A & D Dental Practice Ltd

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. We noted that this was not confirmed by evidence during the assessment. 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. We found this was not fully confirmed by evidence during our inspection.

Emergency equipment and medicines were not always available and checked in accordance with national guidance. We noted a number of items of equipment were missing or had exceeded their use by date including; buccal midazolam, dispersible aspirin, self-inflating bag with reservoir for adults and child size along with oxygen masks sizes 0-4, the provider ordered replacement items immediately. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. Records of servicing and validation of equipment in line with manufacturer’s instructions were available for the majority of equipment. We noted that the cone-beam computed tomography (CBCT) machine had not been serviced since 2022. The provider submitted evidence that this servicing was scheduled to be carried out following our inspection. Fire exits were clear and well signposted, and fire safety equipment was serviced and well maintained.

With the exclusion of the previously mentioned CBCT, the practice ensured the majority equipment was safe to use and maintained and serviced according to manufacturers’ instructions. The practice was based in a rented building with responsibility for the maintenance of the environment and facilities shared with the landlord. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was effective. The practice arrangements to ensure the safety of the X-ray equipment were not robust and the required radiation protection information was not always available. This included cone-beam computed tomography (CBCT) and handheld X-ray equipment. We noted that local rules were not displayed in the service or during domiciliary visits. Warning signs and a 2 stage light for the CBCT were not in place and the provider had not registered radiography equipment with the Health and Safety Executive (HSE). Following our inspection, the provider submitted evidence that HSE registration was completed, local rules available and warning signs were in place. 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. The practice had systems for appropriate and safe handling of medicines. We found that antimicrobial prescribing audits were not carried out in line with guidance or approved timescales.

We did not receive any feedback from patients.

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 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. We found these were not applied consistently so did not always reflect relevant legislation. Required pre employment information such as employment history, references and proof of identification were not always available. Following our inspection the provider submitted evidence that these checks were completed and procedures were updated. The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. 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.

We did not receive any feedback from patients.

Staff followed infection control principles, including the use of personal protective equipment (PPE).

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. We observed the decontamination of used dental instruments. We found this did not fully align 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. Staff had appropriate training. Infection prevention and control (IPC) audits were not completed in recommended timeframes or in line with current guidance. The provider offered assurances these would be updated. The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. We identified scope for improvement in ensuring that completion of monitoring checks for water temperature and flushing of seldom used outlets was recorded accurately. Following our inspection, the provider submitted evidence of updated recording systems and processes. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. We identified that clinical waste bags were not marked in a way to identify the practice as their source. The provider took action to address this issue immediately.

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