Absolute 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 not providing safe care in accordance with the relevant regulations. We will be following up on our concerns to ensure they have been put right by the provider. The impact of our concerns, in terms of the safety of clinical care, is minor for patients using the service. Once the shortcomings have been put right the likelihood of them occurring in the future is low. During our assessment of this key question, we found concerns related to: Safe and effective staffing and recruitment of staff which resulted in a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. Whilst there are issues to be addressed, the impact of our concerns relates to the governance and the oversight of the risks, rather than a patient safety risk.

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 were encouraged to participate in medical emergency scenario training. The premises were visibly 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. The management of fire safety was not effective. A fire risk assessment had never been completed at the practice. The practice submitted evidence that a fire risk assessment had been booked for 22 October 2024. Fire safety awareness training had not been completed for 7 members of staff. All outstanding training was completed on 11 October 2024. However, 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 processes to identify and manage risks; 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. However, the sharps risk assessment did not reflect our findings on the day and the sharps injury poster contained out of date information. A copy of the new sharp’s injury poster was submitted after the assessment. We discussed the risk assessment with staff and were assured this would be addressed and rectified. We noted there was no lone worker risk assessment for the cleaner. A lone worker risk assessment for the cleaner was submitted 2 days after the assessment day. Emergency equipment and medicines were available and checked in accordance with national guidance. However, we noted that medical emergency equipment was not checked weekly and there was no daily fridge temperature check to ensure the Glucagon, a medicine used to regulate blood sugar levels, was stored at the correct temperature. The practice submitted evidence of their new weekly equipment checklist and a new daily fridge temperature log. Staff could access the emergency equipment and medicines 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.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. There were also effective processes to support and develop staff with additional roles and responsibilities. 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 and practice team meetings and ongoing informal discussions. They also discussed learning needs, general wellbeing and aims for future professional development.

The practice had a recruitment policy and procedure to help them employ suitable staff, including for agency or locum staff, however they were not always followed. We noted that pre-employment checks, including DBS (Disclosure and Barring Service) and references were not carried out or risk assessed for 6 of the practice staff before they commenced employment at the practice. Hepatitis B titre levels (to indicate antibodies related to the virus) were not obtained for 1 member of the clinical staff. 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, which included safeguarding. The provider did not ensure clinical staff completed continuing professional development required for their registration with the General Dental Council. Four members of clinical staff did not have the correct level of safeguarding training for their role. All outstanding training was completed on 11 October 2024.

Staff followed infection control principles, including the use of personal protective equipment, and safely segregated and disposed of hazardous waste. The practice completed infection prevention and control audits in line with current guidance. However, it did not reflect our findings on the assessment day, the recent audit did not highlight the lack of thermometer during manual cleaning and the lack of a heavy duty glove log. We discussed this with staff and were assured this would be addressed and rectified.

The practice had infection control procedures that reflected published guidance, however they were not always followed. The thermometer used for measuring the temperature of manual cleaning solution was broken and heavy duty gloves were not changed weekly. A new thermometer was ordered, and a new log to monitor the use of heavy duty gloves was created on the day of assessment. A legionella risk assessment was carried out in 2021 however, many actions were still outstanding on the day of assessment. Hot water temperature logs showed the hot water was not reaching adequate temperatures. The practice adjusted the boiler on the day of assessment and new hot water temperature logs, showing the hot water reaching the required temperature were submitted on 11 October 2024. The practice had cleaning procedures and schedules to ensure effective cleaning. We observed the decontamination of used dental instruments, which aligned with national guidance. Staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes. The equipment in use was maintained and serviced as per manufacturers’ instructions. We saw, and staff confirmed that single use items were not reprocessed.

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