Stoke Lane Dentistry

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We found this practice was not providing well-led care in accordance with the relevant regulations. We will be following up on our concerns to ensure the provider had made the required improvements.

During our inspection of this key question, we found the registered person had ineffective systems or processes in place to enable them to assess, monitor and improve the quality and safety of the services being provided.

This resulted in a breach of Regulation 17, Good governance.

You can find more details of our concerns in the detailed 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 Shared direction and culture is based on the latest evidence we assessed for the Well-led key question.

The judgement for Capable, compassionate and inclusive leaders is based on the latest evidence we assessed for the Well-led key question.

The judgement for Freedom to speak up is based on the latest evidence we assessed for the Well-led key question.

The judgement for Workforce equality, diversity and inclusion is based on the latest evidence we assessed for the Well-led key question.

The practice was experiencing a period of significant change due to its acquisition by the new owner. As a result oversight of the practice had not ensured that systems and processes were embedded in the day-to-day running of the practice.

The practice had ineffective systems for governance and the ongoing assessment and management of risks, including for fire safety, staff training, lone working, sharps injury, management of X-ray imaging, guidance around decontamination of dental instruments.

The practice had a governance system that included policies and procedures, which were accessible to staff and were reviewed on a regular basis.

The practice had systems and processes for learning, quality assurance and continuous improvement. This included undertaking audits according to recognised guidance.However, the systems and processes in place for maintaining equipment were not always effective, as they failed to identify outdated items, for example, the biohazard spillage kit.

Staff were aware of the importance of protecting patients’ personal information. Staff password protected patients’ electronic care records, and paper records were stored securely and complied with General Data Protection Regulations.

There were processes in place for identifying and managing incidents and accidents, and for receiving and acting on safety alerts. We discussed how communications with all staff could be improved by holding regular practice team meetings.

Concerns and complaints were responded to appropriately, and outcomes were discussed to share learning and for improvement.

The practice had taken steps to improve environmental sustainability. For example recycling where possible and turning off electrical appliances when not in use.

The judgement for Partnerships and communities is based on the latest evidence we assessed for the Well-led key question.

The judgement for Learning, improvement and innovation is based on the latest evidence we assessed for the Well-led key question.