Archived: West House Orthodontic Practice

Updated 5 August 2016

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 28 June 2016 and was led by a CQC Inspector assisted by a dental specialist adviser.

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

During the inspection we spoke to the dentists, a orthodontic therapist, dental nurses and a receptionist. We reviewed policies, protocols and other documents and observed procedures. We reviewed 26 CQC comment cards which we had sent prior to the inspection for patients to complete about the services provided at the practice.

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 5 August 2016

We carried out an announced comprehensive inspection on 28 June 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

West House Orthodontic Practice is located in a residential suburb close to the centre of Birkenhead and comprises a reception and waiting room, four treatment rooms, two of which are on the ground floor, offices, storage and staff rooms. Parking is available outside the premises. The practice is accessible to patients with disabilities, impaired mobility and to wheelchair users.

The practice is a referral practice and provides specialist orthodontic treatment predominantly to children and young adults on an NHS basis, and to patients of all ages on a privately funded basis. Orthodontics is specialist dental treatment which corrects irregularities in the alignment of the teeth in order to improve the position, appearance and function of the teeth.

The practice opening times are Monday, Wednesday and Thursday 8.30am to 5.00pm, Tuesday 8.30am to 6.30pm and Friday 8.30am to 4.00pm. The practice is staffed by a principal dentist and an associate dentist, both of whom are specialist orthodontists, a practice manager, an orthodontic therapist, five dental nurses and one receptionist.

A dental service provider who is separately registered with the CQC shares this location. The practice facilities and staff are shared between the two providers.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

We received feedback from 29 people during the inspection about the services provided. Patients commented that they found the practice excellent and well organised, and that staff were professional, friendly and caring. They said that they were always given good and helpful explanations about dental treatment and that the dentists listened to them. Patients commented that the practice was clean and comfortable, that appointments ran to time and all staff were very approachable.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents and acted on safety alerts.
• Staff had received safeguarding training and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Premises and equipment were clean, secure and well maintained.
• Infection control procedures were in place and the practice followed current guidance.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards and guidance.
• Patients received explanations about their care, proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• We observed that patients were treated with kindness, dignity and respect, and their confidentiality was maintained.
• The appointment system patients’ needs and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took into account patient feedback.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and for the delivery of high quality person centred care.

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

• Review the storage of paper-based dental care records to ensure they are stored securely.
• Review the security of the decontamination room having due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: Code of Practice about the prevention and control of infections and related guidance.
• Review the practice’s waste handling policy and procedures to ensure waste is stored securely in accordance with relevant regulations having due regard to guidance issued in the Department of Health, Health Technical Memorandum 07-01: Safe management of healthcare waste.
• Review staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s complaint handling procedures to ensure information is available about the further steps people can take to escalate their complaints, and information on who to complain to about private dental treatment.