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Inspection report

Date of Inspection: 3 July 2013
Date of Publication: 31 July 2013
Inspection Report published 31 July 2013 PDF | 88.03 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 3 July 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.

Reasons for our judgement

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

We noted that the practice was clean and well maintained. The two patients we spoke with told us that the practice was always clean and tidy when they visited. One patient said, “It’s always clean and excellent”. Another person said, “It’s always clean and pleasant here. The four surgeries we observed were clean and free from clutter.

There were effective systems in place to reduce the risk and spread of infection. This was demonstrated through direct observation of the cleaning process and a review of practice protocols that the Health Technical Memorandum 01-05: Decontamination in primary care dental practices and Essential Quality Requirements for infection control were maintained. The practice had a decontamination policy in place. This was supported by a series of practice protocols in relation to infection control. The practice manager told us that audit of infection control was carried out every week. We were informed that a dental nurse was the designated infection control lead, which we evidenced in the infection control policy.

All staff we spoke with recognised the importance of maintaining good infection control procedures. All staff had undergone training on infection control. A member of staff commented, “We use personal protective equipment (PPE) at all times”. Another said, “We disinfect all areas and use new coverings after every consultation. This is in line with our infection control”.

A dental nurse demonstrated the decontamination process to us and this validated the various practice protocols in place for infection control. They showed us the process from taking the dirty instruments through to clean and ready for use again. They used PPE such as double gloves, aprons and masks to prevent infection. The practice used manual cleaning for the initial phase of the decontamination process in the decontamination room; checked under light for any remaining debris or particle. This was followed by sterilisation of the instruments. It was clearly observed by us that clean and dirty instruments did not re-contaminate each other. There were two separate sinks used for these in the decontamination room and a separate sink for washing hands. There were designated dirty and clean areas.

When instruments had been sterilised, they were pouched and stored until required. All pouches were dated with an appropriate expiry date of one year according to the new regulation. The dental nurse told us that regular checks were made to ensure that the expiry dates were not exceeded. This was supported by the use of a stock rotation protocol which we observed. They showed us that systems were in place to ensure that the autoclave used in the decontamination process was working effectively. The practice manager showed us the maintenance contract for the autoclave and compressor demonstrating that they were safe and effective for use. This meant that decontamination of equipment was maintained to the standards set out in current guidelines.

The dental water lines were maintained in accordance with current guidelines. Flushing of the water lines was carried out in accordance with current guidelines and supported by an appropriate practice protocol. A Legionella water test and risk assessment had been carried out by an appropriate contractor.

The segregation and storage of dental and sharps waste was in accordance with current guidelines. The practice used an appropriate contractor to remove dental waste from the practice. Waste consignment notices were available for inspection. We observed that sharps containers were well maintained and correctly labelled. The practice sharps injury protocol was clearly understood by the practice staff. This meant that staff were protected against contamination by blood borne viruses.

We saw that hand wash soap and hand gels were available in all the three toilets we looked at during our visit. The provider m