We carried out an announced comprehensive inspection on 19 April 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

East Midlands orthodontics is located in a Victorian town house close to Nottingham city centre.

The practice was registered with the Care Quality Commission (CQC) in April 2014. The practice provides orthodontic services to mostly NHS patients. Services provided include: teeth straightening and fixed and removable braces.

The practice’s opening hours are: Monday to Friday: 8:15 am to 4 pm, with the practice closed for lunch 12:30 pm to 1 pm. The practice was not open at weekends.

Access for urgent treatment outside of opening hours is by telephoning the 111 NHS service. This information was on the practice answerphone message.

The principal orthodontist is the registered manager. 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.

The practice has one orthodontist; one orthodontic therapist; three dental nurses; one practice manager; a business support; one receptionist and a decontamination technician.

We received positive feedback from 23 patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• Patients spoke positively about their experiences of the orthodontic services they received, and said they were treated with dignity and respect.
• Patients’ confidentiality was maintained.
• There were systems in place to record accidents, significant events and complaints, and learning points were identified and were shared with staff.
• There was a whistleblowing policy and procedures and staff were aware of these procedures and how to use them. All staff had access to the whistleblowing policy.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• There were training opportunities for staff which allowed personal development within their dental role.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included oxygen and emergency medicines.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Patients were involved in discussions about the care and treatment on offer at the practice.
• Governance arrangements were in place for the smooth running of the practice.

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

• Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and ensure an access audit is undertaken for the premises. In addition consider purchasing a portable hearing induction loop to assist patients’ who wear a hearing aid.