Principal Dentistry

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 that 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. Fire exits were clear and well signposted, and fire safety equipment was serviced and well maintained. However, we saw that the 6 monthly service of the fire alarm was overdue. The practice manager assured us that this was scheduled to be completed on 23 August 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. A fire safety risk assessment was carried out by the practice manager in line with the legal requirements. The practice had systems in place for the management of fire safety. We discussed the log of fire safety checks completed and were told that although it was not documented, fire extinguishers were visually checked on a daily basis. The fire alarm was checked weekly and not daily. We were assured that the fire safety log would be updated to record this information. 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. We noted that the sharps risk assessment and sharps policy did not reflect current procedures at the practice and did not identify all items that could be considered to be sharps. Following our assessment, the provider submitted evidence that they had updated their assessment as required. The practice had systems for appropriate and safe handling of medicines. We noted that the practice name and address was not included on medicine labels, we discussed this with the provider and were assured that new labels would be purchased and used which included all of the required information. Antimicrobial prescribing audits were not carried out, but we were assured that this audit would be completed going forward.

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 practice team meetings and ongoing informal discussions. The practice had a small staff team, and we were told that currently the dental nurse had not received a performance appraisal, although they had probationary reviews during the course of their employment. The staff member told us that they were able to discuss learning needs, general wellbeing and aims for future professional development with the practice manager. Following this assessment, we were told that formal staff appraisal meetings would be conducted in future. 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. Staff told us they had received a structured induction programme, which included safeguarding.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff. Changes were required to the recruitment policy to ensure these reflected the relevant legislation. Following this assessment, we were told that the required changes had been made as appropriate. 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, equipment in use was maintained and serviced. The cleaning solution used during the manual cleaning process produced a foam which increased the risk of injury to staff whilst cleaning sharp objects. Staff were monitoring the temperature of the water during the cleaning process but were not logging this. Following this assessment, we were assured that a non foaming solution had been purchased and a new log started to record the temperature of the water used in the manual cleaning process. Staff had appropriate training, and the practice completed infection prevention and control audits every 6 months. The last audit had not been scored and there was no action plan. We were assured that these actions would be completed on future infection prevention and control audits completed. The practice had some procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment completed by the practice manager. We discussed the need for the provider to ensure that the person who carried out the risk assessment and provided advice on prevention and control of exposure must be competent to do so. Following this assessment, we were informed that an external professional company was scheduled to complete a legionella risk assessment on 30 August 2024 and that any action identified would be addressed. Staff were not following manufacturers recommendations when using the solution to clean dental unit water lines. We were assured that manufacturers’ recommendations would be followed going forward and all staff notified of the change of practice. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. There was no sanitary waste bin in the patient/staff toilet. Following this assessment, we were informed that a sanitary waste bin had been purchased.

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