Pemberton Dental Practice

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 accordance with the relevant regulations and had taken into consideration appropriate guidance.

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 processes to identify and manage risks and staff we spoke with were able to describe these to us. Staff felt confident that risks were well managed at the practice, and this was reflected in our findings.
Emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. Staff were encouraged to participate in medical emergency scenario training.
The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely.
We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available.
The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.
Overall, the management of fire safety was effective, and fire exits were clear and well signposted. Improvements should be made to ensure any risks identified in the risk assessment are acted on within the recommended timeframe, or short-term interim arrangements are introduced to manage the risk until the work is complete.

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 we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew their responsibilities for safeguarding vulnerable adults and children.
There were effective 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 annual appraisals, 1 to 1 meetings, during clinical discussions, practice team meetings and ongoing informal conversations.
Staff stated they felt respected, supported and valued, and they loved working in the practice.
The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff. However these were not consistently followed. From the records we were shown, Disclosure and Barring Service (DBS) checks, or a suitable risk assessment were not undertaken for all members of staff at the point of recruitment. We also noted the effectiveness of the Hepatitis B vaccination had not been checked nor a suitable risk assessment undertaken where appropriate, for all clinical staff. This had been identified by the practice prior to the inspection and steps had been taken to address the issues.
Systems and processes for oversight of completed staff training should be improved. Records available showed most training had been undertaken immediately before the inspection. The system failed to ensure that staff completed training at required intervals prior to this, including safeguarding and infection control.

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.
We observed use of personal protective equipment and on the whole, the decontamination of used dental instruments, which aligned with national guidance. We saw, and staff confirmed that single use items were not reprocessed. Where minor improvements were needed, the practice manager confirmed these would be reviewed.
The practice had effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk inspection.
The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste.
The equipment in use was maintained and serviced as per manufacturers’ instructions.
The practice completed infection prevention and control audits in line with current guidance.

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