The Dental Suite

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 medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. On the day of inspection we noted that some emergency equipment was missing. Following the inspection, we received evidence that all missing items had been ordered and were available at the location.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. Staff providing treatment to patients under sedation had also completed immediate life support training. Staff were also encouraged to participate in medical emergency scenario training.

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.

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

However, the provider should take action to implement any recommendations in the practice's fire safety risk assessment. In particular, the 2017 fire risk assessment recommended that an evacuation chair be made available in the event of a power failure or fire, during which the building's lift would be out of service.

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

The practice had a recruitment policy and procedures that broadly reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. Improvements were required to ensure that full employment histories and evidence of Hepatitis B immunity for clinical staff were consistently obtained and appropriately documented in staff records.

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 we spoke with had the skills, knowledge and experience to carry out their roles. The provider informed us that, while the recruitment of an additional dental nurse was underway, staffing levels were sufficient to ensure safe and effective care, with adequate cover maintained at all times. Staff demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. They 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 and 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 broadly reflected published guidance.

Staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes.

We observed use of personal protective equipment and the decontamination of used dental instruments, which broadly aligned with national guidance. However, the practice should improve the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular, we observed that used instruments were not kept moist prior to the decontamination process and hand cream was not provided to support staff skin health. Following our inspection feedback, the provider took prompt action to address all identified concerns. 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. However, the provider should take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, there was no evidence that dead-legs had been removed or isolated, or that flexible hoses had been replaced with copper connections within the water system, as recommended to reduce the risk of Legionella.

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. We noted that the latest audit did not fully reflect the findings observed during the day of inspection. Specifically, the audit did not identify several issues that were evident at the time, including damage to one dental chair and one clinical worktop. Additionally, it failed to note that the clinical waste bins in use were not foot- or sensor-operated, as required for compliance with infection prevention and control standards. Following our feedback the provider assured us that surgery maintenance would be scheduled as soon as possible and that they would endeavour to improve the accuracy of their audits.

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