Chiswick Park 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 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.

While staff demonstrated an open culture in relation to people’s safety, the practice did not always identify and manage risks effectively. The practice had not assessed and mitigated the risks associated with lone working, as the hygienist worked without chairside report. In addition, while the practice’s health and safety risk assessment had briefly assessed the risks associated with the use of sharps, we saw that a sharps injury was not managed effectively after a sharp’s injury recorded in November 2024.

Staff could access emergency equipment and medicines that were checked in line with national guidance, but not all items as advised in guidance issued by the Resuscitation Council UK, were available. Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. Staff providing treatment to patients under sedation had also completed immediate life support 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 the sterilisation equipment in line with manufacturer’s instructions.

The practice had some arrangements to ensure the safety of the X-ray equipment, but not all required radiation protection information was available. This included evidence of an up to date 3-yearly report for one of the x-ray units, and evidence that recommendations from the critical examination of the second x-ray unit had been considered. 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. However, the practice’s fire risk assessment had not assessed if the emergency routes and exits required illumination to aid with safe evacuation during power outages.

The practice had systems for appropriate and safe management of medicines. Improvements were required to ensure that the dispensed medicines included the name and address of the supplying dental service.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. However, this was not always followed. The practice had failed to complete right to work checks for 1 staff member and there were inconsistencies with Disclosure and Barring Service (DBS) checks. For example, 1 dental nurse only had a basic DBS check instead of the required enhanced DBS check. In addition, 1 staff member had only received 2 out of the required 3 vaccinations against Hepatitis B, and did not have evidence of immunity through a titre test. There was no risk assessment in place to mitigate the risks associated with this.

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.

Staff demonstrated knowledge of safeguarding, but not all staff were aware of how safeguarding information could be accessed. Staff knew how to escalate safeguarding concerns within the practice, but not all staff were confident on how to report safeguarding concerns externally.

The practice did not ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. No staff members had completed training in learning disabilities and autism; 3 out of 10 staff members had not completed safeguarding training to a level appropriate to their role; 6 out of 10 staff members had not completed training in fire safety and 7 out of 10 staff members had not completed training on how to recognise and act on potential symptoms of sepsis.

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, 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 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 effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment and current guidance.

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 in line with current guidance.

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