Smileforlife Limited

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 not providing safe care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider has made the required improvements.

During our inspection of this key question, we found concerns related to:

Managing risks and the oversight associated with the use of conscious sedation while delivering dental care and treatment.

These concerns were in breach of Regulation 12, Safe Care and Treatment.

You can find more details of our concerns in the detailed findings below.

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 some risks effectively and staff described the processes. We found shortfalls with the management of risks associated with treating patients under sedation.

Staff could access emergency equipment and medicines that were checked in line with national guidance. They knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year.

Staff members involved in the delivery of care and treatment to patients under sedation did not have the appropriate life support skills, taking into account the guidelines published by The Intercollegiate Advisory Committee for Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2020’. Following our inspection, immediate life support training was arranged for all staff.

The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. Control of Substances Hazardous to Health (COSHH) risk assessments and safety data sheets were available for staff.

We saw some records of servicing and validation of equipment in line with manufacturer’s instructions. We found the monitoring equipment for patients being treated under sedation had not been serviced or calibrated. The air conditioning units had not been serviced.

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

The practice managed fire safety well, and fire exits were clear and well signposted.

The practice had systems for appropriate and safe management of medicines. NHS prescription pads were kept securely, and a log was in place to monitor and track their use.

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

The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover.

There was scope to ensure newly appointed staff had an appropriate role specific structured induction which covered all areas within the practice including practice policies, infection prevention and control, medical emergencies, fire safety, safeguarding, radiography and decontamination processes. Following our inspection, an induction template was created to be used for any future new staff.

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.

The practice ensured staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. However, we identified shortfalls with immediate life support training for staff providing treatment under sedation.

There were 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 practice team meetings and ongoing informal discussions.

Staff felt respected, supported and valued, and they were happy 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 procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment and current guidance. There was no evidence to demonstrate that recommendation from the risk assessment carried out in 2017 had been addressed. The air conditioning units had not been serviced. This was arranged to be carried out following our inspection.

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 however this was not undertaken at regular 6 monthly intervals to improve the quality of the service in line with current guidance.

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