Lowton Dental Centre

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 most staff had completed training in emergency resuscitation and basic life support every year. We addressed this with management and was assured this would be rectified. 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. We discussed storing these in a more accessible location to ensure staff could access these in a timely way. On the day of assessment, there was no blood and bodily fluid spillage kit available. However, immediately during the assessment, the provider submitted evidence that a blood and bodily fluid spillage kit had been ordered. 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 the practice had the fire extinguishers serviced annually.

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. However, on the day of assessment, the practice could not provide any evidence to ensure the fire alarm and emergency lighting had been serviced. The provider sent evidence within 24-hours following the assessment that the fire alarm and emergency lighting had been booked in for servicing on Monday 12 August 2024. The practice had arrangements to ensure the safety of the X-ray equipment. This included cone-beam computed tomography (CBCT). However, we noted, the 3-yearly routine performance testing reports of the intra-oral X-ray machines and the annual routine testing report of the CBCT machine had outstanding actions. The practice had risk assessments to minimise the risk that could be caused from substances that are hazardous to health. However, improvements could be made to ensure all substances are regularly reviewed, risk scored and stored in a logical order to ensure they can be accessed in a timely way. The practice had implemented systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety. However, we noted sharps injury posters were not displayed in all clinical rooms. We addressed this with staff and were assured this would be rectified. The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.

At the time of our assessment, patients felt there were enough staff working at the practice. They were able to book appointments when needed.

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 had a recruitment policy and procedure to help them employ suitable staff. These reflected the relevant legislation. During the on-site assessment, we reviewed 6 staff files. We noted that references were not consistently sought, and disclosure and barring service (DBS) checks were not consistently carried out by the practice prior to employment. We addressed this with management and were assured future recruitment would be in line with legislation. The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover. We noted on the day of assessment, 1 clinician’s indemnity did not cover the individual for the required number of hours worked. This was addressed immediately, and the practice sent evidence within 24-hours of the assessment to show this had been rectified. Newly appointed staff had a structured induction, and clinical staff completed continuing professional development required for their registration with the General Dental Council. Improvements could be made to ensure there was a central log of what training the staff had completed. On the day of assessment, we noted one staff member had not completed annual medical emergency training and all staff had not undertaken annual fire safety training. The practice acted immediately and sent evidence all staff had completed fire safety training in the days following the assessment.

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 and there was an effective schedule in place to ensure clinical areas and toilets were kept clean. Improvements could be made to ensure there is a documented cleaning schedule for all non-clinical areas. Staff followed infection control principles, including the use of personal protective equipment (PPE). Hazardous waste was segregated and disposed of safely. Improvements could be made to ensure expired medicines were disposed of appropriately. We observed on the day of assessment, the outdoor clinical bin was not locked. We discussed this with staff and were assured this would be addressed and rectified. We observed the decontamination of used dental instruments, which aligned with national guidance.

The practice had infection control procedures which reflected published guidance and the equipment in use was maintained and serviced. Staff had appropriate training, and the practice completed infection prevention and control (IPC) audits in line with current guidance. Improvements could be made to the procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. Monthly hot and cold-water temperature checks were completed and logged. However, those seen were not always within the temperature ranges required by the risk assessment which had not been identified by the practice. The practice had policies and procedures in place to ensure clinical waste was segregated.

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