We spoke with the practice manager, two reception staff and two dental nurses. At this inspection we looked at the infection control processes and procedures that were in place at the practice. We also looked at the way in which patient records were stored.

We found there were systems in place for the decontamination of instruments and staff were able to explain the processes and procedures they used to decontaminate instruments. These processes were in line with current Department of Health guidance. Patients told us that they found the premises always appeared clean and tidy. They were aware of staff wearing appropriate protective clothing while providing care and treatment.

On this occasion we did not look at the content of patient records. We were shown the electronic system that was in place to store all information relating to patients and their treatment. Referral letters and medical histories were scanned into the electronic record. Archived records were sent off site to a secure storage facility.

We carried out this inspection to check that improvements had been made to ensure there were systems in place to monitor quality in respect of staff appraisal and supervision. We checked that staff had seen and taken regard to all the content of previous reports prepared by the Care Quality Commission (CQC).

We spoke with four staff and the registered manager who were able to tell us of the changes that had been implemented following our last reports of this service. We did not speak to any patients during this visit.

Staff told us they had received a personal development review and we were able to see records of these meetings and discussions. The registered manager had a plan for annual staff appraisals and the programme was clearly displayed in the office.

All CQC reports were filed and were clearly highlighted where issues had been identified. We also saw that the area compliance manager had regularly checked the action plan to ensure any improvements to the service were carried out in a timely way.

We carried out this inspection to check that improvements had been made to ensure staff received appropriate training and were supported through a regular system of supervision and appraisal. At this inspection we found that the registered manager had ensured all staff were up to date with training in the subjects identified by the provider as required annually.

There were systems in place for the provider to assess the performance of clinicians. However we had concerns that the registered manager responsible for the service had not monitored the process effectively.

As part of this inspection we spoke with eight people about their care and treatment. They told us that their dentist explained the treatment they needed in a way they could understand. We looked at patient records in which the dentists recorded the discussions they had with patients regarding their treatment plan. One of the people we spoke with said: “I ask lots of questions, they are always happy to answer.”

The majority of people we spoke with had been patients at the practice for a number of years. They told us they were very satisfied with the standard of treatment provided by the dentists. Comments included: “I trust him.” And "She is so kind and caring.”

People also told us that they had been able to get treatment at times of emergency and were pleased that the practice had ben able to offer them an appointment, to deal with their problem, the same day.

We had concerns that staff had not been supported through a formal supervision and appraisal system to further their professional development. They had not had the opportunity to discuss any issues about their role, their personal development or training needs.

During our visit we spoke to two of nursing staff at the practice. They were able to demonstrate that they were aware of the safe practices required to meet the essential standards of decontamination in a dental practice. They explained accurately the processes and procedures in place to decontaminate instruments.