Night and Day Emergency Dentist

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.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safeguarding during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Involving people to manage risks during this assessment. The score for this quality statement is based on the previous rating for Safe.

The practice systems to identify and manage risks were not effective. Processes and procedures were in place to enable staff to complete risk assessments, we found these were not always completed in line with guidance.

Staff could access emergency equipment and medicines. We found not all equipment was available as recommended and these were not always checked in line with national guidance. Checks to confirm the availability and effectiveness of equipment had not been completed in the 2 months prior to our inspection. The provider offered assurances that action would be taken to address this issue.

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

Satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions were not always available.

The practice arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available were not consistently applied. We noted that local rules for the safe and authorised operation of radiography equipment were available but not displayed and evidence that radiography equipment was registered with the health and safety executive was not available. 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.

We identified scope for improvement with the safe and effective management of risk from fire. A fire risk assessment had not been completed for the service and fire evacuation drills were not carried out. Evidence to confirm that the fire alarm and extinguishers were serviced in line with manufacturers guidelines was not available. Following our inspection, the provider submitted evidence that a fire risk assessment had been completed, and action taken to address the issues identified.

The practice systems for appropriate and safe management of medicines were not effective. A process to accurately monitor the available number of medicines was not established. In addition, medicines were not stored securely. We found that medicines were not always dispensed in line with recognised guidance and practice information was not always recorded accurately on dispensing labels. Records of the temperature of the medicines fridge were not kept. The provider took immediate action to address these issues.

The practice had a recruitment policy and procedures that reflected relevant legislation. We found these were not applied consistently as not all required pre-employment information was available for all staff. Specifically, evidence of conduct in previous employment and a DBS check were not available for all 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.

Processes were established to enable the practice to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. We found these processes were not always consistently applied and evidence to confirm completion of training was not always available.

The practice had infection control procedures that reflected published guidance. We found these were not consistently applied.

Staff used personal protective equipment during decontamination of used dental instruments. We found the process did not always follow recognised guidance

We saw, and staff confirmed that single-use items were not reprocessed.

The practice procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, were not robust, effective or in line with the practice own risk assessment and current guidance. Records to confirm flushing of seldom used outlets and checks of water temperature were not carried out.

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

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.