We carried out this announced inspection on 9 May 2017 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 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 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

Anglesea Terrace Orthodontic Practice is in St Leonards On Sea and provides NHS and private treatment to patients of all ages.

There is no level access for people who use wheelchairs and pushchairs due to steps down to the practice. Car parking spaces, including spaces for patients with disabled badges, are available near the practice.

The orthodontic team includes a principal orthodontist, an orthodontic therapist/practice manager, three dental nurses and one administrator/receptionist. The practice has two treatment rooms.

The practice is owned by an individual who is the principal orthodontist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 48 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a mostly positive view of the practice.

During the inspection we spoke with the principal orthodontist, the orthodontic therapist/practice manager, three dental nurses and the administrator/receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 8.45am until 5.00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• 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.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

We carried out an announced comprehensive inspection on 6 October 2015 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.

Anglesea Terrace is an orthodontic practice in St Leonards On Sea, East Sussex, offering NHS and private orthodontic treatment to adults and children.

The practice is situated in the centre of St Leonards On Sea. The practice has two treatment rooms, a decontamination area for the cleaning, sterilising and packing of dental instruments, a waiting area and a reception area. The practice is located in the basement of the main building. The practice does not have disabled access due to steep descending steps at the front of the building. The practice is open Monday 8.45am to 5.00pm, Tuesday 8.45am to 6.00pm, Wednesday 8.45am to 5.00pm, Thursday 8.45am to 5.00pm and Friday 8.45am to 2.30pm (8.45am to 6.00pm on alternate Fridays). The practice is not open on Saturdays and sometimes opens late on Tuesdays for private patient appointments.

Anglesea Terrace has one orthodontist (who is also the registered manager), an orthodontic therapist and three dental nurses (one of whom is a trainee). The clinical team are supported by one receptionist/ administrator. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected 36 completed cards. All of the comments cards provided a positive view of the service the practice provides. Patients commented that staff were polite, kind and friendly. Patients wrote that they were treated with dignity and care. Patients also commented that the environment was clean, tidy and hygienic. We also spoke with two patients during our inspection who were highly satisfied with the treatment and support they received at the practice.

Our key findings were:

• There were systems in place to reduce the risk and spread of infection. The practice was visibly clean and well maintained.
• The practice had effective systems in place to gain the comments and views of people who used the service.
• Patients were highly satisfied with the treatment they received and were complimentary about staff at the practice.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
• We observed that staff showed a caring approach towards patients at the practice.
• The orthodontic care records we looked at provided full and accurate details of the treatment and care which patients received.

• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children.
• Staff were proud of the practice and their team. Staff felt well supported in their roles.

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

• Check that all staff files contain the relevant recruitment checks.