XO Dental

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 processes to identify and manage risks and staff we spoke with were able to describe these to us. Staff demonstrated an open culture in relation to people’s safety. Staff felt confident that risks were well managed at the practice, and this was reflected in our findings.

Emergency equipment and medicines were available in accordance with national guidance and staff could access these in a timely way. However, the systems for checking these should be reviewed taking into account the guidelines issued by Resuscitation Council (UK). The checks had not identified a medication required in the event of severe allergic reaction had expired, and that there were no syringes to administer it. Replacements were immediately obtained.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. Staff were also encouraged to participate in medical emergency scenario training. The dentist providing treatment to patients under sedation had also completed immediate life support (ILS) training. The provider was unaware if the nurse they brought was ILS trained, or if they brought additional medical emergency equipment including a second oxygen tank which is required.

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.

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).

The management of fire safety was effective, and fire exits were clear and well signposted.

The practice had systems for appropriate and safe management of medicines.

The practice had a recruitment policy and procedures that mostly reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. However, the provider should review their procedures and ensure all appropriate checks are consistently completed prior to new staff commencing employment at the practice. The policy stated a Disclosure and Barring Service (DBS) check would be carried out for new employees, but a system was not in place to facilitate this. The provider assured this would be actioned.

The practice ensured clinical staff were qualified and registered with the General Dental Council. Evidence of appropriate professional indemnity cover was obtained from clinical staff, but the provider did not always ensure the cover included the scope of practice of the clinician. The implant dentist attended with a nurse, but no information was obtained about them.

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 sufficient levels of 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 had arrangements to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals.

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, one-to-one meetings, during clinical supervision, practice team meetings and ongoing informal discussions.

Staff stated they 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. The air ventilation in the decontamination room should be reviewed to ensure this works effectively.

We observed use of personal protective equipment and the decontamination of used dental instruments, which aligned with national guidance. We saw, and staff confirmed that single-use items were not reprocessed.

There was a process for staff to report and respond to sharps injuries. However, staff did not have access to a service to obtain advice and timely follow up. After the inspection, the provider assured us they were in the process of contracting with an occupational health service.

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. We highlighted a recommendation in the legionella risk assessment report to insulate hot water pipes to support them in maintaining hot water temperatures in the accepted range.

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

The equipment in use was maintained and serviced as per 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.