Maryport Smile Centre

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 systems and processes in place to identify and manage risks, but these were not effective. Where steps had been taken to identify and assess risks, these had not been addressed. For example, the five yearly electrical fixed wiring inspection undertaken in 2021 identified a number of risks with the overall rating of the safety of electrical wiring being ‘Unsatisfactory’. Some steps had been taken to address this. Evidence provided following this inspection showed that 3 of the 4 identified ‘potentially dangerous’ issues had been addressed, leaving 1 ‘potentially dangerous’ matter referred to in the electrical inspection report, still waiting to be addressed.

Staff could access emergency equipment and medicines. Staff checking these items were not using a recognised checklist from the Resuscitation Council UK. Some items were missing from the kit.

Staff were able to demonstrate they 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.

We saw satisfactory records of servicing and validation for most of the equipment in line with manufacturer’s instructions. However, we found systems in place did not support the mitigation of risk, or the required response to emerging risk. For example, we found the washer disinfector in the decontamination room was redundant. The Legionella risk assessment had not been reviewed to determine the impact of this on effective Legionella management. There was no servicing regime in place for air conditioning units in the practice.

In a recent service and testing of fire safety equipment, it had been identified that two of the fire extinguishers required replacement. These had been ordered but were not yet in place, leaving the practice with less fire extinguishers than required, according to the risk assessment recommendations. Evidence submitted by the provider after our inspection demonstrated that the new fire extinguishers had been received and were now in place.

Fire exits were clear and well signposted.

The practice had arrangements to ensure the safety of the X-ray equipment, and the required radiation protection information was 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.

The practice had systems for appropriate and safe management of medicines. However, although NHS prescription pads were kept securely, a log was not effective in monitoring and tracking their use. We found clinicians were not using the log as required, to record prescriptions issued to patients and any voided prescription sheets.

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

We were able to confirm that dentists and dental therapists 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 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 could show that staff training, including continuing professional development, was up-to-date and reviewed at the required intervals for clinical staff and nurses.

Processes in place to support and develop staff with additional roles and responsibilities required strengthening. Findings from our inspection demonstrated that those assessing risk were not sufficiently knowledgeable in how to respond to, mitigate and balance risks. We also observed that systems in place to drive improvement were not effective, for example, in findings from audit and completion of full audit cycles to demonstrate improvement over time.

Staff discussed their learning needs, general wellbeing and aims for future professional development during one-to-one meetings and practice team meetings. We did not see evidence to demonstrate that this was an effective way of monitoring staff progress in their learning and development.

The practice had infection control procedures that reflected published guidance.

Staff 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, in line with a risk assessment and current guidance. However, when equipment had become redundant, for example, the washer disinfector, the impact of this on Legionella management had not been considered.

The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste. We observed that clinical waste bins were in a segregated area but this area was accessible to all, and bins were not secured or tethered to stop them being moved or tampered with.

The majority of equipment was maintained and serviced in line with manufacturers’ instructions.

The practice completed infection prevention and control audits in line with current guidance. However, completed infection control audits had not identified that details for occupational health services in the event of needlestick injuries, were incorrect. We asked the provider to seek the correct information for local services and update these information posters.

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