Backwell Dental Care 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.

The practice had processes to identify and manage risks. Staff described these to us and demonstrated an open culture in relation to people’s safety. Staff felt confident that risks were managed at the practice and reporting of risks was encouraged. Hazardous substances were labelled and stored safely. Fire safety measures were in place and fire exits were signposted. Emergency equipment and medicines were available and checked regularly. However, the frequency of checks did not follow national guidance, which we brought to the providers attention. Staff could access these in a timely way. Staff knew how to respond to a medical emergency and completed training in emergency resuscitation and basic life support annually. Staff providing treatment to patients under sedation had completed immediate life support training. The premises were visibly clean, maintained and free from clutter. Some areas of flooring in treatment rooms were damaged, and a dental chair had a small tear in the upholstery. Whilst there was an air conditioning unit in the decontamination room, there was no extractor fan or other means of ventilation. We were advised that these would be prioritised works in the next round of refurbishment. We saw records of servicing and validation of equipment in line with manufacturer’s instructions. When checking X-ray equipment, we were unable to locate isolation switches in treatment rooms and this information was not recorded in local rules. We found isolation switches were fitted in cupboards, out of view. We suggested signage should be placed in surgeries, giving the location of isolation switches. The practice had systems for safe handling of medicines. All information on stock control in relation to Midazolam used for sedation was up to date and maintained correctly, but the Midazolam was not stored in a locked cupboard. We brought this to the attention of staff on the day of inspection. Antimicrobial prescribing audits were carried out.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum 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 encouraged clinical staff to complete continuing professional development (CPD) required for their registration with the General Dental Council. When checking records of training and CPD we observed that the recommended levels had not been maintained for some staff. When we made the practitioner and provider aware of this, it was acted on immediately and evidence of completed courses were provided to us in the week following our inspection. The practice had processes to check staff training was up-to-date and reviewed at the required intervals. Where some training requirements had been overlooked we drew this to the attention of the provider so this process could be strengthened. There were processes in place to support staff with additional roles and responsibilities. Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient levels of staff on duty at all times. 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 appraisals and in practice team meetings and ongoing informal discussions. They also discussed learning needs, general wellbeing and aims for future professional development.

The practice had infection control procedures that reflected published guidance. This included procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. The practice had cleaning procedures and schedules to ensure effective cleaning. Where there was damage to flooring in treatment rooms, and damage to coverings on a dental chairs this was recorded in infection control audits. The process of moving this information to scheduled upcoming refurbishment works could be strengthened. 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. We observed that when safer sharps were not used by dentists, these were dismantled in the treatment room on a tray, which nurses took to the decontamination room for disposal. We suggested that sharps bins should be in surgeries, allowing the dentist to dispose of them, which would better align with the practice sharps handling policy. 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.

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