Oswald House Dental Practice

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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 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 processes to identify and manage risks. We found these were not always applied consistently or effectively, particularly in relation to risks form fire, sharps injury and lone working. Staff demonstrated aa commitment to developing an open culture in relation to people’s safety.

Emergency equipment and medicines were not always available and checked in accordance with national guidance. We found that processes to monitor the effectiveness and availability of equipment were not in place, specifically all equipment associated with the delivery oxygen and maintaining airways had exceeded its manufacturers use by date or was not available. We identified scope for improvement in ensuring that staff could access emergency equipment in a timely way. Staff took immediate action to address these issues at the time of our inspection and submitted evidence that all required equipment was now available.

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, and free from clutter. Hazardous substances were clearly labelled and stored safely. We identified scope for improvement in ensuring premises were maintained in line with guidance. Records to confirm a satisfactory Electrical Installation Condition Report (EICR) certificate had never been obtained for the service and were not available during or following our inspection. The provider submitted evidence that an appointment was sought for this to be carried out.

We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions.

The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available.

Records to confirm that fire exits were clear and fire detection and suppression equipment in good order were not available. A fire risk assessment completed by a suitably qualified person had not been carried out for the service. Furthermore, records to confirm that monitoring checks of smoke alarms, fire exits and extinguishers were not available. Following our inspection, the provider submitted evidence that the fire risk assessment was scheduled to be carried out and that monitoring systems had been updated.

We identified scope for improvement with the practice systems for appropriate and safe management of medicines. NHS prescription pads were not always kept securely, and a log to monitor and track their use was not in place. Staff took action on the day of our inspection to address these issues.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum staff.

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 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 arrangements to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. However, we found these were not yet established within the service preventing the provider from having clear oversight of completion of required training by all staff.

As the service had been without a permanent manager for 2 years, processes to support and develop staff with additional roles and responsibilities were not established or effective. Processes to allow staff to discuss any issues, training needs or receive updates on the development of the service were not in place.

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.

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.

The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment and current guidance. We found these were not consistently applied. Records to confirm flushing of seldom used outlets was carried out. Water temperatures for outlets on the top floor of the service had not been carried out or recorded. The provider informed us action would be taken to address this issue.

The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste.

The equipment in use was maintained and serviced as per manufacturers’ instructions.

The practice completed infection prevention and control audits. We found these did not always reflect our observations of processes at the service and action plans were not developed where required. The provider informed us action would be taken to address this.

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