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Inspection report

Date of Inspection: 20 May 2013
Date of Publication: 14 June 2013
Inspection Report published 14 June 2013 PDF | 87.32 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 20 May 2013, 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

We found that the practice had one surgery, based on the ground floor.

The people we spoke with said the practice was always clean. They confirmed that the dentist and nurses always offered them glasses to protect their eyes, should they wish to use these. People told us that the dental practitioners wore gloves, aprons and masks when it was appropriate to do so. They told us they saw staff washing their hands before, during and after treatments. They said that they thought the treatment room was very clean and hygienic.

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. We noted that the practice facilities were clean and well maintained throughout.

The dental nurse 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. There were infection prevention and control policy and procedures in place that were up to date.

Personal protective equipment (PPE) was available for staff when carrying out dental procedures.

In 2009 the Department of Health published Health Technical Memorandum 01-05: Decontamination in primary care dental practices 2009. This provides guidance for the dental decontamination of dental instruments and infection control in general dental practice.

The practice's decontamination room was based on the ground floor. The room was found to be laid out in accordance with the national guidance.

The dental nurse spoken with explained the process for managing used instruments within the practice and decontamination room to ensure clear and separate areas for clean and dirty instruments. The room was utilised to ensure that all the used equipment was cleaned and sterilised between each use. Dental instruments, once used, were placed in a sealed container prior to transporting to the decontamination room for dirty instruments.

The dental nurses washed and rinsed the instruments. Instruments were then checked for debris under a magnifying light and placed in an autoclave to sterilise them to ensure they reached the approved level of sterilisation. All sterilised instruments were bagged and dated, in line with safe control of infection procedures.

Staff were able to confirm that they were supplied with the correct PPE when working in the decontamination room to minimise the risk of cross infection.

Staff spoken with were aware of cleaning schedules for the surgery and decontamination room. We saw that the surgery was cleaned by the dental nurse between each person, using appropriate equipment to agreed standards. There was a supply of gloves, aprons, wipes, paper towels and hand gel available within the treatment rooms. There were effective systems in place to reduce the risk and spread of infection.

Legionella risk assessments were in place and checked on a regular basis; appropriate waste disposal arrangements were in place. Validations of technical dental equipment such as autoclaves were in place and recorded.

Health Technical Memorandum (HTM) 01-05 identifies that each practice should be capable of meeting the essential quality requirements and best practice. One element of this practice is that "practices should audit their decontamination processes using an audit tool." The Department of Health has already devised such a tool that is available for all practices to use. We found that the service had completed these audits as recommended.