Watford Smiles - 107 Hempstead Road

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 had also been 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 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 most equipment in line with manufacturer’s instructions. Fire exits were clear and well signposted, and fire safety equipment was 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 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, sepsis awareness and lone working. A fire safety risk assessment was carried out in line with the legal requirements. The management of fire safety was mostly effective. However, the practice had not ensured that the action plan was obtained with the risk assessment report in order to complete recommended actions. In addition, we were not provided with evidence that the smoke detection equipment or emergency lighting had been serviced or that monthly testing of the emergency lighting was carried out. The practice had some arrangements to ensure the safety of the X-ray equipment. However not all the documentation relating to the X-ray equipment including for the cone-beam computed tomography (CBCT) was available on the day of the assessment. We were provided with evidence to show that critical examination and acceptance tests were carried out at the time of installation for 3 out of 4 intra-oral X-ray units. We were not provided with evidence that all the recommended actions from these tests had been completed. This included consulting the practice’s Radiological Protection Advisor about the structure of the walls where the X-ray beam was directed. In addition, an annual performance check for the CBCT had last been completed in September 2022 and the service had not carried out alternative monthly quality assurance tests to give assurance that the machine was functioning correctly.

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 we spoke with stated they felt respected and valued. They were proud to work in the practice. One staff member stated, “Leaders are approachable and always here to listen, communication is a big thing within our practice.” Staff discussed their training needs during annual appraisals, 1 to 1 meetings, 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. 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. However, not all staff files reflected relevant legislation. For example, we saw that satisfactory evidence of conduct in previous employment were not always requested for clinicians. 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.

The practice appeared clean and there was an effective schedule in place to ensure it was kept clean. However, we observed that not all mops used for environmental cleaning were stored appropriately. 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 mostly aligned with national guidance. However, we saw that boxes used for transportation of dental instruments were not clearly differentiated. Improvement could be made to the written protocols for the management of dental instruments which were not used during the day.

The equipment used for infection control procedures was maintained and serviced. Staff demonstrated knowledge and awareness of infection prevention and control guidance, 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 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.

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