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Inspection report

Date of Inspection: 23 August 2013
Date of Publication: 18 September 2013
Inspection Report published 18 September 2013 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 23 August 2013, 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.

People were cared for in a clean, hygienic environment.

Reasons for our judgement

During our inspection visit we noted the practice was visibly clean, well-organised and well maintained. People we spoke with stated they felt the practice was kept clean and hygienic.

We saw there was a separate decontamination area used for decontamination instruments and that equipment was available to ensure that the decontamination process met with the requirements of the Health Technical Memorandum 01-05 (HTM 01-05). The HTM 01-05 is the guidance that dentists are required to follow to ensure that their practice is safe and minimises the risk of cross infection. The document sets out two standards of compliance for dental practices. These are, “essential quality requirements” which must be achieved and “best practice” which are ideal and desirable.

We were shown the decontamination procedure by the dental nurse who confirmed they had received training in the use of personal protective equipment (PPE) and handling of clinical waste and they were aware of the policy relating to blood-borne viruses and other cross-infection policies.

We saw that there were policies and procedures in place to reduce the risk and spread of infection. For example, we saw records that showed staff were immunised against hepatitis B and that PPE would be used to help prevent infection and cross contamination.

The practice manually washed, soaked and used an ultra-sonic cleaning bath to clean the instruments and then used an autoclave to sterilise them. An autoclave is a device used in dental practices to sterilise dental equipment. An illuminated magnifier was available to check for soiling on instruments after they had been cleaned. We observed staff used PPE during the decontamination process. We noted sterilised instruments were packaged and date stamped with the timescale in which they could safely be used and were stored safely in enclosed drawers and cupboards.

We noted the decontamination room and dental surgery had a dirty to clean workflow which meant that used and sterilised instruments were kept apart, this reduced the risk of sterilised instruments becoming contaminated.

We saw the surface of the dental chair in the surgery was intact. We observed that the chair and surgery was cleaned between consultations as per the guidelines specified in the HTM 01-05.

Staff we spoke with were able to correctly describe the single use symbol that was used to identify dental instruments that could only be used once.

We saw single use instruments were disposed of in sharps bins. We saw that colour coded bags and sharps containers were present for the clinical waste and we were told this was collected by a registered carrier. We saw records that confirmed this was the case. We checked the storage facilities for the clinical waste and noted they were secure.

We saw records that showed the dental surgeries had a daily cleaning system in place and records that showed infection control audits were carried out. The manager showed us the practices cleaning schedules which included steam cleaning on a weekly basis as they told us this was more hygienic.

We saw records that showed the autoclaves were validated at the start and the end of each day and the ultra-sonic baths were also checked and tested daily.

This all meant that people were cared for in a clean safe environment and by staff who were aware of the need to prevent cross infection.