Heath Street Dental

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. Immediate life support training had also been completed by some staff members. Staff were encouraged to participate in medical emergency scenario training. 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. However, we found there was no self-inflating bag to use for a child and the adhesive defibrillator pads to use with the automated external defibrillator (AED) had expired. The practice immediately ordered these items following feedback. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. We looked at dental materials stored within the treatment rooms and found expired items in 3 surgeries. These items were immediately removed following our feedback and the practice implemented a system to effectively monitor and track expiry dates of dental materials. We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. Fire exits were clear and well signposted. Yearly testing of the fire alarm, emergency lighting and fire extinguishers was due in January 2024. This was booked for the day after our assessment.

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 in line with the legal requirements by the practice manager. The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. However, yearly electromechanical checks of the intra-oral x-ray machines had not been completed since 2021. The service booked for this to be completed immediately following our feedback. Rectangular collimators were not routinely used, despite this being a recommendation from the radiation protection advisor. Rectangular collimators reduce the effective dose to the patient. The rectangular collimators were fixed to each intra-oral x-ray unit immediately following feedback. 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. Safer sharps were available for clinicians to use, but not all clinicians used them. There were no needle guards to use as a substitute. Needle guards were purchased immediately following feedback. A sharps risk assessment had been carried out in line with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. Improvements could be made to ensure the antimicrobial audits reflected the current guidance from the Faculty of Dental Surgery and College of General Dentistry on antimicrobial prescribing.

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 and 100% of patients were able to get appointments at a time which was convenient for them.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels most of the time. Leaders told us that recruiting new nurses had been a challenge for the practice. Staff stated they felt respected, supported and valued. They were proud to work in the practice. Staff discussed their training needs during 6 monthly appraisals, 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.

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 did not fully align with guidance issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practice. Heavy duty gloves and aprons were not routinely used and the temperature of the water used for manual cleaning of the dental instruments was not monitored to ensure it was below 45 degrees Celsius. While decontaminated instruments were pouched, there were inconsistencies with dating them, so there were no assurances they would all be reprocessed within 12 months. X-ray holders were not pouched or reprocessed within 24 hours. Following feedback, the decontamination procedures were reinforced and reminder notices were placed in the decontamination rooms with check lists for staff to follow.

The practice had infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits. 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.