Highview Dental Practice

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.

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 and staff we spoke with were able to describe these to us. Staff demonstrated an open culture in relation to people’s safety. Staff felt confident that risks were well managed at the practice. However, this was not always confirmed by our findings.

The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely.

The management of fire safety was effective, and fire exits were clear and well signposted.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year.

However, systems to maintain oversight of the emergency equipment were not working effectively. Emergency equipment was not checked in accordance with national guidance, and this meant the provider had not identified missing and out-of-date items, which we highlighted. The provider sent us evidence the missing items had been ordered following the assessment.

We did not see satisfactory records of servicing and validation of all equipment in line with manufacturer’s instructions. The gas boiler was last serviced in November 2022, this should be completed annually. The provider did not service the air conditioning units. We discussed contacting the manufacturer for guidance on this.

Processes in place to maintain oversight of the use of radiography equipment needed improving. The required radiation protection information was not always available and the information that was, was not up to date, for example local rules. There was no X-ray warning signs on surgery doors and the orthopantomography (OPG) isolation switch was not labelled. We did not see X-ray servicing certificates for the OPG and the X-ray machine in one of the surgeries. Annual electromechanical serving of the X-ray equipment had not been carried out and there were some actions that had not been addressed from the critical examination report.

The practices systems for appropriate and safe management of medicines needed strengthening. We highlighted that improvements could be made to the tracking system used to reduce the risk of prescription theft or misuse and prescription pads should be always stored safely. The provider assured us improvements would be made.

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.

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.

Staff stated they felt respected, supported and valued and they were proud to work in the practice.

The practice did not have oversight processes to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. We saw gaps in the completion of staff training. We also did not see evidence that newly appointed staff had an appropriate role specific structured induction.

There were limited formal procedures such as documented team meetings and staff appraisals to support and develop staff with additional roles and responsibilities and for staff to discuss their learning needs, general wellbeing and aims for future professional development.

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 some areas for improvement with the decontamination of used dental instruments, to ensure it aligned with national guidance. We saw and staff confirmed that single-use items were not reprocessed.

The practice had effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment and current guidance.

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 yearly rather than following current guidance of every 6-months.

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