We carried out this announced inspection on 31 October 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Orthoworld 2000 is an orthodontic practice located in Nottingham city centre. The practice provides mainly NHS (95%) orthodontic treatment.

The practice is located on two floors with three treatment rooms. All of the clinical areas including the treatment rooms are located on the ground floor. There is ramped access into the practice and a pay and display car park close to the practice.

The orthodontic team includes: three orthodontists; two orthodontic therapists; one student orthodontic therapist; three qualified dental nurses; one designated receptionist; one trainee dental nurse; one treatment co-ordinator and a practice manager.

The practice is owned by an organisation 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 the practice was the practice manager

On the day of inspection we collected nine completed CQC comment cards. This information gave us a positive view of the practice.

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

The practice opening hours are: Monday and Tuesday: 8:30 am to 5:45 pm; Wednesday and Thursday: 8:30 am to 4:30 pm and Friday: 9 am to 3 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and 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 measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

We spoke with three parents of three young patients aged under 18 and with a young patient who was with their parent.

A patient told us they had been asked for their views. We found that patients expressed their views and were involved in decisions about their care.

Parents told us their family members were treated with respect. One parent said staff were, “Reassuring” and “Always respectful.”

A patient told us they were happy with the care and treatment they had received. Parents also told us they were happy with the care their family members had received. One parent said, “It’s very good”.

Parents told us they felt the premises were kept clean. One parent said it was, “Spotless and tidy.” We found that patients were protected from the risk of infection because staff followed appropriate guidance.

Parents told us they felt staff knew what they were doing when caring for their family members. We found that staff received appropriate professional development.

We found that systems were in place for seeking the views of patients. We found that the provider assessed and monitored the quality of service that patients received.