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Inspection report

Date of Inspection: 4 February 2014
Date of Publication: 16 April 2014
Inspection Report published 16 April 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 4 February 2014, observed how people were being cared for and talked with people who use the service. We talked with staff and reviewed information given to us by the provider.

Our judgement

Patients were protected from the risk of infection because appropriate guidance had been followed.

Reasons for our judgement

There were effective systems in place to reduce the risk and spread of infection. The premises were clean and tidy. On our tour of the practice we saw that all the sinks had lever operated taps and that liquid soap and paper towels were provided. The clinical waste bins in the treatment rooms and decontamination room were not foot or knee operated. The provider had put measures in place to ensure that patients were protected from infection and cross infection by wiping the bin lid and contaminated areas with disinfectant wipes after each use and discarding the wipe and disposable gloves to avoid cross infection. This meant that patients and staff were protected from infection and cross infection.

The surgeries were clean and light. We saw that the dentists and nurses wore clean uniforms and that personal protective equipment (PPE) was available for use both by staff and patients. These included for example, disposable gloves, masks, aprons and eye protection.

We saw that there was a purpose built decontamination room which meant that instruments were not being cleaned in the treatment rooms; this reduced the risk of infection and cross infection. The decontamination room had an easy to clean floor and work surfaces.

Staff transported instruments to and from the dental surgery, hygienist treatment room and the decontamination room in separate lockable lidded boxes for clean and dirty instruments. This meant that the provider had taken steps to reduce the risk of cross infection.

We spoke with a member of staff who was responsible for the decontamination of instruments. They spoke knowledgably about the Department of Health requirement in the 'Decontamination Health Technical Memorandum 01-05: Decontamination in primary care dental practice Edition 2013' (HTM 01-05). For example, they told us about the change in the length of time instruments can be stored before they must be sterilised again before use. They also explained and demonstrated the steps they took to ensure instruments were cleaned correctly.

We saw that equipment used for decontamination was checked to ensure that it was working correctly and this was recorded. For example, we saw that there were suitable arrangements in place for validating and testing the autoclave. We saw that it was tested each cycle and the test strips were signed and dated and held in a file. Additionally, we saw that the autoclaves were serviced regularly. This meant that the provider used sterilising equipment that was operating correctly.

The surgery, hygienist treatment room and the decontamination room displayed notices of the ‘clean’ and ‘dirty’ zones. The provider had dedicated one full surface to the clean zone and one full surface to the dirty zone. The provider explained that staff had been extensively trained on where the zones started and finished and the demarcation points to avoid inadvertent placement of items in the wrong zone. The provider also explained that staff were only allowed to use the zoned areas once inducted and trained to avoid any risk of inadvertent cross infection to staff and patients. This meant that the provider had procedures in place to reduce the risk of infection and cross infection.

The sharps boxes were located off the floor and out of the reach of children. This demonstrated that the provider was following best practice.

The practice had infection control, cleaning and waste management policies in place. Staff told us that the clinical waste was segregated and stored securely for collection by authorised collectors. We saw records that confirmed this and saw that clinical waste was placed in clinical waste bags for disposal.

We saw that the provider used the National Patient Safety Agency colour coding scheme for cleaning equipment. For example, mops were colour coded for cleaning specific areas of the premises. This meant that the provider had taken steps to reduce the risk of the spread of infection.

The service had amalgam separators i