St John's Wood Orthodontic Clinic

We carried out this announced comprehensive inspection on 15 May 2023 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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 dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which generally reflected published guidance. Improvements could be made to ensure sterilised, pouched instruments were appropriately dated prior to storage.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• Improvements were required with regard to the systems to manage risks for patients, staff, and the premises.
• 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. However, improvements were required to ensure all necessary information was available.
• Clinical staff provided patients’ care and treatment in line with current guidelines.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was effective leadership and a culture of continuous improvement.
• Staff felt involved, 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 practice had information governance arrangements.
• Quality assurance processes could be improved by ensuring radiographic audits were taken at regular intervals.

Background

St Johns Wood Orthodontics is in the London Borough of Westminster and provides NHS and private dental care and treatment for adults and children.

There is step free access to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 6 Orthodontists 3 dental nurses, 1 trainee dental nurse, 5 orthodontic therapists, 1 practice manager and 2 receptionists. The practice has 4 treatment rooms.

During the inspection we spoke with 1 Orthodontist 2 dental nurses, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday to Friday 9.00am- 5.00pm

Saturday 9.00am - 1.00pm

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

• Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.

• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular with regard to lone working risks.

• 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 in relation to fixed electrical wiring.

• Improve the practice’s infection control procedures and protocols 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 with regard to dating pouched instruments.