Recent CQC dental inspection reports show that Legionella and water safety remain areas where otherwise well-run dental practices can get caught out.
Often, the problem isn’t that nothing is being done. It’s that the assessment, monitoring, records and follow-up don’t quite join together.
Here are five issues appearing in recent CQC findings that practice managers may want to check.
1. A Legionella risk assessment exists, but the actions haven’t been completed
Having a current Legionella risk assessment is only the starting point.
Recent CQC inspections have highlighted practices where risks had been identified but remedial actions had not been completed or there was insufficient evidence to show they had been completed.
A useful question to ask is:
Can we show what was identified, who was responsible, what was done and when it was closed?
2. Water temperatures aren’t being properly monitored
Hot and cold water temperature monitoring remains a basic part of controlling Legionella risk.
CQC has recently identified practices where temperatures were outside the recommended range or where monthly temperature monitoring was not being completed and recorded.
A good assessment should clearly identify the correct monitoring points, frequency and acceptable temperature ranges.
3. Low-use outlets aren’t being managed
Stagnant water creates favourable conditions for bacterial growth.
CQC has highlighted practices where infrequently used outlets were not included in an effective flushing regime.
This can become particularly relevant after changes to surgery use, staffing patterns, refurbishments or equipment.
4. The practice has records, but they don’t demonstrate control
This is one we see regularly.
A practice may be disinfecting dental unit waterlines, flushing outlets and carrying out checks, but records can be incomplete, difficult to follow or fail to demonstrate what happened when something went wrong.
CQC’s current guidance makes clear that dental practices require a written waterline management scheme and Legionella risk assessment, with recommendations implemented by the registered manager.
The paperwork should make compliance easier to demonstrate, not harder.
5. Nobody really owns the Legionella system
Water safety can fall between several people: the practice manager, dental nurses, landlord, maintenance contractor and external water hygiene company.
But somebody within the practice needs to understand the assessment and make sure its recommendations and ongoing control measures are actually implemented.
Recent CQC findings have included situations where staff were unable to demonstrate that recommendations from an existing Legionella assessment had been followed.
A dental practice is not a normal commercial building
Dental practices add several complications to ordinary hot and cold water systems:
- Dental Unit Water Lines (DUWLs)
- Reverse Osmosis systems
- independent water bottles
- very narrow-bore pipework
- periods of stagnation
- aerosol-generating procedures
- patients who may be particularly vulnerable to infection
For that reason, a Legionella assessment for a dental practice needs to understand both the building water system and the dental equipment connected to it.
A useful 10-minute check
If you’re responsible for a dental practice, ask yourself:
Can I immediately find our current Legionella risk assessment, our scheme of control, our recent monitoring records and evidence that any actions identified have been completed?
If the answer is no, that’s a useful place to start.
Dental Water Safety
Dental Water Safety specialises in Legionella risk assessments and water-safety compliance specifically for dental practices.
We are based in Nottingham and work with dental practices across the East Midlands and throughout the UK.
If you’d like an independent review of your current arrangements, call 0115 697 0510 or contact hello@dentalwatersafety.co.uk.