Eastgate House Dental Surgery

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 all but one had completed training in emergency resuscitation and basic life support in the previous 12 months. Staff we spoke with told us that equipment and instruments were well maintained and readily available. Staff felt confident that risks were well managed at the practice, and the reporting of risks was encouraged.

Emergency equipment and medicines were not managed effectively and checked in accordance with national guidance. In particular, a child size self-inflating bag with reservoir was not available. Oropharyngeal airways sizes 0 and 4 were not available. Size 0, 1, 2, 3 and 4 clear facemasks were not available. The premises were clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. Fire exits were clear and well signposted.

Improvements were needed to ensure that equipment was safe to use and maintained and serviced according to manufacturers’ instructions. The management of fire safety was not effective. A fire risk assessment was carried out 2 years prior to our visit. The provider could not demonstrate that a review of the risk assessment had taken place. Actions resulting from this fire risk assessment remained outstanding. Specifically, the risks associated with not having automatic emergency lights in the practice had not been considered. Annual fire drills were carried out. Improvements are needed to ensure evacuation times are captured at the time of fire drills to test the evacuation process is effective. One out of 9 staff had not completed fire safety training in previous 12 months. The practice had arrangements to ensure the safety of the X-ray equipment. The practice had not implemented effective systems to assess and manage risks to patient and staff safety. This included management of substances hazardous to health and lone working. The cleaner worked when the practice was closed. They did not have access to control of substances hazardous to health (COSHH) risk assessments and safety data sheets for the products they used. A lone working risk assessment was available for the cleaner but did not assess the cleaner's risks to their own wellbeing when working alone in the practice. A sharps risk assessment was available. Staff were aware of the detection and management of Sepsis.

At the time of our assessment, 15 patients told us they felt there were enough staff working at the practice. Fourteen told us they were able to book routine appointments when needed. Seven told us they knew how to get emergency dental treatment. All 15 said that staff were professional and considerate.

Staff we spoke with told us that there were sufficient staffing levels. Staff said they felt respected, supported and valued. They were proud to work in the practice. Staff discussed their general wellbeing at practice team meetings and ongoing informal discussions. 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 registered with the General Dental Council and had appropriate professional indemnity cover. The practice had a recruitment policy and procedure to help them employ suitable staff, but improvements were needed. Evidence of a full employment history, for 1 staff member was not available. Evidence of conduct in previous employment and reason why the last employment ended (as appropriate) and a health assessment for 4 staff members was not available. We were told that newly appointed staff had an induction but records of this were not kept. Hepatitis B immunity status was not known for 2 clinical staff. Improvements could be made to take action to ensure that all clinical staff have adequate immunity for vaccine preventable infectious diseases. The practice did not have effective arrangements to ensure staff training was up-to-date and reviewed at the required intervals. In particular, evidence of safeguarding children training (specific to role) for 1 staff member was not available. Evidence of vulnerable adults training (specific to role) for 2 staff was not available.

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.

The practice appeared clean. Staff followed infection control principles but improvement was needed. Specifically, a dental instrument manual cleaning scrubbing brush and glove replacement protocol was not in place to ensure regular changes took place. The clinical waste bin in the decontamination room was not foot operated. We observed the decontamination of used dental instruments aligned with national guidance.

The practice had infection control procedures which reflected published guidance but improvement was required. Cleaning schedules were available but were not completed. Evidence to verify that staff had oversight of the standard of cleaning was not available. Infection prevention and control training certificates were not available for 2 clinical staff. 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. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. However, we noted that the sensor on the female sanitary waste bin was not working.

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