Melton Orthodontics Nottingham Street

We carried out this announced focused inspection on 22 June 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 usually ask five key questions, however due to the ongoing COVID-19 pandemic and to reduce time spent on site, only the following three questions were asked:

• Is it safe?

• Is it effective?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic appeared to be visibly clean and well-maintained.
• The practice had infection control procedures which reflected published guidance. We found these were not always implemented.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were not always available as recommended.
• The practice had systems to help them manage risk to patients and staff. We found these were not always implemented effectively or following guidance.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice 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.
• Leadership and governance and oversight were not always effective.
• Staff felt involved and supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• The dental clinic had information governance arrangements.

Background

The provider has one practice and this report is about Melton Orthodontics Nottingham Street.

Melton Orthodontics Nottingham Street is in Melton and provides private orthodontic treatment for adults and children.

There is level access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for people with disabilities, are available near the practice. The practice has made some reasonable adjustments to support patients with additional needs.

The dental team includes four dentists, two of whom are orthodontic specialists, four dental nurses, one orthodontic therapist, a practice manager and two receptionists. The practice has four treatment rooms.

During the inspection we spoke with two dentists, three dental nurses, one receptionist 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 Friday from 8.15am to 4.15pm

Every other Tuesday and Wednesday from 8.15am to 6.30pm

One Saturday per month from 8.30am to 12.30pm

We identified regulations the provider was not complying with. They must:

Take action to ensure audits of radiography and infection prevention and control are undertaken at regular intervals and follow recommended guidance, to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

Full details of the regulation the provider was not meeting are at the end of this report.

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

Take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, ensure that monthly water temperature checks of sentinel taps are recorded as per the legionella risk assessment.

Take action to ensure the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular, a satisfactory fixed wire electrical safety certificate was not available.