Hillton Dentistry Gillingham

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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 accordance with the relevant regulations.

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 identified but had failed to manage some risks effectively and staff described the processes. However, sharps safety, sepsis awareness and lone working had been risk assessed appropriately.

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.

The premises were visibly clean, some areas in the practice had not been maintained sufficiently, there were cracks in the wall and holes in the ceiling. Cupboards, drawers and worktops were visibly damaged, a suction tube was heavily soiled, and an operator chair covering was torn. This provides an infection control risk as these areas cannot be cleaned effectively. All areas were 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). However, we noted there were no rectangular collimators fitted to the X-ray units. An action recommended in the three yearly engineer servicing records was to use rectangular collimators. Rectangular collimators reduce the amount of exposure to radiation.

The practice managed fire safety, and fire exits were clear and well signposted. We saw the most recent fire risk assessment had recommended the action of the fitting of smoke detectors in some areas of the practice. This had not been carried out.

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.

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. They told us that there were enough staff on duty at all times, However, the practice manager was not afforded protected time to carry out compliance and some administration duties as they were also covering reception duties. We discussed this with the provider. 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.

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 annual appraisals and practice team meetings and ongoing informal discussions.

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

The practice had infection control procedures that reflected published guidance. However, this was compromised in some areas of the practice where the environment, fixtures and fittings were damaged and could not be effectively cleaned.

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. We saw there was limescale build up on the taps in the decontamination room. This poses a risk of bacterial build up and contamination.

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 in line with current guidance. The issues we had identified had been recorded but had not been actioned.

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