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Inspection report

Date of Inspection: 13 December 2013
Date of Publication: 21 January 2014
Inspection Report published 21 January 2014 PDF | 91.15 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 13 December 2013, talked with people who use the service and talked with staff. We 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

We saw there was a policy for infection prevention and control (IPC) which covered the required elements of practice; minimising blood borne viruses procedure; decontaminating instruments used in dental treatment; hand hygiene; clinical waste; personal protective equipment (PPE) which refers to gloves, aprons, masks and visors; blood spillage; environmental cleaning. We saw that the policy had been checked and updated in July 2013 to ensure that new guidance was included. Information flow charts were displayed with respect to checking staff’s need for hepatitis B immunisation and about what to do in the event of a needle stick injury.

We saw certificates showing that the dentist and nurse had both received and updated training in IPC and decontamination, in order to maintain safe standards of work.

The Department of Health published in November 2009 a document called Health Technical Memorandum 01-05: Decontamination in primary care dental practices (HTM01-05). It set out in detail the processes and practices essential to prevent the transmission of infections and provide clean safe care.

Staff showed us the method used for decontaminating reusable instruments. A dedicated room had been provided and equipped in line with professional guidance. There was a separate hand washing sink. There was a clear flow of work from dirty to clean, to ensure that cleaned items were not re-contaminated.

We saw that items were brought from the treatment room in a lidded box to prevent contamination of the areas en route. Staff put on their protective visor, disposable apron and gloves then scrubbed in the first sink. They then put the instruments into the washer disinfector. After this, staff checked all items under an illuminated magnifier and if any visible dirt remained the instrument was returned for repeat scrubbing. Hollow hand pieces were wiped and oiled. Instruments were then put through a cycle of the steam autoclave to be sterilised. After this they were bagged and dated so that the dentist would know they were safe for re-use.

All work surfaces and splash backs had good surfaces that were easily cleanable. The provider may like to note that the tiled floor had grouting that was not easily cleanable and therefore posed a potential hazard. The dentist told us this was to be replaced with easily cleanable wooden flooring.

We saw documents showing that the washer disinfector and autoclave had been professionally checked and serviced. Staff had carried out daily and weekly checks on the correct functioning of the machines. The dentist ordered materials for carrying out the protein residue test for efficacy and cleanliness as required by the HTM01-05 chart 13.3.

We saw that clinical waste was stored safely and disposed of legally.

We saw the practice's cleaning plan and schedule, and saw that the check lists for daily cleaning had been completed. People who used the service confirmed they always found the environment to be clean.