Dental Arts - Harrogate Also known as Ace Denta 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.

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 and leaders told us of the new procedures they have implemented to manage risks for patients, staff, equipment and the premises. Staff told us that missing and expired emergency medicines and equipment had been replaced. We saw evidence of checklists being used to ensure emergency medicines and equipment were in stock and in date. Checklists detailed each item that was required as set out by the Resuscitation Council (UK) to ensure nothing was missed.

We observed the practice had made the following improvements to comply with the regulations: Missing emergency medicines and equipment had been replaced and were available and checked in accordance with national guidance. The practice had made improvements to the storage of hazardous substances which were clearly labelled, and the safety data sheets were stored in a way that would enable quick access in an emergency. The practice had made improvements to ensure equipment was safe to use and maintained and serviced according to manufacturers’ instructions. We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions including an Electrical Installation Condition Report, Gas Safety Certificate and a Portable Appliance Testing record. However, not all the outstanding maintenance certificates were provided on the day of assessment. The provider had booked a service for the compressor for the 10 September 2024 and we have since received a service report.

Improvements have been made to ensure the environment and equipment was now safe, but there were still improvements needed for the oversight and assurance. The practice had implemented some systems to assess, monitor and manage risks to patient and staff safety. However, these were yet to be embedded, and therefore were not yet fully effective. There were still no sharps or health and safety risk assessments in place. The provider had appointed an external company to carry out a fire risk assessment. However, the provider had not recognised some inaccuracies within the risk assessment report. We recommended the practice ask the company to return to address these inaccuracies to ensure the risk assessment was specific to the practice. They have since confirmed this has been done. We saw evidence of smoke alarm and fire extinguisher servicing. However, there were still no internal assurance processes for regular testing of smoke alarms and visual checks of fire extinguishers. Improvements had been made to ensure the safety of the X-ray equipment and we saw evidence of the required radiation protection information. We saw evidence of the critical examination document for the X-ray machine in an upstairs surgery and local rules were displayed for the upstairs X-ray machine. However, there was still no evidence of registration with the Health and Safety Executive for the use of radiography. Improvements had been made to medicines management procedures which were in line with current legislation and guidance. Labels on dispensed antimicrobials were now in line with the Human Medicines Act 2012. A process had been implemented to monitor stock control and identify if any were missing and antimicrobials were in a locked cupboard. However, the key was in the lock on the day of assessment and therefore not secure.

During our assessment on the 24 July 2024, we were not assured that staff had the skills, knowledge and experience to carry out their roles because there were gaps with knowledge when speaking with staff and in staff training. During the follow up assessment process, some staff confirmed that they were now up-to-date with training and had submitted evidence that outstanding training had been completed. There were still some staff that were unaware if they were up-to-date with all their required training.

During our follow up assessment process, we received some of the outstanding evidence to show that all clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. We also received evidence of a Disclosure and Barring Services (DBS) check for 1 of the 2 staff members that were previously not available. There were still improvements required to the systems for ensuring staff training was up-to-date and reviewed at the required intervals, and that clinical staff can demonstrate effectiveness of Hepatitis B vaccinations.

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.

Improvements had been made to ongoing monitoring of water systems. On the day of assessment, an external company was booked in to carry out a Legionella risk assessment. We have since been provided a copy of the report and recommended actions. We saw evidence that lesser used water outlets such as the tap in the disused laboratory were being flushed to prevent water stagnating. However, we were still not assured that staff responsible for the management of legionella had the appropriate skills and training.

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