At the last inspection on 19 July 2013, we identified that infection control practices were not effective. The manual cleaning of instruments was cursory and infection control procedures had not been audited. Some tests specified by the Health Technical Memorandum 01-05 (HTM 01-05) on equipment used for decontamination were not carried out. The practice did not have systems in place to assess and monitor the quality of the service provided. Plans to identify a separate decontamination room had not been established. The last patient survey had been undertaken in 2008.

At this inspection, we found that the provider had made improvements. Decontamination and sterilisation procedures were undertaken in line with the provider's policy. The practice manager had carried out detailed audits of infection control and record keeping. They demonstrated to us how changes had been made to improve practice. Satisfaction surveys had been undertaken and analysed, and related feedback was discussed in a staff meeting to implement changes required.

Patients we spoke with were complimentary about the service. One said “the dentist has a very nice manner." Medical histories were regularly taken to identify and minimise any potential risks to patients. One patient said the dentist was “scrupulous” in this regard.

There were arrangements in place to deal with foreseeable emergencies. Drugs and equipment recommended by the Resuscitation Council UK (RCUK) were almost all in place and staff regularly undertook basic life support training.

Whilst the practice had systems to reduce the risk and spread of infection, we found some areas of concern. The premises did not allow for a separate decontamination room, regarded as best practice. The manual cleaning of instruments was cursory and this procedure had not been audited, which was contrary to Department of Health essential requirements which said this should be carried out every six months. Some tests specified by the Health Technical Memorandum 01-05 on equipment used for decontamination were not carried out.

The practice did not have systems in place to assess and monitor the quality of the service provided. This included gathering patients’ views. Whilst patients we spoke with on the day of the inspection told us they were happy with the service, the last patient survey had been undertaken in 2008. A lack of a systematic approach to quality monitoring meant that people could not be sure of the effectiveness of the provider's infection control procedures and other quality measures.