Dental Perfection Branston

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 some 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.

Most emergency equipment and medicines were available and staff could access these in a timely way. However, we found some items to be missing or out of date. We found the checks of medical emergency medicines were carried out monthly rather than the recommended weekly and there was no recording of checks for the medical emergency equipment in accordance with national guidance. Items that were either missing or found to be out of date were ordered immediately during our inspection.

Staff 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 however, we found some items were not stored safely in the decontamination area which was open to the public.

We saw satisfactory records of servicing and validation of some of the equipment in line with manufacturer’s instructions. There was no evidence available for the servicing of the air conditioning units. Evidence was submitted following our inspection to show an appointment had been arranged for the servicing to be carried out.

There was scope for improvement in the practice’s arrangements to ensure the safety of the X-ray equipment. There was no information regarding the Radiation Protection Advisor at the practice. Local rules seen recorded out of date information.

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.

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. However, the practice were not working in accordance with this policy. Not all recruitment information, in line with Schedule 3 of the Health and Social Care Act (Regulated Activity) Regulations 2014, was available for all staff. Disclosure and barring service (DBS) checks were not available for all staff and not carried out at the point of recruitment. There were systems in place to ensure clinical staff had received appropriate vaccinations, including vaccination to protect them against the Hepatitis B virus. However, the effectiveness of the vaccination was not known for clinical staff except for 1 dentist.

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

There was no documented evidence to demonstrate that newly appointed staff had an appropriate role specific structured induction. We were told that inductions were carried out however, this was not documented.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient levels of staff on duty at all times. Staff knew how to escalate safeguarding concerns within the practice and externally. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed.

The practice did not ensure that staff completed safeguarding training to the appropriate level for their role. At the time of our inspection, sufficient evidence of training was seen for only 2 members of staff. Following our inspection, evidence was submitted from a further 5 members of staff.

The practice did not have arrangements to ensure 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 within their capabilities. Staff discussed their learning needs, general wellbeing and aims for future professional development during annual appraisals, 1-to-1 meetings, practice team meetings and ongoing informal discussions.

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

The practice had some infection control procedures that reflected published guidance. Local anaesthetic cartridges were not stored in blister packs in treatment rooms and we found instruments that were not stored in line with guidance. Evidence was submitted following the inspection to show these issues had been rectified.

Some staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes. There was no evidence to show that 5 staff members had carried out infection prevention and control training.

We observed use of personal protective equipment and the decontamination of used dental instruments, which aligned with national guidance. We saw and staff confirmed that single use items were not reprocessed.

There was scope for improvement to ensure that the practice had effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems in line with current guidance. A Legionella risk assessment was carried out in 2015 however, it was unclear if the recommendations had been carried out. Following our inspection, plans were put in place to have a new risk assessment carried out. Limescale was found on taps in 3 of the treatment rooms.

At the time of our inspection, the decontamination area was found to be accessible to the public, with hazardous solutions openly available. This posed a potential health and safety risk. Following a discussion with the practice manager and the provider, immediate action was taken to mitigate the risk. A physical barrier was installed at the entrance to restrict public access, and all hazardous solutions were removed from the area.

Improvements were required to the practice’s protocols to ensure safe segregation and disposal of hazardous waste. At the time of our inspection, the clinical waste bin in the decontamination area did not have a lid and was accessible to the public. The outside clinical waste bin was not secure. These shortfalls were both rectified following our inspection.

We found shortfalls with the servicing of equipment in use as per manufacturers’ instructions. The autoclave servicing was found to be out of date as documentation reviewed showed one was last serviced in May 2023. An engineer had been arranged to carry out the service for the week following our inspection.

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.