The Dental Surgery

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.

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 identified and managed risks in relation to sharps safety and sepsis awareness effectively. However, we saw that improvements were needed to ensure that the fire risk assessment was reviewed annually and the ongoing fire actions were carried out; a lone working risk assessment was not available for those who work alone.

Staff demonstrated an open culture in relation to people’s safety. They felt confident that risks were well managed at the practice, and but this was not wholly reflected in our findings.

Staff could access emergency equipment and medicines, but these were not consistently checked in line with national guidance. They knew how to respond to a medical emergency, but not all staff had completed training in emergency resuscitation and basic life support every year.

The practice had arrangements to ensure the safety of the X-ray equipment; however, these were not wholly effective, and not all of the required radiation protection information was available. For example, there was no signage to warn of radiation in use, the controlled area was not specified and the local rules to ensure radiation is used safely, were not clear. In addition, the X-Ray units had not received annual electromechanical servicing. Following the inspection, we received evidence that the practice had sought guidance and made improvements to the radiation protection files and the X-Ray units had all received servicing.

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.

A fire safety risk assessment was carried out in line with the legal requirements, however this had not been reviewed annually. In addition, whilst the fire alarm had been serviced annually, this was not in line with minimum requirements which stipulates 6 monthly services should be carried out.Fire exits were clear and well signposted.

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.

Staff had the skills, knowledge and experience to carry out their roles but told us that there were not always 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. However, the information displayed of who to escalate concerns to externally was incorrect.

The practice did not have effective arrangements to ensure staff training, including continuing professional development (CPD), was up-to-date and reviewed at the required intervals. Not all clinical staff were able to demonstrate that they had undertaken all CPD relevant to their roles as recommended by the General Dental Council (GDC).

We saw gaps in the following mandatory and recommended topics: fire safety, safeguarding adults and children, medical emergencies, infection, prevention and control (IPC), Interacting with People with a Learning Disability and Autistic People, Legionella, legal and ethical, Mental Capacity Act, Sepsis and complaints handling.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or 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 discussed their learning needs, general wellbeing and aims for future professional development during annual appraisals, practice team meetings and ongoing informal discussions.

Staff felt respected, supported and valued, and they were proud to work in the practice

The practice had ineffective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. A risk assessment had been completed in line with current guidance, but control measures such as monitoring water temperatures were not always completed regularly and action had not been taken when anomalies were identified. For example, water temperatures were consistently recorded outside of the stated range, and no action had been taken to address this. Following the inspection, we received assurance that improvements were being made to the practices processes and an engineer had been contacted to investigate the water temperatures.

The practice had infection control procedures that reflected published guidance but were not always being followed. The practice appeared visibly clean, however we did not see appropriate environmental cleaning equipment at the practice. In addition, the cleaning schedules did not contain enough detail to fully support consistency in cleanliness standards.

The practice completed infection prevention and control (IPC) audits, but these were not reflective of practice or in line with current guidance. For example, audits were not completed at recommended intervals and did not include action plans.

Staff and demonstrated knowledge and awareness of infection prevention and control processes, but not all had received appropriate training.

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

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

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