Updated 19 November 2021
We carried out this announced inspection on 26 October 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 CQC inspector who was supported by a specialist dental adviser.
As part of this inspection we asked the following questions:
• 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 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 well-led?
We found that this practice was providing well-led care in accordance with the relevant regulations.
Background
Rothwell Orthodontic Practice is well-established and offers mostly NHS treatment to children and young people. It is a referral clinic for orthodontic treatment. The dental team is small and consists of one orthodontist, one nurse and one receptionist. There is a manager who oversees the practice but who is mostly based at the provider’s other practice in nearby Desborough. Free car parking is available at a public car park just opposite the practice. There is no access for wheelchair users.
The practice is open Monday to Friday from 9am to 5pm.
The practice is registered as a company 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 the practice is the principal dentist at the sister practice in Desborough.
On the day of inspection, we spoke with the practice manager, the orthodontist, the nurse and the compliance consultant. We looked at practice policies and procedures and other records about how the service was managed.
Our key findings were:
- The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
- The practice had systems to help them manage risk to patients and staff.
- Staff felt respected and valued.
- The decontamination of dental instruments did not follow nationally recommended guidance.
- Essential staff pre-employment checks were not fully undertaken to ensure suitable staff were employed at the practice.
- Recommendations in the practice's fire safety risk assessment had not been actioned to ensure staff and patients and the premises were kept safe in the event of a fire.
- The practice appeared to be visibly clean and reasonably well-maintained.
- Comprehensive procedures had been implemented to reduce the spread of Covid-19.
There were areas where the provider could make improvements. They should:
- Improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance. In particular, ensuring that adequate personal protective equipment is worn, instruments are kept moist whilst awaiting sterilisation and are examined correctly for residual debris.
- Take action to ensure clinicians record in the patients’ dental care records or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.
- Take action to implement any recommendations in the practice's fire risk assessment.
- Implement an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
- Implement systems for appraising staff performance.