We carried out this inspection to ensure that the provider had made improvements following our previous inspection.

We found that improvements had been made in the management of risks around infection control. Arrangements were in place to ensure that risks were minimised and managed appropriately.

We found that appropriate checks had been carried out for staff to ensure they were suitable to work at the dental practice.

During our inspection, we spoke with four people, four staff, and the practice manager.

Arrangements were in place to ensure that people consented to their treatment, before this was delivered. One person told us, “The dentist always asks me.”

We found that improvements had been made to protect people from harm. Staff were aware of their responsibilities and action had been taken to ensure that staff were confident with the procedure they should follow.

Whilst some improvements had been made, we continued to find inappropriate practices in one treatment room. This meant that people could not be assured that the instruments used were safe and would protect them from the risk of infection.

We found that only appropriate medicines, which were needed, were available at the dental practice.

We found that some action had been taken to ensure staff checks were carried out. However, these checks had not been completed to ensure that staff were suitable to work with all people.

Staff training records showed that improvements had been made in the availability of this information, and in the training opportunities that staff were offered. One staff said, “I have had all the training now.”

We found that improvements had been made in securely storing people’s dental records.

We received concerns about Antrim House regarding poor cleanliness and hygiene standards that placed people at risk of health acquired infections.

We carried out an unannounced inspection on 28 May 2012. This meant that the provider was unaware of our intended inspection. We found that the provider was not meeting the essential standards we looked at.

The provider sent us an action plan that told us what action they had taken to improve standards. However, the action plan provided insufficient information to show how standards would be improved, so people receive a safe effective service.

We carried out an unannounced follow up inspection on 6 August 2012. During our inspection we used a number of different methods to help us understand the quality of the service provided to people.

On the day of our inspection the provider and practice manager were not present but we spoke with the provider by telephone. We spoke with two dentists, two dental nurses, the receptionist and a person who use the service. We looked at four dental records and the practice’s policies and procedures. We looked at staff training records. We spoke with staff about the decontamination procedures of instruments used for dental treatment.

The practice is situated in a residential area. There were car parking facilities available at the front of the property. The property consisted of a reception/waiting area, four treatment rooms and toilets.

We found that dental records contained relevant information to show people were involved in their dental plan. One person who accessed the service said, “I was made aware of my treatment options.”

Staff did not have access to a safeguarding policy and were unaware of their responsibility of safeguarding people from potential abuse.

We found that the decontamination process of instruments used for dental treatment was inadequate and placed people at risk of health acquired infections.

We observed that the practice was not disposing their clinical waste appropriately and this could compromise people’s health and safety.

The practice had a stock of emergency medicines that were not appropriate for the treatment the service offered and staff were not trained to administer them.

There was insufficient evidence to demonstrate whether staff had received essential training to ensure they had the skills and competence to undertake their role.

Staff personnel records contained insufficient evidence to show if staff were suitable to work at the practice.

We received concerns about this service from an anonymous source alleging substandard hygiene and cleanliness of the practice.

We carried out an unannounced site visit at Antrim House on Monday 28 May 2012. This means the provider did not know we were visiting.

We used a number of methods to find out if practices and systems in operation were appropriate to ensure people were not placed at risk of contracting avoidable infections.

The practice had four treatment rooms located on the ground and first floor. The staff team comprised of four dentists, six dental nurses, receptionist and a practice manager.

We looked at the practice’s decontamination regime; this is where instruments used for dental treatment are cleaned and go through a sterilising process. We also interviewed a dental nurse who demonstrated a good understanding of the decontamination process.

We spoke with three people who use the service who confirmed their satisfaction with the service provided and the hygiene and cleanliness of the practice.

The practice manager said three out of six dental nurses had completed the infection prevention and control training. There were no clear up to date records to evidence what training staff had received and when.

We found that instruments used for dental treatment were not all packaged or stored appropriately and this could place people at risk.

The practice had a small stock of emergency medicines in place; we found that the use by date on a number of these medicines had expired.