Arrow Dental Practice

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 . Where we found concerns relating to safe and effective staffing and safe environments, these were addressed immediately following feedback from the inspection team.

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 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. Daily huddles were held each day during lunch time, where staff escalated and discussed any concerns or risks. Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. Staff were encouraged to participate in medical emergency scenario training.

Most emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. However, the medical emergency kit did not include clear face masks or a self-inflating bag, which are recommended by the Resuscitation Council UK. In addition, there were no temperature checks to ensure that glucagon, which is a medicine used to treat low blood sugar, had been stored at a temperature between 2 and 8 degrees Celsius, according to manufacturer’s guidance. Following feedback, the service took immediate action and ordered replacement equipment and medicines. A daily log to record the fridge temperature was introduced. 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.

A fire safety risk assessment had been carried out in line with the legal requirements by an external company in 2007. This was reviewed by the principal dentist and a health and safety consultant yearly. The fire brigade had carried out an onsite assessment of the practice in the year preceding our inspection, and recommendations had been actioned. The management of fire safety was effective. The practice ensured equipment was maintained and serviced according to manufacturers’ instructions. Practice 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. Annual electromechanical servicing of all x-ray equipment had been completed. Improvements were required to ensure the 3 yearly performance checks were completed on time and all recommendations implemented. 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. Antimicrobial prescribing audits were carried out.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. One staff member said, ‘Our team are well trained, co-operative and dedicated to maintaining high standards of care.’ This was evident on the day of our assessment. Staff stated they felt respected, supported and valued. They were proud to work in the practice. Staff discussed their training needs during annual appraisals, clinical supervisions, practice team meetings and ongoing informal discussions. They also discussed learning needs, general wellbeing and aims for future professional development. Staff participated in daily huddles at lunch time, to discuss any concerns or issues. Staff demonstrated a robust 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. Whilst most staff members had a disclosing and barring service (DBS) check completed, improvements were required to ensure that this was also carried out for trainee dental nurses. Following feedback, the practice immediately applied for DBS checks to be completed for the trainee dental nurses. 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 ineffective arrangements to ensure staff training was up-to-date and reviewed at the required intervals. Not all staff had up to date training in safeguarding children and vulnerable adults, but all staff we spoke with had robust knowledge on how to deal with any safeguarding concerns. In addition, not all staff had completed training on learning disabilities and autism. Since 1 July 2022, health and social care providers registered with Care Quality Commission (CQC) must ensure that all staff receive training on learning disabilities and autism at a level appropriate to their role. Following feedback, the service sent evidence that all staff had completed and were up to date with this training. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. Some nursing staff had received additional training and were oral health educators.

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 and 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. Improvements were required to ensure the clinical waste bins were locked, as they were accessible to members of the public. Following feedback, the practice arranged for locks to be fitted to the bins through the waste collection company. We observed the decontamination of used dental instruments, which aligned with national guidance.

The practice completed infection prevention and control (IPC) audits every 6 months. Any actions arising from these audits had been noted and actioned. There were effective processes in place to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. The equipment used for the decontamination of dental instruments was well maintained and serviced.

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