Ramsbottom Dental Care

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 that those concerns highlighted have been addressed by the provider. The impact of our concerns, in terms of the safety of clinical care, is minor for patients using the service. Once the shortcomings have been put right the likelihood of them occurring in the future is low. During our assessment of this key question, we found concerns related to: Safe and effective staffing and recruitment of staff which resulted in a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the body of the report below. 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.

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; staff we spoke with were able to describe these to us. Staff felt confident that risks were well managed at the practice, and the reporting of risks was encouraged. 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 management of fire safety was effective, and fire exits were clear and well signposted. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. Staff were encouraged to participate in medical emergency scenario training. Most emergency equipment and most medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. However, we noted that clear face masks, sizes 0, 1, 2, 3 and 4 and dispersible aspirin were missing from the medical emergency kit. These were order during the assessment. The practice should take action to ensure the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff, however they were not always followed. On the day of assessment, we checked 10 recruitment files. We noted that pre-employment checks, including Disclosure and Barring Service (DBS) were not carried out for 8 members of staff before they commenced employment at the practice. Hepatitis B titre levels were not obtained for 3 members of the clinical staff. Titre levels are required to indicate levels of antibodies following a vaccination to ensure the vaccine has been effective. Following the assessment, the practice submitted evidence that DBS risk assessments had been conducted on 12 November 2024 whilst the practice awaits new DBS checks. Hepatitis B risk assessments had also been conducted on 12 November 2024 whilst the practice sourced titre level results. The provider did not always ensure clinical staff completed continuing professional development required for their registration with the General Dental Council. Five members of clinical staff did not complete all aspects of safeguarding training needed for their role. Four members of staff did not complete fire safety awareness training. However, the practice submitted evidence in the days following the assessment that all outstanding training was completed on 11 November 2024. The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. Newly appointed staff had a structured induction, which included safeguarding.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew their responsibilities for safeguarding vulnerable adults and children. Staff stated they felt respected, supported and valued, and they were proud to work in the practice. Staff discussed their training needs during annual appraisals, 1 to 1 meetings and practice team meetings and ongoing informal discussions. They also discussed learning needs, general wellbeing and aims for future professional development.

The practice had cleaning procedures and schedules to ensure effective cleaning. Staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes. The equipment in use was maintained and serviced as per manufacturers’ instructions. We saw, and staff confirmed that single use items were not reprocessed. The practice had infection control procedures that reflected published guidance however, they were not always followed. The thermometer used for measuring the temperature of manual cleaning solution was not in use on the day of assessment. The thermometer was found and moved back into the decontamination room on the day of assessment. The practice completed infection prevention and control audits in line with current guidance. However, it did not reflect our findings on the assessment day, the recent audit did not highlight the lack of thermometer during manual cleaning. We discussed this with staff and were assured this would be addressed and rectified.

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