Chestnut Smile Centre

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. Immediate life support training was also completed by staff providing treatment to patients under sedation. 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.

Most emergency equipment and all medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. However, we noted the portable suction was missing from the kit. The provider ordered a replacement on the day of our assessment. 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.

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 management of fire safety was effective. A fire safety risk assessment was recently carried out in line with the legal requirements, and the provider was in the process of actioning the recommendations within the risk assessment. 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. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. The practice should improve their systems for checking and monitoring the safety of the X-ray equipment and to ensure all the required radiation protection information is available. On the day of our assessment, the practice were unable to provide evidence of registration with the Health and Safety Executive (HSE) for working with radiation and the intra-oral X-ray machines had not undergone their 3-yearly routine performance testing. The practice acted immediately and submitted evidence to show they had registered with the HSE and had booked the intra-oral X-ray machines for the 3-yearly routine performance testing on 6 January 2025. However, the local rules were clearly displayed, and the units has undergone annual electromechanical servicing.

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 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. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities. The practice had arrangements to ensure staff training was up-to-date and reviewed at the required intervals. On the day of assessment, we looked at 8 staff files, and noted 1 member of staff had not completed their annual fire awareness training. The practice acted immediately and submitted evidence following the assessment that this had been completed. The practice should implement an effective recruitment procedure to ensure appropriate checks are completed prior to new staff commencing employment, and to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases. The practice had a recruitment policy and procedure that reflected the relevant legislation. However, these were not consistently followed. We noted on the day of our assessment that Disclosure and Barring Service (DBS) checks and Hepatitis B titre levels (to indicate immunity levels to the virus) were not always sought by the practice at the time of employment. The provider submitted evidence following the assessment of DBS risk assessments and Hepatitis B risk assessments whilst they awaited new DBS checks and titre level results. The provider has assured us that all future recruitment will be in line with legislation.

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.

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 policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. Improvements should be made to the procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. Staff completed and recorded monthly hot and cold-water temperature checks. However, the records seen on the day of assessment were not within the temperature ranges required by the risk assessment. The practice took immediate action and submitted evidence following the assessment that temperatures were now in line with the risk assessment.

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