The Dental Surgery

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. The clinical team had completed face to face medical emergency training in December 2023, and medical emergency scenarios were discussed in practice meetings. Improvements could be made to ensure that the trainee dental nurse, who commenced their employment at the practice in March 2024, also completed training in emergency resuscitation and basic life support. 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. The practice implemented systems for reporting on accidents and incidents. Staff felt confident that risks were well managed at the practice, and the reporting of risks was encouraged.

Emergency equipment and medicines were now available and checked in accordance with national guidance. Staff could access these in a timely way. The practice checked medical emergency drugs and equipment weekly as set out in the relevant guidance published by the Resuscitation Council (UK). In addition, the practice now had a bodily fluid kit and mercury spillage kit. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. The practice had colour coded mops and buckets and these were stored correctly. The practice had implemented the use of cleaning logs to ensure the effectiveness of cleaning. We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. These included validation and servicing records for the autoclave and the ultrasonic bath. We saw records to demonstrate that the protein residue tests, automatic control tests and cleaning efficacy tests had been carried out on the ultrasonic cleaner in line with the current guidance. Fire exits were clear and well signposted, and fire safety equipment was serviced and well maintained.

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. We were shown evidence that the air conditioning system had been serviced and the gas appliance had been checked for safety. In addition, electrical installation condition checks had been carried out on 15 December 2023, and we were shown evidence to confirm that the remedial works highlighted in the report had been scheduled for 24 May 2024. A fire safety risk assessment had been carried out on 22 December 2023 and the recommendations made within the risk assessment had been acted upon. Fire drills were being carried out and staff had completed fire awareness training. The management of fire safety was now effective. The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. The practice had systems in place for the quality assurance of wet film processing. 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 and sepsis awareness. The practice had implemented the use of needle guards and updated their sharps risk assessment. Staff had completed sepsis awareness training and sepsis prompts had been displayed in the practice. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. The audit was reflective of the arrangements within the practice and it included a detailed action plan to drive continuous improvement.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. Since the last inspection in November 2023, the practice had employed a trainee dental nurse to ensure that dentists worked with chairside support at all times. 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. Staff we spoke with demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. The practice now had a dedicated safeguarding folder. This included a safeguarding flowchart with contact details of the Local Authority, a safeguarding children in the dental practice checklist, and an updated safeguarding children and vulnerable adults policy. Staff knew their responsibilities for safeguarding vulnerable adults and children. The trainee nurse told us they had received a structured induction programme, which included safeguarding. We discussed with the provider the benefits of ensuring that the trainee nurse also completed safeguarding training at a level appropriate to their role.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff. These broadly reflected the relevant legislation. We noted that the trainee nurse had a basic Disclosure and Barring Service (DBS) check on file, instead of the required enhanced certificate. We brought this to the provider`s attention and they took immediate action by initiating an application for an enhanced certificate. 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. Since the last inspection, all long-standing members of the dental team had completed fire safety, sepsis, Legionella awareness, Mental Capacity Act (2005), learning disability and autism awareness and face to face basic life support training. The practice had arrangements to ensure staff training was up-to-date and reviewed at the required intervals. They had implemented an effective system to monitor staff training. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities

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). Cracks on the work surfaces had been sealed, tears on the dental chairs had been repaired and the flooring in the treatment rooms was now coved to the wall. The practice had implemented improvements to ensure that there were effective systems in place to control the storage time of sterilised instruments. Improvements had been made to ensure that hazardous waste was segregated and disposed of safely. We observed the decontamination of used dental instruments, which aligned with national guidance.

The practice had updated their infection prevention and control policy which now reflected published guidance and was tailored to the service. Staff had appropriate training, and the practice completed Infection prevention and control (IPC) audits in line with current guidance. The audits carried out in December 2023 and April 2024 included a detailed action plan to drive continuous improvement. A Legionella risk assessment had been carried out on 22 December 2023 and the recommendations made within the risk assessment had been acted upon. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. The practice had implemented systems to ensure that dental materials were not used beyond their expiry date.

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