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Inspection report

Date of Inspection: 18 August 2014
Date of Publication: 9 September 2014
Inspection Report published 09 September 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 August 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

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

Reasons for our judgement

In November 2009, and updated in March 2013, the Department of Health published a document called 'Health Technical Memorandum 01-05 Decontamination in primary care dental practices' (HTM 01-05). This document describes in detail the processes and practices essential to prevent the transmission of infections and promote clean safe care. It is used by dental practices to guide them to deliver an expected standard of decontamination.

We saw at this practice there were systems in place to reduce the risk and spread of infection. The practice had a designated decontamination room which had been designed to accommodate all the equipment necessary for decontamination and to separate decontamination procedures from the clinical area. This meant that contaminated and sterilised instruments did not come into contact with each other. Staff were able to describe the decontamination process to us and explain the dirty to clean workflow which they adhered to.

During our visit we spoke with all the staff at the practice that day; the receptionist, who also carried out decontamination of instruments, the dentist and their dental nurse. They were all able to demonstrate their awareness of the safe practices required to meet the essential standards of HTM 01-05. They were aware of the need for personal protective equipment (PPE). They also described the checks they carried out to be assured that decontamination equipment was functioning properly. There were regular checks of the autoclave and washer disinfector (items of equipment used in the decontamination process) to ensure they continued to operate effectively.

Staff were able to describe the decontamination procedures in operation within the surgery. They ensured that clinical areas were cleaned between patients and explained the workflow to separate clean and contaminated areas in the surgery. The practice used single use equipment wherever possible. This is equipment that is designed to be used once and then discarded to prevent cross contamination.

The dentist who was also one of the providers of this service was the lead person responsible for infection prevention and control procedures. They had audited the infection control procedures within the practice. The most recent audit had shown that the practice was 99% compliant with best practice procedures. The provider had also produced an infection control annual statement in October 2013 which complied with the Code of Practice on the prevention and control of infections. This meant that all information in relation to infection prevention and control had been reviewed and recorded.

The practice had carried out a risk assessment for Legionella. (Legionella is a bacteria found in water storage systems which can cause illness in people.) The provider continually monitored the water systems at the practice. Regular checks of water temperatures were carried out and recorded to check that optimum temperatures, to minimise the risk of Legionella, were maintained. Water from all outlets was sent for testing annually. Dental unit water lines were flushed at the beginning and end of the day and between patients. This was done to minimise the risk of both Legionella and cross infection.

There was a cleaning schedule in place for the cleaner to adhere to. This provided detailed guidance for the frequency of cleaning and the equipment to be used in certain areas. This meant that equipment used for high risk areas was not used for clinical areas to minimise the risk of cross contamination. The practice appeared clean and tidy.