We carried out an announced comprehensive inspection on 12 December 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.

John Evans Orthodontic Practice - Goldington Road is an orthodontic referral centre in Bedford providing NHS and private orthodontic care and treatment and is more commonly known as Bedford Braces. The practice is situated in a converted domestic property, on the first floor. It consists of two treatment rooms and a separate decontamination room for cleaning, sterilising and packing dental instruments. There is also a separate room which houses the panoramic dental X-ray machine.

The staff at the practice consist of a principal specialist orthodontist, an orthodontic therapist, a practice manager and a receptionist (who are also qualified dental nurses) and three additional dental nurses.

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.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• There were systems in place to check equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the orthodontist and orthodontic therapist took X-rays at appropriate intervals.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• During our visit we observed staff were positive, friendly, supportive and put patients at their ease.

• We reviewed 21 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection and were very positive. Common themes were patients felt they received excellent professional and friendly care in a calm and hygienic environment from staff who were caring, polite, informative and very happy to answer any questions.

• There was an effective system in place to act on feedback received from patients and staff.

• There were systems in place to assess, monitor and improve the quality of service provided.

During our visit to the surgery on 20 February 2012 we spoke with three young people waiting to see the orthodontist. We were told that the dentist always treated them politely, told them what he was doing and spoke directly to them and not just their parent/carer. One young person said, “I really don’t mind coming here. I hardly ever have to wait, so I don’t miss that much time off from school”. The young people told us that the dentist was easy to speak with and parents agreed with them.

People told us that the surgery was always clean and tidy. One new patient who was waiting to be seen for the first time said, “first impressions are very good, it is clean and very tidy”.

All of the young people that we spoke with told us told us that the dentist explained their treatment to them and that they understood about the treatment they were to have before it started. The parent of a young person waiting to be seen for the first time told us that the referring dentist had explained why they considered a referral necessary and they were expecting the orthodontist to confirm the need for treatment.