Smileright Dencare Limited - Basingstoke

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 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.

During our assessment of this key question, we found concerns related to the safety of the premises, recruitment, training, support and development of staff, and the infection prevention and control standards being followed at the practice. This resulted in a breach of Regulations 12, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can find more details of our concerns in the evidence category 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.

Staff told us they knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. However, although we saw evidence that one member of staff had completed basic life support training online, we did not see evidence that any ‘hands-on’ training had been completed by any staff, as recommended by the Resuscitation Council UK Quality Standards for Primary Dental Care. Information sent to us following the inspection did not provide evidence that the whole staff team had completed basic life support training.

We saw that leaders were not always able to identify and manage risks. For example, there was no risk assessment for sharps. Additionally, leaders could not demonstrate an understanding of their specific responsibilities in relation to detecting and controlling potential risks in the care environment as they were unaware of who was responsible for servicing and maintenance of the equipment and facilities.

Emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way.

The treatment rooms and reception area were clean, well maintained and free from clutter. However, we saw 2 storerooms were filled with waste, confidential patient information and broken or expired equipment. Following the inspection, we saw evidence that these rooms had been cleared. We also found that the taps at various sinks had visible signs of corrosion and limescale which increases the risk of Legionella proliferation. In addition, the head rest of one dental chair was not intact.

Hazardous substances were clearly labelled but not stored safely as they were in an area accessible to patients. In addition, not all dental materials and cleaning products had up to date risk assessments or safety data sheets accessible to staff, in line with Control of Substances Hazardous to Health (COSHH) regulations 2002.

Fire exits were clear and well signposted although several were seen to be kept open with rubber wedges. Staff told us they would ensure they are following the fire risk assessment by keeping fire doors closed.

We did not see satisfactory records of servicing and validation of all of the equipment in line with manufacturer’s instructions. We did not see evidence that the compressor had been serviced since 2018. We also did not see servicing records for the air conditioning or the water heater.

A fire risk assessment had last been carried out on 16 March 2018 by an external company. However, the practice had not completed the actions outlined within this risk assessment. We saw no evidence that the fire alarm or emergency lighting had been serviced, or any records of periodic testing or checks of the fire alarm, emergency lighting or fire extinguishers. In-house testing of the fire alarms should be recorded weekly, and in-house testing of the emergency lighting and fire extinguisher visual checks, should be recorded monthly. We saw no records to demonstrate that staff had performed fire evacuation drills. The provider told us that the building owner carried out the servicing and testing of fire safety equipment but was unable to provide documentation of this. In addition, we did not see evidence of an Electrical Installation Condition Report (EICR). Following the inspection, we were sent an EICR that had been arranged by the building owner, however the report stated the dental installation was not tested.

Arrangements to ensure the safety of the X-ray equipment were ineffective. Although the required radiation protection information was available, the 3 intra-oral x-ray units had not been subjected to yearly electromechanical servicing and we did not see any evidence of any performance checks for 1 of the units, which should be completed on a three yearly basis following the initial Critical Examination and Acceptance Test Report.

Staff told us that there were sufficient staffing levels.

Staff stated they felt respected, supported and valued.

Staff we spoke with demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew their responsibilities for safeguarding vulnerable adults and children.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff. These reflected the relevant legislation but were not always being followed. Information relevant to staff employment in the role as required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was not always available. For example, we were told that a cleaner was employed but there were no recruitment records available; Disclosure and Barring Service (DBS) checks were not available for 2 staff members and no associated risk assessment had been carried out. A full employment history and satisfactory evidence of conduct in previous employment was not available for 4 staff members. Satisfactory information about any physical or mental health conditions was also not available for 4 staff. We were not shown evidence of Hepatitis B immunity (titre levels) or a risk assessment for 3 staff members.

The provider had an induction process, but this was not being followed or completed. The practice ensured clinical staff were qualified, registered with the General Dental Council (GDC) and had appropriate professional indemnity cover. There were ineffective arrangements to ensure staff training was up-to-date and reviewed at the required intervals. The registered manager did not have access to the computer-based system that was used to monitor staff training and development. The practice had ineffective processes to support and develop staff with additional roles and responsibilities. We did not see evidence that dental professionals maintained a personal development plan as required by the GDC. We did not see evidence that staff had received appropriate support, training and professional development. Not all clinical staff were able to demonstrate that they had undertaken all continuing professional development relevant to their roles as recommended by the General Dental Council. We saw gaps in the following topics: radiography, safeguarding adults and children, Mental Capacity Act, Legionella, infection, prevention and control (IPC), legal and ethical, oral cancer, learning disabilities and autism, Sepsis, and complaints handling.

The practice appeared clean but there was not an effective schedule in place to ensure it was kept clean. Records did not demonstrate that cleaning was completed at the stated intervals and the staff were unclear on the frequency of cleaning at the practice. We saw that whilst there was appropriate cleaning equipment available to staff this was not being used.

Staff followed infection control principles, including the use of personal protective equipment (PPE).

We saw household waste which had not been disposed of appropriately. Hazardous waste was segregated but not disposed of safely. We saw an overflowing clinical waste bin in a publicly accessible area. Records showed the waste had not been collected in accordance with the contractor’s agreement, for example the last consignment note was dated 19 December 2024 and no collection had taken place since that date. Following the inspection, we received confirmation that the clinical waste had been collected.

We observed the decontamination of used dental instruments, which aligned with national guidance.

The practice had infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. Staff demonstrated knowledge and awareness of infection prevention and control processes and we saw single use items were not reprocessed.

The practice had completed infection prevention and control (IPC) audits, but these were not reflective of the practice or completed in line with current guidance.

The practice had ineffective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. A risk assessment had been completed, but the recommended control measures were not acted upon when temperature checks identified that temperatures were not within the appropriate range to prevent the development of Legionella bacteria.

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