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Inspection report

Date of Inspection: 15 July 2013
Date of Publication: 17 August 2013
Inspection Report published 17 August 2013 PDF | 80.92 KB

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 15 July 2013, observed how people were being cared for and talked with people who use the service. We talked with staff.

Our judgement

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

Reasons for our judgement

All the patients we spoke with told us they found the practice to be very clean and tidy.

The risk of cross infection from decontamination processes, cleaning treatment rooms and poor hand hygiene was minimised. The practice operated procedures that met the up to date guidelines for the decontamination of dental practices issued by the Department of Health (DoH) in March 2013. We observed the dental nurse taking a set of instruments through the decontamination process in a dedicated decontamination room. The process we saw conformed to the guidelines and the dental nurse wore appropriate protective personal equipment (PPE) at the correct stages of the process. We checked all the logs of tests of decontamination equipment. These showed satisfactory results. We saw that staff further reduced the risk of cross infection by following high standards of hand hygiene as required by the practice’s hand hygiene procedures. For example thorough hand washing was carried out between before starting decontamination of instruments. We witnessed dental nurses following the DoH guidance for cleaning surgery rooms between treatments.

The practice maintained high standards of general cleanliness and hygiene for their patients. The practice had a cleaning policy which outlined cleaning requirements for clinical, non-clinical and communal areas. The dental nurse cleaned the dental surgery and the decontamination room. The hygienist cleaned their treatment room and the receptionist cleaned the communal waiting area. The toilets were provided in the rented building and cleaned by the landlord. The dentist did not record checks of the quality of cleaning, but visually observed cleaning on a daily basis. They said “if they [the staff] had missed something, I would say”. Communal areas were carpeted and therefore separate mops and buckets to reduce the risk of cross infection were not required at this practice.

The risk of contamination from clinical waste was minimised because the practice operated a system of segregating clinical waste from general waste. We found that full bags of clinical waste were stored in the clinical waste bins until collection. The bins for sharp instruments and syringes were held off the floor in the decontamination room to prevent them being knocked over and presenting a risk of a puncture wound from sharp objects. We looked at the practice records confirming that clinical waste was collected by a licenced waste carrier and the consignment notes showing that clinical waste was removed at agreed intervals by the carrier. This conformed with the hazardous waste legislation of 2005.

The risk of patients contracting infection from waterborne bacteria was minimised because we saw that the practice had a copy of the legionella risk assessment undertaken within the last two years. The legionella risk assessment and monitoring of hot and cold water temperatures were conducted by an external company contracted by the practice’s landlord. We saw evidence that contractors attended on a weekly basis to undertake checks of the fire and water systems.

The risk of patients’, dentists’ or staff contracting hepatitis B were reduced because we saw records confirming that all staff had received their course of vaccinations.