Archived: Mee Healthcare

During this inspection we found the provider had taken appropriate actions to address the shortfalls we identified at our previous inspection. However we noted the provider was still working towards ensuring the actions were monitored to maintain safe practice for the well-being of patients. For example the practice was still seeking to appoint a registered manager and to recruit a permanent dental nurse to work with the dentist, to ensure appropriate standards were maintained.

We saw records which demonstrated the practice had employed an agency nurse whenever clinics were taking place to ensure they met the General Dental Council 'Standards for the Dental Team'.

We were shown the provider, Mee healthcare, had provided training for the dentist and Mee Healthcare unit manager (who is the optometrist) about the national guidance and standards for cleanliness and infection control. Staff spoken with demonstrated a greater awareness of this guidance and had taken steps to implement it. We saw they maintained the required records and had appropriate management and storage for clinical waste which was handled in line with national guidance.

We did not speak with patients as part of this inspection. However the dentist showed us some patient feedback notes. These indicated patients had been happy with the care and treatment provided by the service.

During this inspection we found the provider had not taken appropriate actions to address the shortfalls we identified at our previous inspection. They had not implemented systems to demonstrate compliance with the requirements of the Department of Health's - Health Technical Memorandum 01-05: Decontamination in primary care dental practices (HTM 01-05 2013). The practice demonstrated they did not have fully effective systems in place to reduce the risk and spread of infection for patients' safety and protection.

We saw the practice had some evidence to show testing of the cleaning equipment had been completed as required, since April 2014. However we found gaps in these records since July 2014.

We saw the provider had not taken the action agreed at the last inspection for the storage and removal of clinical waste. This potentially poses a risk to patients from cross contamination.

We found no evidence to show the provider had undertaken an infection control audit in line with recommended national guidance HTM 01-05. We saw they had not completed the action plan they sent us following our inspection in January 2014.

In the inspection in January 2014 we found there had been no testing of the water system to assess the risk of Legionella bacteria in the water. The provider told us they would take steps to manage this risk. We were shown a risk assessment had been undertaken by an appropriate external agency in September 2014. However there was no evidence to demonstrate the risks identified had been managed for patients' safety and protection.

We spoke with the dentist who was not fully conversant with the underpinning systems and processes in the practice to control and manage risks of healthcare acquired infection. At the time of this inspection the practice had only one dentist present and no dental nurses. No patients were seen during the inspection. However the dentist told us they would see patients for an examination without a nurse present. This is a breach of the General Dental Council Standards - Principles of dental team working points.

At the time of our inspection, there was no registered manager in post. We have advised the provider of the requirement to register a manager in respect of all regulated activities offered by this service.

' People receiving appropriate emergency care

' cleanliness and infection control

' the assessment and monitoring the quality of service provision

The provider was required to provide a report which stated what actions they were going to take to achieve compliance with the essential standards. The provider submitted an action plan on 26 February 2014. The purpose of the inspection was to check the necessary improvements had been made to ensure compliance with the essential standards.

Whilst we found improvements had been made by the provider to two of the essential standards they were still not compliant with the relevant legislation for control of cleanliness and infection.