During our previous inspection on 18 June 2013 we identified patients were not protected from the risk of infection because appropriate guidance had not been followed. Aspects of the provider’s quality assurance system were not being used at the practice and patients were not asked for their views about the service. We set a compliance action and the provider wrote to us telling us how they would become compliant.

At this inspection we found improvements had been made. There were effective systems in place to reduce the risk and spread of infection. We viewed all areas of the practice as part of our inspection and found they were clean and tidy.

We spoke with the practice manager and two dental nurses. They demonstrated a good understanding of the requirements of the Health Technical Memorandum 01-05, which provides guidance on decontamination of dental instruments. We saw tests were conducted daily to confirm the autoclaves were working correctly.

Patients were asked for their views about their care and treatment and the practice manager had taken action to improve the response rate from patients’ surveys.

The provider conducted a wide range of audits as part of a rolling programme of reviews. These included infection control, specialist referrals, x-rays, equipment and records. There was an effective system in place to regularly assess and monitor the quality of service patients received.

We looked at six treatment plans showing that patients provided consent before treatment was delivered. Where treatments were complex, the dentists explained the advantages and disadvantages of each option and gave patients time to make a decision.

We observed three consultations and spoke with three patients. One said, “The reception staff are quite nice and the nurse is very, very good”. Another said, “I trust them and always feel quite at ease”. However, one patient told us the dentist did not take account of an allergy they suffered from.

We saw the practice was visibly clean, but procedures used to clean and sterilise instruments were found to be inadequate and inconsistent. Appropriate guidance was not being followed. This put patients at risk of infection.

Dentists and nurses were completing appropriate professional development training. We looked at records of appraisals and saw none had been completed for two years. However, these were now being undertaken by the practice manager.

There was no effective system in place to seek the views of patients about their care and treatment. We found some audits were not being completed in accordance with the provider’s policy.