Smiles By Gurms

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We found this practice was providing safe care in line with the relevant regulations and had taken into consideration appropriate guidance.

Although there are issues to be addressed, the impact of our concerns relates to the governance and the oversight of the risks, rather than a patient safety risk.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

The judgement for Learning culture is based on the latest evidence we assessed for the Safe key question.

The judgement for Safe systems, pathways and transitions is based on the latest evidence we assessed for the Safe key question.

The judgement for Safeguarding is based on the latest evidence we assessed for the Safe key question.

The judgement for Involving people to manage risks is based on the latest evidence we assessed for the Safe key question.

The practice had systems and processes to identify and manage risks. However, we found these were not always applied consistently or effectively, particularly in relation to risks associated with medical emergencies, equipment, dental radiography, fire safety and Legionella.

Systems for checking emergency equipment and medicines required strengthening as they had not identified that items of medical emergency kit were missing or out of date. Items that were missing or were found to be out of date were ordered immediately following our inspection. We were also assured weekly checklists would be updated to ensure all items were present and expiry dates had not been exceeded.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year.

The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely.

The servicing and validation of most of the equipment was overdue and not in line with manufacturer’s instructions. However, we saw evidence all equipment requiring servicing had been scheduled to be completed.

Arrangements to ensure the safety of X-ray equipment, including ensuring radiation protection information was up to date, required strengthening. This included cone-beam computed tomography (CBCT), laser and handheld X-ray equipment. We found servicing for the CBCT and X-ray equipment was overdue. However, we saw evidence during the inspection this had been scheduled to be completed. We were unable to see evidence recommendations within the critical examination for the CBCT had been actioned. We were provided assurance outstanding recommendations would be actioned immediately. Local rules were not specific to the X-ray equipment and had not been reviewed since 2021. We were unable to see evidence of a Laser Protection Advisor (LPA), Laser Protection Supervisor (LPS), local rules, policies and safety measures for the laser equipment. We were provided assurance laser equipment would not be used until all necessary arrangements were in place. We do not assess compliance with the Ionising Radiation regulations 2017 and the Ionising Radiation (Medical Exposure) regulations 2017 but we do request services to provide evidence that demonstrates their compliance to inform our findings.

Fire exits were clear and well signposted, and an external fire risk assessment had been completed in 2025. However, the management and oversight of fire safety required improvement. The external fire risk assessment completed in May 2025 had outstanding recommendations for action. We were assured that immediate action would be taken to address these. Servicing of the fire alarm and emergency lighting were overdue. We saw evidence these had been scheduled to be serviced. There were no records to demonstrate that emergency lighting or fire extinguishers were checked on a regular basis. We were provided assurance monthly checks would be implemented immediately.

The practice had systems for appropriate and safe management of medicines.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including locum staff.

The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover.

Newly appointed staff had an appropriate role specific structured induction.

Staff had the skills, knowledge and experience to carry out their roles. They told us that there were enough staff on duty at all times. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew how to escalate safeguarding concerns within the practice and externally.

The practice put measures in place following our inspection to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals.

There were processes to support and develop staff with additional roles and responsibilities. Staff discussed their learning needs, general wellbeing and aims for future professional development during appraisals, one-to-one meetings, practice team meetings and ongoing informal discussions.

The practice had infection control procedures that reflected published guidance.

Staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes.

Staff used personal protective equipment and decontaminated dental instruments after use, in line with national guidance. We saw, and staff confirmed that single-use items were not reprocessed.

The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. At the time of our inspection, we found recommendations from an external risk assessment completed in 2024 had not fully been addressed. We were provided assurance any outstanding actions would be reviewed and addressed immediately.

The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste.

Equipment was maintained and serviced in line with manufacturers’ instructions.

The practice completed infection prevention and control audits; however, there was scope to ensure these were completed bi-annually in line with current guidance.

The judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.