Mansfield Orthodontic Practice - 17 Woodhouse Road

We carried out this announced inspection on 20 February 2020 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 provider 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:

Are services safe?

We found this practice was not providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

Background

Mansfield Orthodontic Practice is in Mansfield, it provides both NHS and private specialist orthodontic treatment to adults and children.

There is level access in to the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including parking for people with disabilities, are available near the practice.

The dental team includes four specialist orthodontists, three orthodontic therapists, nine dental nurses, two receptionists, two laboratory technicians, a sterilisation operative and a business manager. The practice has three treatment rooms, one of which is located on the ground floor. The practice has centralised decontamination facilities.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Mansfield Orthodontic Practice is the principal orthodontist.

On the day of inspection, we collected 81 CQC comment cards filled in by patients and spoke with two other patients. Feedback received about the practice was positive.

During the inspection we spoke with two specialist orthodontists, one orthodontic therapist four dental nurses, the sterilisation operative, one laboratory technician and the business 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 8am to 5pm and Friday: from 8am to 2pm.

Our key findings were:

• The practice appeared to be visibly clean and well-maintained.
• The provider had infection control procedures which reflected published guidance. Improvements could be made to the process for manual cleaning dirty instruments.
• Staff knew how to deal with emergencies. Improvements were needed to the system for checking appropriate medicines and life-saving equipment were available and in date.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider’s recruitment procedures were in need of review and improvement.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Not all clinical staff had received sepsis awareness training.
• Staff provided preventive care and supported patients to ensure better oral health.
• The practice did not keep a log of NHS prescriptions held in the practice.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance arrangements.

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

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

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