Twindent 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. 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 medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. We noted that size 0, 3 and 4 clear facemasks and a child size oxygen mask was not available. Staff immediately ordered replacement equipment and we were shown evidence to confirm this. Aspirin was not the recommended size. We were assured that the correct size of Aspirin would be obtained as soon as practicably possible. We have since received evidence which confirms this shortfall has been addressed. 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 maintained and serviced according to manufacturers’ instructions. The practice ensured the facilities were maintained in accordance with regulations. A fire safety risk assessment was carried out the month before our visit. The audit highlighted that emergency lighting was present in the practice building. We were told that automatic emergency lighting would be fitted during a refurbishment planned to take place in October 2024. 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. We noted the sanitary bin in the patient toilet was not specific to a wheelchair user’s requirements. We have since received evidence which confirms this shortfall has been addressed. 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. Immunity to Hepatitis B was not known for 9 clinical staff. Improvement could be made to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases. We have since received evidence which confirms this shortfall has been addressed. The practice had systems for appropriate and safe handling 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. 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.

The practice had a recruitment policy to help them employ suitable staff. Improvements could be made to the practice's recruitment procedures to ensure complete and detailed records are maintained for all staff. In particular, recording the reason why a new staff member’s previous employment ended, a written record of their full employment history and conduct in their previous employment is requested from their employer as opposed to a work colleague. 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. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities.

The practice appeared clean and there was an effective schedule in place to ensure it was kept clean. We observed that surgery 1’s treatment operator’s stool covering was torn. We have since received evidence which confirms this shortfall has been addressed. A seal between the floor and cupboards in surgery 3 was missing. The provider told us this appeared to have been missed when the surgery was refurbished. They assured us they would get the contractor back to remedy this shortfall as soon as practicably possible. 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 could be made to ensure that cleaning equipment was stored separately to reduce the risk of cross contamination. We have since received evidence which confirms this shortfall has been addressed.

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 and we saw single use items were not reprocessed. 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. 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.