HANOVER DENTAL PRACTICE HD23 LIMITED

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• 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.

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 risks effectively and staff described the processes. Staff demonstrated an open culture in relation to people’s safety. They felt confident that risks were well managed at the practice, and this was reflected in our findings.

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. We identified scope for improvement in ensuring that glucagon, a medicine used to treat low blood sugar, was stored in line with the manufacturer’s guidance. The provider took immediate action to address this.

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) equipment.

The practice managed fire safety well, and fire exits were clear and well signposted. We identified scope for improvement in ensuring accurate records were kept to confirm that required monitoring checks of the effective operation of fire detection and suppression equipment were carried out. The provider took immediate action to address this.

We identified scope for improvement with practice systems for appropriate and safe management of medicines. Evidence that all clinicians followed recommended prescribing guidance for antibiotics was not always available and labels for dispensed medicines did not always include all required information for patients. NHS and private 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 agency or locum staff.

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. A number of staff provided feedback indicating they did not always feel there were enough staff on duty at all times. Staff 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.

Processes to enable staff to discuss their learning needs, general wellbeing and aims for future professional development during were not established. Records to confirm that staff received appraisals, one to one meetings or had opportunity to formally discuss concerns were not available. The provider acknowledged this issue and offered assurances that a schedule of appraisals and staff meetings would be established.

Although some staff stated they felt supported, respected and valued, a number expressed dissatisfaction at the level of support and processes for communication in place at the service. The provider offered assurances that action would be taken to address this issue.

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. We identified scope for improvement in ensuring that infectious clinical waste bags were marked in a way to identify the practice as their source. The provider took immediate action to address this and submitted evidence of updated processes following our inspection.

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.