Dental Confidence

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 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. This included sharps safety, sepsis awareness and lone working.

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.

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) and handheld X-ray equipment. When we checked, we observed that the last service of the CBCT equipment was in 2023. We brought this to the attention of the provider who confirmed that arrangement for servicing would be made immediately.

We do not assess compliance with the Ionising Radiation regulations 2017 and the Ionising Radiation (Medical Exposure) regulations 2017 but we do request services to provide evidence that demonstrates their compliance to inform our findings.

The provider should improve the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam CT (Computed Tomography). This includes ensuring equipment is serviced and tested in accordance with manufacturer guidance.

The practice managed fire safety well, and fire exits were clear and well signposted.

The practice had systems for appropriate and safe management of medicines. However, during our review of the medicines dispensing process we found that some dispensing labels did not include all the information required by regulations. We brought this to the provider’s attention.

The provider should improve the practice's protocols for medicines management and ensure all medicines are stored and dispensed safely and securely. This includes ensuring that all medicines labels contain all information required by regulations.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. When we reviewed recruitment records and pre-employment checks, we noted that all documents were not held for all staff. In some cases, pre-employment checks that were aged, had been accepted at the time of recruitment. We noted copies of qualifications were not held for some staff and, where the provider told us they had a policy of updating Disclosure and Barring Service checks every 5 years, this was not consistently applied.

The provider should improve the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

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

Newly appointed staff had an appropriate role specific structured induction.

Overall we found 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. 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.

At the time of our inspection some staff members had only been in post for a short time. During inspection we observed that they were unsure of how to access and utilize fully some of the systems that support their day-to-day work. Management staff we spoke with agreed that there should have been arrangements in place to ensure that any newer staff had sufficient support when undertaking new duties.

The practice had access to systems that should ensure staff training, including continuing professional development (CPD) was up-to-date and reviewed at the required intervals. When we checked this, we saw that there were significant gaps. For example, there were gaps in records for two of the clinicians. It was apparent that although the compliance tool used was overseen by management, the systems in place did not trigger conversations required to ensure evidence of training and CPD was submitted and recorded.

The provider should implement practice protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development.

Staff discussed their learning needs, general wellbeing and aims for future professional development during annual appraisals. Practice team meetings and ongoing informal discussions also gave staff the opportunity to raise any training subjects they wished to pursue.

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 procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment and current guidance. We observed there was a toilet in the loft space that was out of use, but it was unclear whether or not this had been disconnected from the pipework and capped off, to remove a dead leg on the pipework. We asked the provider to check the sentinel points listed on the water temperature testing sheets, and to confirm whether these were correct, and to check that an infrequently used outlet in the loft of the building, was being flushed regularly.

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