Worthing Dental Centre

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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 not providing safe care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider has made the required improvements. Whilst there are issues to be addressed, the impact of our concerns relates to the governance and the oversight of the risks, rather than a patient safety risk.

During our inspection of this key question, we found concerns related to

the safety of the premises and equipment, recruitment, and training, support and development of staff, and the infection prevention and control standards being followed at the practice.

These concerns resulted in breaches of regulations 19 Fit and proper persons employed) and 17 Good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the report findings below.

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 ineffective processes to identify and manage risks.

A fire safety risk assessment had been carried out in March 2024 by an external company. Following inspection a new fire safety risk assessment completed in March 2025 identified the previous recommendations had not been acted on. We saw that fire evacuation drills had not been completed since August 2022 and not all staff had completed fire safety training. Records showed testing the emergency lighting, fire alarms and fire extinguisher checks were inconsistent. The provider told us that all recommendations would be implemented and a contractor will complete the required work to improve fire safety. Overall, we found that the management of fire safety was not effective as the provider had not taken timely and appropriate action to mitigate the risks previously identified.

Fire exits were clear and well signposted, although improvements were needed to ensure that instructions of what to do in the event of a fire were more clearly displayed throughout the practice.

We saw the last Electrical Installation Condition Report (EICR) was completed in October 2019. Information sent to us following inspection confirmed that an EICR was completed in April 2025 and highlighted a number of actions. Although the provider confirmed that required works were all scheduled to start on 17 May 2025, we were not assured that the management of electrical safety was effective as the provider had not arranged for this to be checked within the required 5-year timescale.

Overall, the premises were clean, well maintained and free from clutter. However, in the basement we saw combustible materials stored there including cleaning equipment, broken or expired electrical equipment, Gypsum waste and confidential patient information records.

The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health. Improvements could be made to ensure that all hazardous substances were stored securely. We saw cleaning materials not stored in line with Control of Substances Hazardous to Health (COSHH) regulations.

Systems for checking emergency equipment and medicines required strengthening as they had not identified that items of medical emergency kit were missing. There were no paediatric pads for the Automated External Defibrillator (AED). We brought this to the provider`s attention and they ordered these items immediately following 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 practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. Improvements were underway to ensure that clinicians used rectangular collimators as recommended.

The practice had systems for appropriate and safe management of medicines. A log was in place to monitor and track the use of NHS prescription pads, improvements could be made to ensure these were kept securely.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff. However, we saw that recruitment processes had not always been followed and documentation as required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was not always available. For example, there were no recruitment records for three staff employed, not all clinical staff had evidence of immunity to Hepatitis B, and there was no evidence that all staff had completed a health declaration. In addition, satisfactory evidence of conduct in previous employment had not always been obtained.

Newly appointed staff did not always have an appropriate role specific structured induction. Although there were computer based systems in place to ensure staff training was up-to-date and reviewed at the required intervals, these were not used effectively. We identified gaps in core areas relevant to dentistry such as safeguarding, learning disabilities and autism, Sepsis and Legionella. Furthermore, staff had not participated in medical emergency update training as recommended by the Resuscitation Council (UK) guidelines.

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

Staff told us they had clear responsibilities, roles and systems of accountability to support good governance and management. However, improvements were needed to ensure that leaders had sufficient oversight of the practice on a day-to-day basis. Feedback comments from staff told us that the practice manager worked remotely and that the practice would benefit from an onsite manager. The provider told us there were plans to recruit a new practice manager.

Feedback from staff was obtained through remote meetings and informal discussions. Staff feedback demonstrated that the remote nature of these conversations required review.

Improvements could be made to ensure processes to support and develop staff with additional roles and responsibilities were in place and embedded within the practice team. Not all staff had received 1 to 1 meetings or appraisals to support development.

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

The practice did not have robust protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste in line with the guidance issued in the Health Technical Memorandum 07-01. Clinical waste (Gypsum) had not been disposed of appropriately and we saw an overflowing clinical waste bag in the basement area. Records showed this had not been collected in accordance with the contractor’s agreement.

We saw the practice was visibly clean throughout but there were no records to demonstrate that the communal areas had been cleaned at the required intervals. Appropriate cleaning equipment was not always available and not stored correctly in line with guidance. Following the inspection, we received confirmation that the excess clinical waste had been collected and coloured mops and buckets had been ordered.

Staff demonstrated knowledge and awareness of infection prevention and control processes.

The practice had infection control procedures that reflected published guidance but these weren’t always followed. Infection prevention and control audits had been completed however these did not identify the shortalls.

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 records of servicing and validation of equipment in line with manufacturer’s instructions. We were not assured that 4 of the 6 autoclaves had been serviced as records were duplicated.

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. Improvements were needed to ensure that local anaesthetic cartridges were decanted from their blister packs at the point of use.

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