Dental Surgery

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 they have been put right by the provider. The impact of our concerns, in terms of the safety of clinical care, is minor for patients using the service. Once the shortcomings have been put right the likelihood of them occurring in the future is low.

During our assessment of this key question, we found concerns related to the safety of the premises, adequacy and availability of emergency equipment, training, support and development of staff. There was also a lack of systems or processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of service users and others who may be at risk.

This resulted in a breach of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the evidence category findings below. Whilst there are issues to be addressed, the impact of our concerns relate to the governance and the oversight of the risks, rather than a patient safety risk.

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.

Processes to identify and manage risks required strengthening. Staff felt confident that risks were well managed at the practice however, this was not reflected in our findings. Systems for checking emergency equipment and medicines required strengthening as they had not identified that items of medical emergency kit were missing or out of date. Items that were missing or were found to be out of date were ordered immediately during our assessment. Weekly checklists were introduced following our assessment to ensure all items were present and expiry dates had not been exceeded. Patient areas of the premises appeared visibly clean. We found unsatisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. We found the compressor had not been serviced since February 2022. This was completed shortly after our assessment. The management of fire safety was ineffective. No fire safety risk assessment had been carried out at the time of our assessment and there was no monitoring of fire safety equipment. An external company carried out a fire safety risk assessment the week following our assessment and there were recommended actions to be carried out. The practice did not have arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was not available. The equipment had not been serviced since 2019. The provider did not have evidence to demonstrate registration with the Health and Safety Executive for the use of X-rays. Evidence of this registration was submitted the day after our assessment and servicing of the equipment was completed a week after our assessment ensuring the equipment was safe to use. The practice had limited risk assessments to minimise the risks that could be caused from substances that are hazardous to health. There was scope for improvement regarding the practice’s systems to assess, monitor and manage risks to patient and staff safety.

The practice did not have an up-to-date recruitment policy and procedure 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.

Staff we spoke with demonstrated some knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff were not aware of ‘Was Not Brought’ where a child is not bought to their appointment by their parent or guardian and there was no guidance or other documentation available. This was introduced following our assessment.

The practice did not ensure that staff completed safeguarding training to the appropriate level or updated their training at appropriate intervals. Evidence of training for all staff was submitted following our assessment.

The practice did not have arrangements to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. We were assured by the practice manager that this would be monitored in the future.

Staff discussed their learning needs, general wellbeing and aims for future professional development during ongoing informal discussions.

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

The practice had infection control procedures that required strengthening to reflect published guidance. We observed use of personal protective equipment. We saw and staff confirmed that single use items were not reprocessed.

Procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment required improvements. We found the hot and cold water temperatures were not monitored consistently and the hot water was not reaching the recommended 55 degrees Celsius.

Although patient areas of the practice appeared clean there was no effective schedule in place to ensure that the practice was kept clean or logs to demonstrate cleaning completed. We observed safe segregation and disposal of hazardous waste.

Some improvements were required to the flooring in 1 treatment room. Replacement of the flooring was planned to be carried out in March 2025.

The equipment in use was maintained and serviced as per manufacturers’ instructions.

The practice did not complete 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.