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Inspection report

Date of Inspection: 16 September 2013
Date of Publication: 2 October 2013
Inspection Report published 02 October 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 16 September 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff, reviewed information given to us by the provider and took advice from our pharmacist. We took advice from our specialist advisors.

Our judgement

There were effective systems in place to reduce the risk and spread of infection.

Reasons for our judgement

There were effective systems in place to reduce the risk and spread of infection. The provider showed us and we read their practice policies and procedures for management of infection control. The provider had a copy of the Department of Health’s infection control Code of Practice guidance. This publication is related to the Health and Social Care Act 2008.

The people we spoke with told us the practice appeared clean when they visited for appointments. One person told us, “Yes. They move with the times, the surgeries never get “tired” and are always updated.” Another person told us, “Oh yes, it’s always very clean and tidy here.” We saw the surgery teams had sufficient supplies of gloves, masks and eye protection. Staff had facilities to wash their hands in dedicated hand washing sinks and relevant signage about proper hand washing routines. Hand cleaning gels were also available to patients below signage reminding them of hand hygiene. This demonstrated good practice in preventing the spread of infection and showed appropriate infection control procedures took place routinely.

We examined the facilities for cleaning and decontaminating dental instruments. Instruments were cleaned and decontaminated in a separate dedicated hygiene area away from the dental surgeries. We looked at the procedures for cleaning of instruments in all the surgery rooms. We found there were clear flows from ‘dirty’ to ‘clean’ for instruments used in the surgeries. One of the dental nurses showed us how instruments were decontaminated and sterilised. There were procedures in the treatment rooms for dealing with the clean and dirty instruments so that there was no cross contamination. Dirty instruments were taken to a separate dedicated room for thorough cleaning and decontamination. This room was laid out in accordance to government guidance for dental practices. With separate hand washing and dental instrument cleaning areas.

The dental nurse showed us how they used an illuminated magnifier to check for any debris or damage to equipment throughout the cleaning stages. We saw the practice used non vacuum sterilisers in the decontamination room which, once the equipment was placed in date stamped sealed view packs, provided sterility of instruments in line with current guidance. Equipment checks were carried out during each surgery session and recorded to ensure the equipment was in good working order.

Waste items were disposed of and stored in accordance with current guidance and the provider had a contract with a clinical waste contractor. We saw that the differing types of waste were appropriately segregated. Single use items were seen to be disposed of safely as were sharp objects such as needles used for injections. This showed the practice maintained effective hygiene and infection control practices.

We looked at the consulting rooms where patients were examined and treated. The rooms and equipment appeared clean and surfaces were free of non-essential items. The nurses we spoke with told us they had cleaning duties between patients and at the end of treatment sessions. We saw the dental nurses cleaned all the surface areas in the surgeries after each patient. There were completed records for cleaning schedules. However the provider may wish to note that in two of the surgeries we looked at there were gaps between the skirting boards and the floor surface where dust and debris could accumulate which could lead to the spread of infection.

We saw there were effective systems in place to reduce the risk and spread of infection. We spoke with staff about the cleaning routines and infection control training they had undertaken. All staff employed by the practice had undertaken relevant training in infection control within the last year. The provider employed a specialist cleaning service to clean the surgeries and the public areas of the practice to carry out an additional deep clean of each surgery every six months.