The Fenton Dental Studio

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• 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. During our assessment of this key question, we found concerns related to the safety of the premises and the management of risks associated with fire and the use of substances hazardous to health, safe and effective staffing, the management of people`s medicines and the management of medical emergency equipment. These concerns resulted in breaches of Regulations 12 (Safe care and treatment) and 17 (Good governance) 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.

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 of them had completed training in emergency resuscitation and basic life support every year. Emergency equipment and medicines were not always available and not checked in accordance with national guidance. There were no records to demonstrate that the practice checked the medical emergency drugs and equipment at least weekly as set out in the relevant guidance. On the day of the assessment, the adrenaline (an injection to treat severe allergic reactions), Glucagon (a medication to treat severe hypertension) and the oropharyngeal airways were out of date. In addition, the practice did not have paediatric pads for the Automated External Defibrillator (AED). We brought this to the providers attention and they took immediate action by placing an order for the expired or missing items. Staff told us that equipment and instruments were well maintained and readily available. They felt confident that risks were well managed at the practice, and the reporting of risks was encouraged.

A fire risk assessment dated 2017 was made available for review. This was not completed by a person who had the qualifications, skills, competence and experience to do so. In addition, the risk assessment did not include an emergency evacuation plan, considerations to the size of the premises to establish the appropriate fire detection and warning systems, the needs of vulnerable people and staff fire safety training requirements. The fire exit routes were not clearly signposted. The door leading from Surgery 1 to the back garden was signposted as a fire exit. We noted that the door was locked and obstructed. We observed combustibles in the basement in close proximity to the compressor. The practice had not assessed if the emergency routes and exits required illumination. Staff told us that fire detection equipment was tested regularly, however there were no records to demonstrate that periodic in-house checks were carried out. Following the on-site assessment and in response to our feedback, the provider had commissioned an external fire risk assessment. We were provided with the report on 13 January 2025. The risk assessment had identified a number of actions required, of high and medium risk. Overall, we found that the management of fire safety was not effective. Hazardous substances were not always stored safely. In addition, the practice had not carried out risk assessment to minimise the risk that could be caused from the substances hazardous to health. Following the inspection the provider told us that they had added a lock to the cabinet used to store hazardous substances. The treatment areas within the premises appeared clean and free from clutter.

We saw satisfactory records of servicing and validation of the sterilising equipment and compressor in line with the relevant legislation. 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 some systems to assess, monitor and manage risks to patient and staff safety. This included sharps safety, sepsis awareness and lone working. The practice had some systems for appropriate and safe handling of medicines. The practice had a dispensing log in place to effectively monitor stock. Antimicrobial prescribing audits were carried out. Improvements were needed to ensure that dispensing labels included the practice name and address in line with the relevant guidance.

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. One staff member told us, “I feel very valued by all the clinicians … This gives me validation daily to continue to do a job that I love doing and maintaining my standards of service that I provide for them.” 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. One staff member told us, “I have an open and honest relationship with all four clinicians, as to what their expectations are, to give me honest feedback since the beginning of working with them.” 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. Improvements could be made to ensure this covered safeguarding and procedures to escalate safeguarding concerns within the practice.

The practice had a recruitment policy that reflected relevant legislation. Improvements could be made to ensure that enhanced Disclosure and Barring Service (DBS) certificates, where appropriate, were requested at the point of employment. In addition, if the provider relied on DBS checks carried out by a previous employer, a risk assessment should be carried out to support the decision not to renew a DBS check. One clinical staff member was unable to demonstrate their level of immunity to Hepatitis B. There were no records to show that the provider had assessed the risks associated with non-responding or unvaccinated staff. Following the inspection the provider submitted evidence to show they had ordered a blood test kit to demonstrate immunity levels. The practice did not have effective arrangements to ensure staff training was up-to-date and reviewed at the required intervals. Not all members of staff had completed training in basic life support, autism and learning disability awareness, fire safety, mental capacity, sepsis awareness and infection prevention and control. Following the inspection the provider submitted further certificates of training covering these topics. We noted that several of these had been obtained after the on-site assessment and some training remained outstanding. Overall, improvements were needed to the systems in place for the monitoring of training. The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover.

Hazardous waste was segregated and disposed of safely. Improvements were needed to ensure that clinical waste awaiting collection was stored securely. We noted that the outside clinical waste bins were not locked, and they were stored in an area accessible to tenants occupying the first floor of the premises. The practice appeared clean and there was an effective schedule in place to ensure it was kept clean. Staff followed infection control principles, including the use of personal protective equipment (PPE). 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 demonstrated knowledge and awareness of infection prevention and control processes and we saw single use items were not reprocessed. 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 judgement for Medicines optimisation is based on the latest evidence we assessed for the Safe key question.