The Village 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.

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.

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 extinguishers were serviced and well maintained. Most emergency equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. On the day of assessment, we noted the aspirin available was not dispersible, the midazolam (a controlled drug used to treat prolonged seizures) available was injectable rather than oral, and the adult and child resuscitation bag masks were out-of-date. The practice acted immediately and submitted evidence in the days following the assessment that these had been ordered. The practice should implement an effective system for identifying, disposing and replenishing out-of-date stock.

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. The practice had arrangements to ensure the safety of the X-ray equipment and the required radiation protection information was available. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was effective. However, we noted the practice had not conducted a fire drill. The practice submitted evidence a fire drill had been completed in the days following the assessment. The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health. Improvements could be made to ensure all risk assessments are dated and risk scored.

At the time of our assessment, the patients felt there were enough staff working at the practice. They were able to book appointments when needed.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. Staff stated they felt respected, supported and valued. They were proud to work in the practice. Staff discussed their training needs during practice team meetings and ongoing informal discussions. At the time of assessment, the practice were in the process of implementing annual appraisals for staff. 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 ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. Improvements could be made to arrangements to ensure staff training was up-to-date and reviewed at the required intervals. During the assessment, we noted 2 staff members had not completed annual fire awareness training. The practice acted immediately and submitted evidence following the assessment that these have now been completed. The practice had a recruitment policy and procedure to help them employ suitable staff. These reflected the relevant legislation. However, we noted that disclosure and barring service (DBS) checks were not always carried out by the practice prior to employment. The practice sent evidence in the days following the assessment that DBS checks have now been undertaken and have assured us that all future recruitment will be in line with legislation. Newly appointed staff had a structured induction, and clinical staff completed continuing professional development required for their registration with the General Dental Council. On the day of assessment, we noted Hepatitis B titre levels, to ensure immunisation against Hepatitis B, were not available for 3 staff members. In the days following the assessment, the practice submitted evidence that Hepatitis B declarations have been completed by these staff members whilst they await blood test results. The practice should consistently follow an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice and take action to ensure that all clinical staff have adequate immunity for vaccine-preventable infectious diseases.

Patients told us that the practice looked clean, and equipment appeared to be in a good state of repair.

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. Staff told us that single use items were not reprocessed.

Staff followed infection control principles, including the use of personal protective equipment (PPE). We observed the decontamination of used dental instruments, which aligned with national guidance. The practice appeared clean and there was an effective schedule in place to ensure clinical areas were kept clean. However, improvements could be made to ensure there is a documented cleaning schedule for all non-clinical areas. Hazardous waste was segregated and disposed of safely. On the day of assessment, we observed the clinical waste bin was not secured or tethered. We discussed this with staff and were assured this would be addressed and rectified.

The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. The practice had infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits in line with current guidance. However, staff were not always consistently following recommended routine testing of decontamination equipment in the Health Technical Memorandum 01-05 to confirm effective cleaning. We discussed this with staff and were assured this would be addressed. Improvements could be made to the procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. Monthly hot and cold-water temperature checks were completed and logged. However, the log was a tick box and did not document the temperatures of each water outlet tested, and the temperature range on the log was not within the temperature ranges required by the risk assessment. In addition, not all required outlets were being tested in line with the risk assessment. We addressed this with staff and were assured this would be rectified. The practice should take action to implement any recommendations in the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular, ensuring the monthly temperature checks are within the required temperature range.

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