We carried out this announced inspection on 13 June 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

Orthodontics Penzance is in Penzance and provides mostly NHS orthodontic treatment to children. Some adults pay privately for their treatment.

There is adapted access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the town centre. Disabled patients can be dropped off outside the practice.

The dental team includes two orthodontists (specially trained dentists), five dental nurses/receptionists and a practice cleaner. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist 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 14 CQC comment cards filled in by patients and spoke with two other patients. This gave us a positive view of the practice.

During the inspection we spoke with the practice owner and principal orthodontist and three dental nurses/receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 8.30am – 1pm and 2pm – 5pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which would benefit from review.
• Staff knew how to deal with emergencies.
• 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 a suitable staff recruitment policy.
• 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. Adequacy of patient paper records security was under review.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• 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 staff and patients for feedback about the services they provided.
• The practice had not received any complaints in the last 12 months.

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

• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

• Review the practice's responsibilities to take into account the needs of patients and to comply with the requirements of the Equality Act 2010 and the guidance from the Accessible Information Standards.