London Dental House and Medical Clinic

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:

safe and effective staffing and support and development of staff,

the infection prevention and control standards not being followed at the practice

the safety of equipment and premises,

and management of people's medicines and prescriptions.

These concerns were in breach of Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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 initial validation and Written Scheme of Examination for the autoclave and compressor were not available for review.

The practice did not have systems for appropriate and safe management of medicines. The practice dispensed prescription only medication, including antibiotics to patients. The provider could not demonstrate that they had an effective stock control system in place to account for medications held on site or to identify any missing medication. In addition, the antimicrobial prescribing log had not been maintained since 2024, and the provider did not have medication dispensing labels that included the practice details. Following the inspection the practice manager submitted evidence that they had completed training in antimicrobial prescribing on 14 April 2025.

The practice had some systems in place to ensure the premises were safe. The electrical installation condition test and checks to ensure portable appliances were safe to use had been carried out. A gas safety certificate dated 2 March 2024 was made available for review. The certificate stated that the next safety check was due before 2 March 2025. The provider could not demonstrate that servicing had been carried out in line with this recommendation. In response to our inspection feedback, the provider told us that servicing was booked for 15 April 2025.

The management of fire safety was effective, and fire exits were clear and well signposted. The practice carried out periodic in-house checks of the fire safety equipment. Improvements could be made to ensure the practice carried out fire evacuation drills in line with the recommendations of the fire risk assessment. Following the inspection, the provider submitted evidence that the practice had carried out a fire evacuation drill on 14 April 2025.

Emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. 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 visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely.

The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. This included cone-beam computed tomography (CBCT).

Improvements were needed to ensure that persons providing the care and treatment to patients had the qualifications, competence, skills and experience to do so safely. We reviewed the appointment book and a sample of clinical records and noted 1 clinical staff may have worked out of their scope of practice. In response to our inspection feedback, the provider told us, that a full audit of the relevant staff member’s treatment records was underway, and oversight of clinical processes would be strengthened by checking appointment bookings.

We saw that other clinical staff working in the practice were qualified, registered with the General Dental Council and had appropriate professional indemnity cover.

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

We observed the decontamination process and identified gaps in the trainee dental nurses` knowledge of infection prevention and control. The provider could not demonstrate that there were effective systems in place to supervise trainee dental nurses when they were learning new skills.

The practice manager told us that newly appointed staff received an induction; however, this was not recorded. In light of our findings in relation to the gaps in staff`s knowledge, we identified that the induction process was not effective.

The practice manager and the dentist we spoke with demonstrated knowledge of safeguarding and knew how to escalate safeguarding concerns. On the day of inspection, safeguarding information was not accessible to staff. We brought this to the provider`s attention and they took immediate action by displaying information about internal and external safeguarding processes in the waiting area.

Staff were up-to-date with relevant training, including continuing professional development.

The practice had been operating for less than a year and there were plans in place to discuss staff learning needs and general wellbeing during annual appraisals.

The decontamination process staff demonstrated did not reflect published guidance set out in in the Department of Health publication ‘Health Technical Memorandum 01-05: Decontamination in primary care dental practices’ (HTM01-05). There was no dedicated handwashing facility in the decontamination room and staff did not wear appropriate Personal Protective Equipment (PPE), including heavy duty gloves, for the decontamination process. Tools used for manual cleaning were not in line with best practice guidance. Containers for transportation of instruments for decontamination and those for sterilised instruments were not clearly marked for their respective functions. Additionally, we observed multiple instances of cross-contamination of surfaces. In response to our inspection feedback the provider told us that in-house infection control training had been booked for all clinical staff to refresh their knowledge and reinforce decontamination procedures.

We noted that the last entry for testing the autoclave was dated 5 March 2025 in the logbook. This meant, that the practice could not demonstrate that daily and weekly tests on the autoclave were being carried out in line with the manufacturer`s instructions, or in the absence of such instructions, in line with the guidance set out in HTM01-05.

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.

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.