Archived: Total Orthodontics Horsham

Updated 27 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The inspection took place on 15 March 2017 was led by a CQC inspector who was supported by a specialist dental adviser.

Prior to the inspection, we asked the practice to send us some information that we reviewed. This included the complaints they had received in the last 12 months, their latest statement of purpose, and the details of their staff members including proof of registration with their professional bodies.

During the inspection, we spoke with the clinical lead, practice manager, dental nurses and receptionists and reviewed policies, procedures and other documents.

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 therefore formed the framework for the areas we looked at during the inspection.

Updated 27 April 2017

We carried out an announced comprehensive inspection on 15 March 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

Total Orthodontics is part of a group of specialist dental practice’s providing orthodontic treatment to children and adults on a referral basis (Orthodontics is a specialist branch of dentistry concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teeth and their function).

Orthodontic treatment is provided under NHS for children except when the problem falls below the accepted eligibility criteria. Private treatment is available for these patients as well as adults who require orthodontic treatment.

The practice is situated in a converted commercial property. The practice has a suite of treatment and consulting rooms and a separate decontamination room on the first floor of the building with a reception and waiting area on the ground floor.

The practice is open; Monday 8.30am – 6.30pm, Tuesday 8.30am – 5.00pm, Wednesday 8.30am – 4.30pm, Thursday 8.30am – 5.00pm, Friday 8.30am – 4.30pm, Saturday 9.00am – 1.00pm (one in four).

The practice has four orthodontists providing orthodontic care and are supported by three orthodontic therapists, four dental nurses, a practice manager, administrative staff and two receptionists.

The practice manager and the lead clinician are the registered manager’s. 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.

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 12 patients. These provided a completely 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.

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 clinical lead who was supported by an empowered practice manager.
• 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 robust 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 reported incidents and kept records of these which the practice used for shared learning.
• The orthodontists provided care in accordance with current professional guidelines.
• The practice had 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 provider and practice manager.