We carried out this announced inspection on 19 November 2018 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

Northwest Orthodontics Limited provides a NHS Orthodontics service to children under 18 years of age. The service is provided one day per week from the dental department of the Ashton Primary Care Centre.

There is lift access to the dental department for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the Primary Care Centre. The dental department is shared with two other dental services and includes a reception, eight treatment rooms, an X-ray room and an instrument decontamination room.

The dental team at Northwest Orthodontics includes the principal orthodontist and an associate orthodontist, an orthodontic therapist, four orthodontic nurses and three receptionists. The company practice manager supported the team during the inspection.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Northwest Orthodontics Limited is the principal orthodontist.

On the day of inspection, we collected 26 CQC comment cards filled in by patients.

During the inspection we spoke with the principal orthodontist, the associate orthodontist, two orthodontic nurses, a receptionist and the company practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The service is provided on a Monday 9am – 5pm

Our key findings were:

• The dental department appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well 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 suitable information governance arrangements.

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

• Review the current process to ensure the availability of equipment to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the current process for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.