Garston Dental Practice (The Dental Café)

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 equipment and medicines were available and checked in accordance with national guidance. Staff could access these in a timely way. 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. However, improvements should be made to ensure fire extinguisher visual inspections were carried out monthly. We discussed this with staff and were assured this would be addressed.

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 in line with the legal requirements. The management of fire safety was effective. The practice had arrangements to ensure the safety of the X-ray equipment, and the required radiation protection information was available. This included cone-beam computed tomography (CBCT). The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety. However, we noted on the day of assessment, the sharps risk assessment template had not been tailored to reflect the practice protocols. We discussed this with staff, and were assured this would be addressed and rectified. Improvements were required to ensure the practice had risk assessments for all hazardous substances to minimise the risk that could be caused from substances that are hazardous to health. The practice should take action to improve the practice's processes for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken in line with guidance.

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. During the assessment, we checked 8 staff files. The practice had arrangements to ensure staff training was up-to-date and reviewed at the required intervals. However, we noted 2 members of staff had not completed their annual fire awareness training. We saw evidence these were completed on the day of assessment. 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, but we found they had not always been consistently followed. We noted 2 staff members were missing Hepatitis B titre levels (to indicate antibodies related to the virus), and 2 staff members had not undergone disclosure and barring service (DBS) checks at the time of employment. However, the practice had recently undergone a change of management, and the newly appointed manager had identified and sent off for the required DBS checks prior to the assessment day. The practice sent evidence following the assessment that Hepatitis B risk assessments had been conducted whilst they await titre level results. We were assured all future recruitment will be in line with legislation. The practice should take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases and follow an effective recruitment procedure to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.

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 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. 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 infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. However, we noted on the day of assessment, improvements should be made to ensure the practice is carrying out helix tests (a test used to check the sterilisation process has been successful in hollow objects) on the vacuum autoclave (a machine used to disinfect reusable instruments). We discussed this with staff and were assured this would be addressed.

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