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Inspection report

Date of Inspection: 18 February 2014
Date of Publication: 6 March 2014
Inspection Report published 06 March 2014 PDF

People should be cared for in a clean environment and protected from the risk of infection (outcome 8)

Meeting this standard

We checked that people who use this service

  • Providers of services comply with the requirements of regulation 12, with regard to the Code of Practice for health and adult social care on the prevention and control of infections and related guidance.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 18 February 2014, observed how people were being cared for and talked with people who use the service. We talked with staff.

Our judgement

People were protected from the risk of infection because appropriate guidance had been followed. People were cared for in a clean, hygienic environment.

Reasons for our judgement

The practice consisted of three treatment rooms, an equipment decontamination room and a reception room with waiting two areas. There were patient information leaflets that explained the care, treatment and choices available for people that used the services.

The areas in the dental practice were well maintained and the environment, where treatments were carried out, was clean and appropriate. Policies and procedures for infection prevention and control were in place. During the inspection we saw that staff had attended training in infection control. We saw the appropriate application of required infection prevention and control procedures and techniques in place in the areas we observed.

Staff we spoke with understood the importance of infection prevention and control, including decontamination, and could clearly describe their own roles and responsibilities within this area. The practice manager was the overall nominated infection prevention and control (IPC) lead. However, it was not fully clear if they were aware of the specific responsibilities of the IPC lead and there was no specific job description in place to outline these responsibilities.

The practice manager told us that preparations were undertaken prior to using the treatment rooms. This included checking all the water lines in the dentist’s chair and performing appropriate cleaning cycles before and after use. We were informed the treatment rooms were cleaned by the clinical staff between each patient using appropriate equipment to agreed standards.

Staff using the treatment rooms had systems in place to ensure that clean and used (dirty) dental instruments and equipment were kept separate in sealed containers. During our discussions with the head dental nurse, we found they were aware of implementing government guidance on decontamination within dental practices.

The practice manager showed us, and explained to us, the process for managing used instruments within the treatment rooms to ensure clear and separate areas for clean and dirty instruments. There was a dedicated decontamination room which had a clear pathway where contaminated (dirty) instruments followed to become clean. We were told the dental nurses rinsed and washed the instruments and then used an ultrasonic bath to remove any debris before instruments were checked under magnification. Autoclaves were then used to sterilise instruments to the approved level of sterilisation. Clean instruments were stored in sealed packaging and date stamped according to national guidelines. The staff we spoke with had the required levels of competence and training in relation to these areas.

Validation of the technical dental equipment such as autoclaves and x-ray machines was in place and recorded on a daily basis. We also saw evidence of external servicing. There were risk assessments and routine checks in place to minimise the risk of Legionella.

The IPC lead carried out infection control audits, which included references to Decontamination Health Technical Memorandum (HTM-01-05: Decontamination in primary care dental practices).

The practice had a policy in place to prevent exposure to blood-borne viruses and we saw staff had received the appropriate immunisation. The majority of hand-wash sinks we saw had elbow operated mixer taps, in accordance with current best practice guidance. There was a supply of gloves, aprons, wipes, paper towels and hand gel available within the decontamination and treatment rooms.