Jonathan Lever - 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 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.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. We discussed with the provider the benefits of practicing medical emergency scenarios in practice meetings. The provider told us that in the future these would be regularly included in meeting agendas. Staff we spoke with told us that equipment and instruments were well maintained and readily available. The provider described the processes they had in place to identify and manage risks. Staff felt confident that risks were well managed at the practice, and the reporting of risks was encouraged.

Emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. The premises were 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. Whilst fire exits were clear and well signposted, and fire safety equipment was serviced and well maintained, a fire risk assessment to identify the risks associated with fire had not been carried out by a person who had the qualifications, skills, competence and experience to do so. In their response to our inspection feedback, the provider told us that this had been booked for 14 November 2024.

The practice ensured equipment was safe to use and maintained and serviced according to manufacturers’ instructions. The practice ensured the facilities were maintained in accordance with regulations. On the day of the inspection, the practice did not have suitable arrangements to ensure the safety of the X-ray equipment. We noted that the 3-yearly performance check for the intraoral unit in Surgery 2 was out of date and there was no evidence of annual electro-mechanical servicing on the intraoral units. Following the inspection the provider submitted evidence that the intraoral units had been serviced on 13 November 2024 and were in satisfactory condition. The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety, sepsis awareness and lone working. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. Staff stated they felt respected, supported and valued. Staff discussed their training needs during annual appraisals, 1 to 1 meetings, practice team meetings and ongoing informal discussions. They also discussed learning needs, general wellbeing and aims for future professional development. 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 broadly the relevant legislation. On the day of inspection, Disclosure and Barring Service (DBS) checks were not available for the most recently employed members of staff. We were shown evidence that these had now been applied for and evidence that some of the DBS checks had been received was submitted after the inspection. We discussed with the provider the importance of carrying out recruitment checks in line with the legal requirements at the point of employment. In addition, we noted that not all clinical staff had evidence of their response to Hepatitis B vaccination. In response to our inspection feedback, the provider told us that where required, staff had now booked blood tests to check their immunity level. 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, and clinical staff completed continuing professional development required for their registration with the General Dental Council. The practice had arrangements to ensure staff training was up-to-date and reviewed at the required intervals. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities.

The practice appeared clean and there was an effective schedule in place to ensure it was kept clean. Staff followed infection control principles, including the use of personal protective equipment (PPE). Hazardous waste was segregated and disposed of safely. 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. We discussed with the provider to ensure that processes and facilities for manual cleaning were in place in case the ultrasonic baths were unavailable, or instruments with heavy deposits required reprocessing. The provider took immediate action and submitted their manual cleaning procedure document. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits in line with current guidance. The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment.

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