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Inspection report

Date of Inspection: 29 October 2012
Date of Publication: 7 November 2012
Inspection Report published 7 November 2012 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 29 October 2012, talked with people who use the service and 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 four treatment rooms, two equipment decontamination rooms as well as a waiting room and a reception area. We saw there were patient information leaflets that explained the care, treatment and choices available for patients that use the services.

During our inspection, the areas we saw in the dental practice were well maintained. The environment where treatments were carried out were clean and appropriate. We saw that policies and procedures for infection prevention and control were in place. During the inspection we spoke with staff who told us they attended training in infection control on a regular basis. We saw the appropriate application of required infection prevention and control procedures and techniques in place in the areas we observed.

There was a daily and weekly surgery environmental checklist in place which included checks for cleanliness of the environment and equipment and waste disposal processes. We looked at recently completed checklists, which showed that regular audits were taking place and actions were being taken to address any issues found.

The 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. A registered dental nurse was the identified person with specific responsibility for infection prevention and control. We found this role was not fully outlined in a job description but saw the registered dental nurse was aware of their duties.

Preparations were undertaken prior to using the treatment rooms. This included checking all the water lines in the dentists chair and performing appropriate cleaning cycles that included flushing through with cleaning solutions. We were informed the treatment rooms were cleaned by the registered dental nurses between each patient using appropriate equipment to agreed standards.

Staff using the room 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 Principal Dentist and a registered dental nurse, we found they were aware of implementing government guidance on decontamination within dental practices.

The registered dental nurse showed us, and explained to us, the process for managing used instruments within the treatment room to ensure clear and separate areas for clean and dirty instruments. There were two dedicated decontamination rooms which had clear pathways where contaminated (dirty) instruments followed to become clean. We were told the dental nurses placed instruments in dedicated washer disinfector machines before autoclaves

were used to sterilise them 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 in place for Legionella as well as monthly checks. We saw an assessment was conducted by an external company in July 2011. There were appropriate waste disposal arrangements in place for the domestic and clinical waste.

The practice had a policy in place to prevent exposure to blood-borne viruses. There was a supply of gloves, aprons, wipes, paper towels and hand gel available within the treatment rooms. The staff files we looked showed that checks for immunisations such as Hepatitis B had been carried out.