We carried out this announced inspection on 7 February 2019 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Salisbury Orthodontic Practice is in the centre of Salisbury and provides NHS and private orthodontic treatment to adults and children.

There is currently no level access at this practice. The provider has another practice in the city which has level access and patients who cannot manage stairs or who attend with children in pushchairs are seen there. There is some on road parking and public car parks are available near the practice.

The dental team includes four orthodontic specialists, a trainee orthodontic therapist, four dental nurses, a practice manager and a business manager. The practice has two treatment rooms.

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 Salisbury Orthodontics is the principal orthodontist.

On the day of inspection, we collected 46 CQC comment cards filled in by patients.

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

The practice is open:

• Monday - Friday 08.45am – 1.00pm and 2.00pm - 5.00pm

• Closed at weekends.

Our key findings were:

• The practice 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 practice 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 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 fire safety risk assessment and ensure that any actions required are completed and ongoing fire safety management is effective. In particular relating to the installation of an appropriate fire alarm system as identified in the risk assessment instead of the current smoke detectors.