQC comment cards that had been completed by patients. The two patients and their relatives we spoke with were very positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be very polite, flexible, excellent, professional and caring and they were always treated with dignity and respect.

Our key findings were:

• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding, recruitment and the management of medical emergencies.

• The orthodontist carried out an assessment in line with recognised guidance from the British Orthodontic Society (BOS).

• Patients told us they were treated with kindness and respect by staff. Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.

• Patients were able to make routine and emergency appointments when needed.

• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.

• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients.

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

• Review the practice audit protocols to document any learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013

• Review the recruitment policy in regards to Disclosure Barring Service (DBS) records for all new members of staff.

• Implement an external legionella risk assessment.

• Record fridge temperatures where dental materials are stored.

We talked with people who were receiving support and treatment for their orthodontic needs during our visit. They told us that they felt they were involved with all the decision making regarding their treatment and they were consulted about the options available to them. People also confirmed that good information was provided both initially and when their treatment was ongoing.

People also said that they were happy with the care and treatment they received. Comments made included, “My usual dentist referred me here this place is the best around for braces. I have been very happy with my treatment, been told what to expect and how much it will cost.” And “The dentist has explained things thoroughly and all the staff are really friendly and helpful.”

We saw that individual consent forms and medical histories had been completed and signed. We also saw that treatment records were regularly updated to reflect the changes in dental treatment.

We confirmed that procedures were in place to ensure that equipment was cleaned, decontaminated and sterilised. We also saw that suitable arrangements were in place to provide emergency first aid and resuscitation if needed.

Information on how to make a complaint was available to people who used the service. People confirmed that they felt able to raise any concerns they had directly with the dentist and staff if they needed to.