Keep Smiling UK

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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 demonstrated some systems for identifying and managing risks. However, there were areas requiring improvement. Specifically, the practice did not comply with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013,posing a potential risk to staff safety.

The provider informed us they would take action to implement safer sharps practices.

Staff could access emergency equipment and medicines, but these were not checked in line with the national resus council guidance. We found items of the medical emergency kit were missing or out of date. Following the inspection the provider confirmed that the necessary items had been purchased and a system for checking the emergency equipment and medicines in line with national guidance had been implemented.

Staff knew how to respond to a medical emergency. However, they could not confirm that they had undertaken medical emergencies training. Following the inspection the provider sent confirmation that this training had been undertaken.

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.

Fire safety measures such as a risk assessment and appropriately signed exits were in place. However, the practice's fire safety management needed improvement. Fire extinguishers had not been serviced since 2018. Also, regular checks of the emergency lighting and fire alarm system were not conducted. These checks should be carried out 6 monthly. These concerns were addressed with the provider, and after inspection, confirmation was provided that servicing of fire equipment and weekly checks were being implemented.

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

The practice had a recruitment policy and procedures in place, but these required improvements. Documentation as required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was not available for the receptionist / personal assistant. The provider assured us that appropriate recruitment checks would be implemented going forward.

The dentist used agency nurses and satisfactory checks from the agencies were confirmed. However, a formal induction process for these staff members was absent. The provider indicated that an induction program would be established for all future agency staff.

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

The dentist had the skills, knowledge and experience to carry out their role. 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.

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Staff felt respected, supported and valued, and they were proud to work in the practice.

Infection control procedures at the practice generally aligned with published guidance, although some improvements were necessary. Specific areas requiring attention included the use of detergent for instrument cleaning, the absence of an appropriate solution to disinfect dental impressions, a lack of hand cream and alcohol rub, and the failure to conduct regular checks (e.g.foil testing) or daily records for the ultrasonic cleaner in accordance with national guidance. We spoke to the provider about this, and they told us they would make improvements to the procedures.

Staff generally utilised personal protective equipment and decontaminated dental instruments according to national guidance, improvements were required concerning the frequency of heavy-duty glove changes, which were monthly instead of the recommended weekly schedule. The provider confirmed that gloves would be changed on a weekly basis going forward.

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 maintenance and servicing generally conformed to manufacturers' instructions. However, the practice utilised a non-vacuum autoclave that produced data logs in a language not understood by the dentist. Additionally, pressure vessels had not been serviced since 2022, and servicing of emergency lighting and alarms had not been undertaken. The dentist indicated plans to purchase a vacuum autoclave with English data output and to service the outstanding equipment. Following the inspection, the provider confirmed that the pressure vessel had been serviced.

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