Atlantic Dental Practice - Picton

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.

The practice should take action to ensure the training staff receive is sufficient to manage medical emergencies and review the availability of equipment in the event of a medical emergency, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council. Most emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. However, there were insufficient needles and syringes to enable staff to deliver repeat doses of adrenaline if required. We highlighted additional size of needles which should be obtained. Staff knew how to respond to a medical emergency and gave examples where they had. They completed training in emergency resuscitation and basic life support every year, but we noted the clinicians had completed online training only. Staff who did complete hands-on training did this at the company head office and were not encouraged to participate in clinic-based medical emergency scenario training. A building manager was responsible for ensuring that facilities were safe, including electrical and gas appliances. The provider obtained evidence from the building manager to ensure the safety and suitability of the premises. Staff were clear on how to report any faults or concerns. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. Staff we spoke with told us that equipment and instruments were well maintained and readily available. We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. The provider described the processes they had in place to identify and manage risks. There were systems for staff to report risks.

The practice ensured equipment was safe to use and maintained and serviced according to manufacturers’ instructions. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was effective. Fire exits were clear and well signposted, fire safety equipment was serviced and well maintained, and staff participated in evacuation drills.

The practice had arrangements to ensure the safety of the X-ray equipment, and the required radiation protection information was available. The most recent routine testing report highlighted rectangular collimation (used to decrease the radiation dose to patients as well as increase the quality of the images) should be used to minimise dosages. However, this had not been actioned. 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. We highlighted the information to support staff to obtain appropriate advice and follow up after sharps injuries could be made clearer to staff. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.

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. We highlighted where checks of indemnity documents could be improved to ensure evidence of current cover is uploaded in a timely way.

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. Staff discussed their training needs during annual appraisals, 1 to 1 meetings, during clinical supervision, 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. We signposted staff to additional resources to provide information on the range of safeguarding issues they may encounter and encouraged further discussions around this. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities.

The practice had infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. The practice appeared clean and there was an effective schedule in place to ensure it was kept clean.

The practice should review infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices (HTM 01-05) and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance. Staff demonstrated knowledge of and demonstrated infection prevention and control processes including the use of personal protective equipment (PPE), and we saw single use items were not reprocessed. Staff carried out manual cleaning of instruments prior to ultrasonic cleaning. We highlighted the company policy and HTM 01-05 both specify manual cleaning should only be carried out where an automated and validated process is not available, and the ultrasonic bath should be used as the primary method of decontamination. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits in line with current guidance. The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. Staff flushed lesser used taps monthly. We highlighted this should be weekly and logs of this maintained. The practice had policies and procedures in place to ensure clinical and hazardous 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.