Todmorden

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 some processes to identify and manage risks, and staff we spoke with were able to describe these to us. Staff felt confident that risks were well managed at the practice.

The practice had systems for appropriate and safe handling of medicines. Antimicrobial prescribing audits were carried out.

Staff knew how to respond to a medical emergency and had completed training in emergency resuscitation and basic life support every year.

Emergency equipment and medicines were available, and staff could access these in a timely way. However, The practice should implement an effective system of checks of medical emergency equipment and medicines in line with the guidelines issued by the Resuscitation Council (UK). We found their checking process had not identified that airways had expired, the aspirin was not dispersible and there was no portable suction. Glucagon (required in the event of severely low blood sugar) was stored unrefrigerated, and the expiry date had not been adjusted in line with manufacturer’s instructions. Evidence was later sent that these issues had all been addressed.

The premises were visibly clean, well maintained and free from clutter. Hazardous substances were clearly labelled and stored safely. The practice had a generic risk assessment for hazardous substances. We highlighted these should be product specific.

We saw satisfactory records of servicing and validation of equipment in line with manufacturer’s instructions. Some required radiation protection information was not available on the day of the assessment. However, the provider submitted the reports afterwards which predated our assessment.

The management of fire safety was effective, fire detection systems and emergency lighting were installed in line with their risk assessment. Fire exits were clear and well signposted. Just prior to the assessment, the practice was affected by a fire in the adjoining building. The provider carried out an assessment and extensive cleaning of the site to assure the safety of patients and staff. Smoke damaged equipment was not in use until engineer checks could be carried out to ensure its safety. We highlighted that large quantities of combustible items should be cleared from their cellar.

The practice had a recruitment policy and procedures that reflected relevant legislation, to help them employ suitable staff, including agency or locum staff. We found this was not followed in relation to obtaining clinical staff member’s medical history and evidence of vaccinations for their role. There was no evidence of the effectiveness of vaccinations against Hepatitis B for 6 clinical staff members. The provider sent evidence of satisfactory immunity for 2 staff members after the assessment day and confirmed blood tests were in progress for the others, along with risk assessments until immunity status was obtained. The practice should ensure all clinical staff have adequate immunity for vaccine preventable infectious diseases as part of their recruitment processes moving forward.

The practice ensured clinical staff were qualified, registered with the General Dental Council and had appropriate professional indemnity cover.

Newly appointed staff had an appropriate role specific structured induction. The lead nurse had created a handbook to introduce new trainees to useful information about dental procedures and practice protocols, to support their introduction to working in the profession and the practice.

Staff we spoke with had the skills, knowledge and experience to carry out their roles. They told us that there were sufficient staffing levels. The practice should improve the safeguarding policy and ensure it takes into account both vulnerable adults and children.

The safeguarding policy lacked information about the range of safeguarding issues staff may encounter. We signposted the manager to resources to support them and discussed making this information more accessible to staff. Staff knew their responsibilities for safeguarding vulnerable adults and children. However, 3 clinical staff members had not completed the correct level of safeguarding training required for their role. The manager confirmed this would be addressed.

The practice had arrangements to ensure staff training, including continuing professional development, was up-to-date and reviewed at the required intervals. These were mostly effective.

There were effective processes to support and develop staff with additional roles and responsibilities. Staff discussed their learning needs, general wellbeing and aims for future professional development during annual appraisals, 1-to-1 meetings, during clinical supervision, practice team meetings and ongoing informal discussions.

Staff stated they felt respected, supported and valued, and they were proud to work in the practice.

The practice had infection control procedures that reflected published guidance.

Staff received appropriate training and demonstrated knowledge and awareness of infection prevention and control processes. The handbook created by the lead nurse supported trainees to understand and follow the correct processes. We noted staff did not carry out the recommended protein residue tests to validate the washer disinfector. Evidence was sent after the assessment these had been obtained.

We observed use of personal protective equipment and the decontamination of used dental instruments, which aligned with national guidance.

The sharps risk assessment did not reflect the range of sharps used by staff, focusing only on needles. After the assessment the manager confirmed this had been addressed. The sharps policy and risk assessment had been updated in line with the regulations. We saw, and staff confirmed that single-use items were not reprocessed.

The practice had effective procedures to reduce the risk of Legionella, or other bacteria, developing in water systems, in line with a risk assessment. We highlighted some hot water temperatures were just below the accepted range, and staff were not using the substance used to ensure the quality of water in the dental unit waterlines in line with manufacturer’s instructions. The practice should take action to ensure Legionella risks are mitigated, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

The practice had protocols to ensure effective cleaning and safe segregation and disposal of hazardous waste.

The equipment in use was maintained and serviced as per manufacturers’ instructions.

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.