Murray Dental Limited

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. One member of staff was overdue this training but had completed on-line training and we were assured that they would complete face to face update training as soon as possible. Immediate life support training (or basic life support training plus patient assessment, airway management techniques and automated external defibrillator 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.

Emergency equipment and medicines were available, although we noted that the child and adult artificial manual breathing unit (ambu bags) did not have an expiry date recorded on them and were not stored in original packaging. The practice was unable to assure themselves that these items were within their expiry dates. Adrenaline was available in child dosage only and there was not enough available to provide a repeat dose for either adult or child if needed. We saw evidence that these items were ordered on the day of assessment. There was scope to improve the frequency of checks of emergency equipment in accordance with national guidance. We were assured that weekly checks would be completed going forward. Staff could access emergency medicines and equipment in a timely way. The premises were clean 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. Fire alarm service and maintenance had been completed annually this should be every 6 months. We were told that a service had been scheduled for January 2025.

The practice ensured equipment was safe to use, maintained and serviced according to manufacturers’ instructions. Facilities were maintained in accordance with regulations. However, issues for action were identified in the electrical installation condition report. Following this assessment we were told that an electrician was scheduled to visit the practice on 28 and 29 December 2024 and assured that all actions would be completed. There were some outstanding issues for action following the November 2024 fire risk assessment. There was scope for improvement in the management of fire safety. Staff were not recording all daily or monthly checks of fire safety equipment. Following this assessment we were sent a copy of the new logs demonstrating the timely checking of fire safety equipment. 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. There was scope for improvement in the practice’s systems for appropriate and safe handling of medicines. Medicine dispensing labels did not record the practice address and postcode. There were no disposal logs and storage of medication was not secure. There were no logs or stock control system for midazolam or flumazenil used during sedation processes. We were assured that the appropriate action would be taken immediately. Following this assessment we were forwarded logs to demonstrate that a stock control system had been implemented and we were informed that dispensing labels now contained the correct information. Staff were not following College of General Dentistry Guidelines and more detail was required in the antimicrobial prescribing audit. Following this assessment we were informed that updates had been made so that the next antimicrobial audit included more detailed information.

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, during clinical supervision at practice team meetings and during 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. Staff told us they had received a structured induction programme, which included safeguarding.

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. 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. The practice had arrangements to ensure staff training was up-to-date and reviewed at the required intervals. We saw the practice had effective processes to support and develop staff with additional roles and responsibilities.

The practice appeared clean and there was an effective schedule in place to ensure it was kept clean. There was scope for improvement to ensure that staff followed infection control principles. We saw that local anaesthetic ampules were not being stored in blister packs and some burs were not pouched in dental surgeries. We were assured that staff would be reminded to store these products appropriately going forward and following this assessment we received confirmation that the appropriate action had been taken. Hazardous waste was segregated and disposed of safely. We observed the decontamination of used dental instruments. We saw that instruments awaiting sterilisation were not kept moist and there was no log of change of heavy-duty gloves. We were assured that these processes would be amended to ensure they aligned with national guidance and following this assessment we received confirmation that the appropriate action had been taken.

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. However, we saw that some single use items used when placing dental implants were being reprocessed. We were assured that this would be discussed with staff and the appropriate action taken. The practice had procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. Issues for action were identified on the risk assessment which we were assured had been addressed. There was no documentary evidence to demonstrate this but were told that the risk assessment would be updated as required. The practice had policies and procedures in place to ensure clinical waste was segregated and stored appropriately in line with guidance. The practice did not provide sanitary waste bins in staff or patient toilets. Following this assessment we received evidence to demonstrate that these had been purchased and added to the practice’s regular waste collection.

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