Updated 3 September 2021
We carried out this announced focussed inspection on 18 August 2021 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 Care Quality Commission, (CQC), inspector who was supported by a specialist dental adviser.
As part of this inspection we asked:
• Is it safe?
• Is it effective?
• 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 well-led?
We found this practice was providing well-led care in accordance with the relevant regulations.
Background
Harpenden Orthodontics is in Harpenden, Hertfordshire and provides NHS and private orthodontic treatment for adults and children. Orthodontics is a specialist dental service concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teeth and their function. Orthodontic treatment is provided under NHS referral for children except when the problem falls below the accepted eligibility criteria for NHS treatment. Private treatment is available for these patients as well as adults who require orthodontic treatment.
The practice is on the first floor of a shared building so there is no access for people who use wheelchairs and those with pushchairs. Patients who are unable to access the practice are referred to the sister practice in St Albans which has level access. Car parking is available from a pay and display car park near the practice.
The dental team includes four dentists, three of whom are on the General Dental Council (GDC) specialist list for orthodontics, three orthodontic therapists, nine dental nurses, four receptionists, two treatment co-ordinators, one administrator, and a practice manager. The provider owns another practice in St Albans and the principal dentist splits their hours between both practices. The practice has four treatment rooms.
The practice is owned by a partnership and as a condition of registration must have a person registered with the CQC 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 Harpenden Orthodontics is the principal dentist.
During the inspection we spoke with two dentists, one orthodontic therapist, four dental nurses, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.
The practice is open:
Monday and Friday from 8.00am to 4.30pm
Tuesday - Thursday from 8.00am to 5.30pm
Our key findings were:
- Effective leadership was provided by the principal dentist and practice manager and there was a culture of continuous improvement.
- Staff we spoke with felt well supported and were committed to providing a professional, friendly and high-quality service to their patients.
- The practice appeared to be visibly 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 provider had systems to help them manage risk to patients and staff.
- The provider had safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. The practice had a safeguarding champion and two safeguarding leads trained to level three in safeguarding.
- The provider had thorough staff recruitment procedures which reflected current legislation.
- 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 provided preventive care and supported patients to ensure better oral health.
- 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.