The York Dental Suite

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.

The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. 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 equipment in line with manufacturer’s instructions. However, we did not see evidence of the required Electrical Installation Condition Report. Emergency equipment and medicines were available and checked in accordance with national guidance. Staff told us they could access these in a timely way. However, we noted medical emergency equipment and medicines were kept behind a locked door and raised concerns around ease and timeliness of accessibility in case of an emergency. Staff assured us they would consider changing the location to ensure timely and ease of access.

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. The practice had arrangements to ensure the safety of the X-ray equipment, and the required radiation protection information was available. This included cone-beam computed tomography (CBCT) and laser equipment. The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was effective. However, there was no evidence that recommended actions from the risk assessment had been completed. We raised this with the practice manager and were assured any outstanding action would be rectified as soon as possible. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sepsis awareness and lone working. However, a sharps risk assessment had not been completed. We raised this with staff and were assured it would be completed.

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. 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. These reflected the relevant legislation. Newly appointed staff had a structured induction, and clinical staff completed continuing professional development required for their registration with the General Dental Council. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. The practice had systems and processes to ensure clinical staff were qualified, registered with the General Dental Council (GDC) and had appropriate professional indemnity cover. However, these were not always followed. GDC certificates and current professional indemnity cover were not available for 2 members of staff on the day of assessment, and we have not received evidence since the assessment. Hepatitis B titre levels (to indicate antibodies related to the virus) were not kept for 2 of the clinical staff. We discussed this with the practice manager, they planned to contact occupational health to attain the titre levels for those members of staff who did not have them. The practice should ensure accurate, complete and detailed recruitment records are maintained for all staff. The practice had systems and processes to monitor staff training in relation to training being up-to-date and reviewed at the required intervals. We saw staff had not always completed required training. We did not see evidence of Safeguarding training for 2 members of staff, fire safety awareness training for 3 members of staff, and medical emergencies training for 3 members of staff. We raised this with the provider but have not received confirmation since the assessment that any of this training has been completed. The practice should take action to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.

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 was maintained and serviced. Staff demonstrated knowledge and awareness of infection prevention and control processes, and we saw single use items were not reprocessed. Staff had appropriate infection prevention and control (IPC) training, and the practice completed IPC audits in line with current guidance. However, there was no evidence of completing outstanding actions from the audit, or shared learning. The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. 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.