Hartog at Twyford

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 had processes to identify and manage risks and staff we spoke with were able to describe these to us. However, not all the various risks arising from the undertaking of the regulated activities had been suitably identified or mitigated.

Staff demonstrated an open culture in relation to people’s safety. They felt confident that risks were well managed at the practice, but this was not wholly reflected in our findings.

A fire risk assessment dated 28 January 2026 had been carried out by a person who could not demonstrate they had the skills, knowledge and competence to assess the risks associated with fire at the premises and did not accurately reflect the practice. A fire risk assessment carried out by an external contractor in February 2017, was no longer reflective of the practice and had not been subject to regular review. Following the inspection, we received confirmation that a fire risk assessment had been carried out by an external contractor.

Fire exits were clear, but not always well signposted. Fire alarm servicing had not always been carried out at appropriate six-month intervals and was overdue since May 2025. Emergency lighting servicing and air conditioning maintenance were also overdue, with the latter not serviced since July 2022. An electrical installation condition report (EICR) dated 29/07/2026 identified remedial works that had not been completed. Following the inspection, confirmation was received that the air conditioning units had been serviced and that the fire alarm, emergency lighting, and electrical remedial works had been arranged.

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. Staff also participated in medical emergency scenario training.

Not all staff involved in providing treatment to patients under sedation had completed immediate life support training (or basic life support training plus patient assessment, airway management techniques and automated external defibrillator training). Following the inspection, we received confirmation that training had been arranged.

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) X-ray equipment. However, there was some confusion over the local rules as 2 different versions were available, including the template provided by the Radiation Protection Advisor (RPA) which was not populated.

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 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 systems for appropriate and safe management of medicines.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, but this was not always being followed. Information relevant to staff employment in their role as required under Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 was not always available. For example, a Disclosure and Barring Service (DBS) check appropriate to their role was not seen for 2 clinicians, and 7 staff held a DBS from a previous employment with no appropriate risk assessment. Evidence of Hepatitis B immunity was not available for 7 of 19 staff reviewed.

The practice did not have effective arrangements to ensure staff training, including continuing professional development (CPD), was up to date and reviewed at the required intervals. The provider was not able to evidence that all clinical staff had completed CPD relevant to their roles including; safeguarding adults and children, medical emergencies, and complaints handling, which are recommended by the General Dental Council (GDC). We saw additional gaps in training for fire safety, Legionella, and the Mental Capacity Act. Following the inspection, we received confirmation that staff had completed some of the required training, and additional training was planned.

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

Newly appointed staff had an appropriate role specific structured induction.

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.

There were effective processes to support and develop staff with additional roles and responsibilities. Staff discussed their learning needs, general wellbeing and aims for future professional development during annual appraisals, practice team meetings and ongoing informal discussions.

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

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 did not have wholly effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. A Legionella risk assessment had been completed the day before the inspection; however, the document was not available for review and there was no evidence of a previous Legionella risk assessment having been completed. In addition, although water temperatures were being checked, these were not being taken at the sentinel outlets. Following the inspection, the provider provided a copy of the risk assessment and confirmation of the actions the practice is taking.

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.