The Orthodontic Centre (Wokingham)

We carried out this announced comprehensive inspection on 5 October 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 reflected published guidance.
• Staff knew how to deal with medical emergencies. Improvements were needed to ensure medicines and equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises but improvements were needed to ensure processes were effective.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Improvements were needed to staff recruitment procedures to ensure they reflected current legislation.
• 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 orthodontist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Staff told us that leaders were approachable, they felt involved, valued and respected and the service was a good place to work.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

The provider is part of a group The Orthodontic Centre Reading Limited and has 5 practices and this report is about The Orthodontic Centre (Wokingham)

The practice is in Wokingham, Berkshire and provides NHS and private orthodontic 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 2 specialist orthodontist, 2 dentist with specialist interest, 2 orthodontic therapists, 5 dental nurses, 4 reception staff, 1 practice manager, 2 treatment coordinators and 2 administrators. The practice has 3 treatment areas.

During the inspection we spoke with 1 orthodontist, 1 orthodontic therapist, 2 dental nurses, a 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 08:00 – 16:30
• Tuesday 10:00 – 19:00
• Wednesday 08:15 – 17:30
• Thursday 10:00 – 19:00
• Friday 07:45 – 16:15
• Saturday by appointment

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

• 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.

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

• Take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

• Improve the practice's systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities.

Implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council. In particular, ensure that checks of the items are dated, identify that the correct preparation of all medicines are available and ensure out of date items are removed from the stock.