Excel Dental Care

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. Following feedback from the inspection team, the service planned to introduce medical emergency scenario training, which would be included in their monthly practice meetings. 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 monthly. Although the service had implemented a robust system to check the expiry dates of the emergency equipment and medicines, improvements were required to ensure checks of the resuscitation equipment were carried out weekly, according to guidance published by the Resuscitation Council UK. Staff could access the emergency equipment 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.

The practice ensured equipment was safe to use and serviced according to manufacturers’ instructions. The practice ensured the facilities were maintained in accordance with regulations. A fire safety risk assessment had been carried out in line with the legal requirements. The practice was in the process of updating the emergency lighting in the building, which was a required action within the fire risk assessment. 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 and sepsis awareness. The practice had systems for appropriate and safe prescribing of medicines. Improvements were required to ensure that antimicrobial prescribing audits were carried out to reflect current guidance on antimicrobial prescribing from the Faculty of Dental Surgery and Faculty of General Dental Practice.

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. One patient said, “I always manage to get an emergency appointment when I need one.”

Staff we spoke with had the skills, knowledge and experience to carry out their roles. Several staff members had been working at the practice for many years. They told us that there were sufficient staffing levels and they worked well as a team. Staff stated they felt respected, supported and valued. They were proud to work in the practice. Staff discussed their training needs during annual 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. Staff received a structured induction programme, which included safeguarding.

The practice had recruitment procedures to help them employ suitable staff. These reflected the relevant legislation. Agency staff were rarely used, as the receptionist was also a trained nurse and could help with nursing duties when required. 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. Improvements were required as not all staff had received training in treating patients with autism or learning difficulties. The Health and Care Act 2022 states that all health and social care providers must ensure that their staff receive training in how to interact appropriately with people who have a learning disability and autistic people, at a level appropriate to their role. Following feedback, the practice arranged for all staff to complete the appropriate training. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. One staff member told us that they had been appointed as the lead to organise the practice meetings.

Patients told us that the practice looked clean and well maintained.

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 was maintained and serviced. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits every 6 months. Hand hygiene audits had also been completed. 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.