Brace Orthodontics

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. 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 dental equipment in line with manufacturer’s instructions. Fire exits were clear and well signposted.

The practice ensured equipment was safe to use and maintained and serviced according to manufacturers’ instructions. The practice ensured the dental facilities were maintained in accordance with regulations. Staff told us that the dental premises were leased from the Doctors’ practice in a shared building. A document entitled “fire safety risk assessment” had been provided by the Doctors’ practice. However, this was not considered fit for purpose as it had not adequately considered the risks associated with fire in the premises. The day after the inspection the dental practice arranged for a competent person to complete another fire risk assessment. The risk assessment identified that the leaseholder was responsible for the servicing and testing of the fire detection and fire extinguishers for the premises. The dental practice recorded when they heard the weekly smoke alarm tests. Emergency lighting was installed in the dental practice on 19 August 2024 and arrangements were in place for regular periodic testing to be undertaken. We were told that fire evacuation drills were arranged by the Doctors’ practice and although the dental staff participated, the records were not shared with them. We saw that servicing of the fire extinguishers was due in November 2023. We were told that the Doctors` practice arranged the servicing of the fire extinguishers. The practice told us that they would arrange servicing themselves in the future to ensure they meet the requirements in line with the relevant legislation. The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. 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 did not prescribe medicines.

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, during 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 “they had opportunities for group and individual training and that feedback at annual appraisals was always personal” 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. 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.

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). 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 for decontamination was maintained and serviced. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits in line with current guidance. The practice had requested a copy of the Legionella risk assessment for the shared premises from the leaseholder however this had not been provided. 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. We noted that the hot water temperatures recorded were below the recommended temperature. We were told this would be investigated and that a Legionella risk assessment would be completed by a competent person for the dental facility. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance.

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