At our last inspection of this service on 5 November 2013 we found that the provider could not be assured that all their decontamination equipment was functioning effectively. This was because relevant testing and validation of some equipment had not taken place. We also found that the provider had not carried out regular checks to assess and monitor the quality of the service.

We carried out this visit to check on the improvements that the provider told us had been made.

During this visit we saw records which showed that the decontamination equipment at the practice had been validated by a service engineer and the provider had a system in place to carry out other testing as recommended in Department of Health guidance. This meant that the provider ensured that decontamination equipment was regularly monitored to check it was working effectively.

We saw there was now a clear audit plan in place. This documented when audits or safety checks were due. The service had carried out audits of certain aspects of their service. This meant that the practice carried out regular checks to improve the quality and safety of their service.

Everybody we spoke with said that they were able to get appointments quickly and at a convenient time. One person told us: “They bend over backwards to fit you in”. Another person we spoke with told us: “They have a tough job on reception but they are very professional”.

One of the patients we spoke with told us about their examination. “At the ‘check-up’ they looked at my gums and cheeks and explained why”. They told us they had received a thorough examination. Another patient told us: “There’s never a rush, even if they are running late you never feel pressurised”. We saw that the practice assessed patients in order to ensure the intervals between oral health reviews were appropriate to the needs of the individual.

We looked at the servicing and maintenance records for the decontamination equipment. Equipment had been regularly maintained and serviced. However there was no record of the validation of one of the autoclaves (a piece of equipment that is used to sterilise instruments). We saw that the protein residue test (a test that is carried out to ensure that decontamination equipment is effective) that was recommended weekly had only been carried out six times in the last 14 weeks.

The practice procedure for checking emergency drugs was at weekly intervals. We saw the records of the checks and found that the last time they had been checked was 5 September 2013.The monitoring system at the service had not recognised that these checks had not taken place. The service did not have a regular audit plan. This meant the provider had not implemented a robust approach to assessing and managing the risks relating to people's health and safety.