The Orthodontic Practice

We carried out this announced comprehensive inspection on 27 September 2022 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 practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission, (CQC), inspector who was supported by a specialist dental adviser.

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:

• The orthodontic clinic was visibly clean and well-maintained.
• The orthodontic clinic had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available although these needed to be reviewed.
• The orthodontic clinic had systems to help them manage risk to patients and staff.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The orthodontic clinic had staff recruitment procedures which reflected current legislation.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect and staff took care to protect their privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The orthodontic clinic had information governance arrangements.

Background

The Orthodontic Practice is in Derby and provides mainly NHS orthodontic care and treatment for adults and children.

There is level access to the orthodontic clinic for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the orthodontic clinic. Adjustments to support patients with additional needs included having an accessible toilet and wide doors within the orthodontic clinic.

The dental team includes 1 orthodontist, 1 orthodontic therapist, 3 dental nurses (one of whom is also the practice manager), 1 receptionist and an off-site administrator. The practice has 1 treatment room which contains 3 dental chairs.

During the inspection we spoke with the orthodontist, 1 dental nurse 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 8:30am to 5pm.

There were areas where the provider could make improvements. They should:

• Take action to ensure the availability of equipment in the orthodontic clinic to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Improve the orthodontic clinic's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.