Archived: The Lodge Dental Suite - Cheshunt

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. 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. On the day of the on-site assessment, we noted that the practice did not have a spacer device to facilitate the delivery of the medicine Salbutamol. This was obtained immediately. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. Staff told us that the landlord was responsible for the maintenance of the shared premises. Fire exits were clear and well signposted, and fire safety equipment was serviced and well maintained.

We saw satisfactory records of servicing and validation of most equipment in line with manufacturer’s instructions. However, we did not see that the ultrasonic bath had been serviced. Immediately after the assessment a new ultrasonic bath was ordered. The dental compressor was last serviced in February 2023 and reported as being in poor condition. A new compressor was ordered immediately. The practice ensured the facilities were maintained in accordance with regulations. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was mostly effective. Some improvement could be made by recording the periodic in-house testing of the smoke alarms and emergency lighting. Immediately after the assessment, a log was introduced to record these in-house tests. The practice had some arrangements to ensure the safety of the X-ray equipment. However, improvement was required to the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. On the day of the on-site assessment, acceptance and critical examination reports were not available for the mobile X-ray unit which had been obtained in May 2024. However, the provider had already arranged a date of 28 August 2024 for these tests to be completed, before this was highlighted to them. In addition, the local rules were written for the previous intraoral X-ray unit and were therefore not specific to the hand-held X-ray unit. The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health for dental products. However, risk assessments had not been completed for some cleaning products used in the practice. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety and lone working.

At the time of our assessment, the patients felt there were enough staff working at the practice. They were able to book appointments when needed.

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. They were proud to work in the practice. 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. One staff member told us that they were supported to develop and improve their skills and knowledge. “Everyone is friendly and helpful. I’m enjoying my work.” Another said they were, “encouraged to attend regular courses as part of my continued 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 the relevant legislation. However, we saw that satisfactory evidence of conduct in previous employment had not been requested for all staff and that one member of staff had not completed a Disclosure and Barring Service(DBS) check to the appropriate level. An application for the appropriate level of DBS check was arranged immediately following the on-site assessment. 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. Improvement could be made to ensure that staff were provided with information to increase their awareness of the presentation and management of sepsis. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities.

Patients told us that the practice looked clean, and equipment appeared to be in a good state of repair.

Staff told us how they ensured the premises and equipment were clean and well maintained. They demonstrated knowledge and awareness of infection prevention and control processes. Staff told us that single use items were not reprocessed.

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). 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 with the exception of the ultrasonic bath. 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 which included treatment of the dental unit water lines, water quality testing and monthly temperature checks. Some recommended actions from the risk assessment which had been completed immediately before the on-site assessment were identified. This included removal of scale from taps, flushing of infrequently used taps and removal of a dead-leg pipe. Immediately after the on-site assessment, we were provided with evidence that the provider had contacted the landlord of the premises to ensure that actions relating to the shared premises were actioned. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. However, improvement could be made so that the clinical waste container was better secured to a fixed structure. This was rectified immediately.

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