Dee Kay Dental

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.

A building manager was responsible for ensuring facilities were safe, including electrical and gas appliances. The provider requested (but was not always provided with) evidence from the building manager for their own assurance of safety and suitability of the premises. Where this was not provided, the provider was proactive at assessing risks. Staff were clear on how to report any faults or concerns. We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. We noted the dental compressor was serviced but there was no evidence pressure vessel inspections were carried out. The manager arranged for this to be actioned after the assessment.

Emergency equipment and medicines were available, and staff could access these in a timely way. Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year. However, we saw staff had not removed expired items from the kit when they were replaced, the syringes to deliver emergency adrenaline were the incorrect size, midazolam for infusion was available in place of the recommended buccal midazolam, and staff did not know how to replace the pads of the automated external defibrillator. Immediate action was taken to address these issues and prevent reoccurrence. The practice should implement an effective system of checks of medical emergency equipment and medicines taking into account the guidelines issued by the Resuscitation Council (UK).

The practice had processes to identify and manage risks, and staff we spoke with were able to describe these to us. Staff felt confident that risks were well managed at the practice, and the reporting of risks was encouraged. The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. The management of fire safety was effective, and fire exits were clear and well signposted. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. We highlighted a risk assessment should be in place for clinical staff where the effectiveness of Hepatitis B vaccinations has not been confirmed. Newly appointed staff had a structured induction, which included safeguarding. The provider ensured 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. There were also effective processes to support and develop staff with additional roles and responsibilities. Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. They demonstrated knowledge of safeguarding and were aware of how safeguarding information could be accessed. Staff knew their responsibilities for safeguarding vulnerable adults and children. Staff stated they felt respected, supported and valued, and they were proud to work in the practice. 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.

The practice should review oversight of infection control procedures taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices. There were some procedures to reduce the risk of Legionella, or other bacteria, developing in water systems. The building owners were responsible for the building’s Legionella risk assessment and the provider had requested but had not been given a copy. The provider had carried out a risk assessment for the area of the premises they occupied. However, it was not effective. Documented monthly hot water testing showed hot water temperatures were below the accepted range but we experienced hot water temperatures over 80°c during the assessment. After the on-site assessment, the practice manager confirmed they had contacted the building manager to obtain further information and assured us that staff would undergo further training in Legionella prevention. The practice had cleaning procedures and schedules to ensure effective cleaning. We observed the decontamination of used dental instruments, which should be improved to ensure staff follow national guidance. In particular, submerging instruments in water under 45°c to carry out manual cleaning processes. After the assessment the manager confirmed further training was being provided. Staff received appropriate training in infection prevention and control processes. We highlighted the importance of oversight to ensure these are followed. The equipment in use was maintained and serviced as per manufacturers’ instructions. We saw, and staff confirmed that single use items were not reprocessed. Staff used appropriate personal protective equipment, and safely segregated and disposed of hazardous waste. The practice completed infection prevention and control audits in line with current guidance.

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