We visited Stanford Dental on 14 May 2014 to carry out a follow-up responsive inspection to check that the required improvements had been made. These had been identified at previous visits in November 2012 and February 2014.

We found that the provider had effective systems in place that maintained appropriate standards of cleanliness and hygiene to protect people from the risks of a health care related infection.

Improvements had been made that included new sinks being installed that met department of health requirements for the cleaning and rinsing of used instruments. The infection control policy had been updated and an infection control lead had been appointed. Decontamination procedures had improved and an infection control audit undertaken which highlighted that infection control measures were effective.

Staff were supported in the workplace. They had received an annual appraisal which covered their competency together with a development plan. Staff meetings were held monthly where training issues were discussed. New staff undertook a structured induction process which was recorded and held in their personal files.

The provider assessed and monitored the services they provided by analysing patient surveys and suggestions, staff ideas for improvement and learning from complaints and untoward incidents. Some audits had been undertaken recently and there was a timetable in place for 2014 that identified the type of audit and when it would be actioned.

Since our last visit on 29 November 2012 we found that improvements had been made at the practice but some areas still needed attention.

The provider sought people's feedback through patient surveys, a suggestion box and by monitoring complaints. The complaint's procedure was not displayed for the information of people who used the service. People's privacy was now being respected.

Infection control procedures were not effective although some of our previous concerns had been rectified. The surgery was clean and tidy, instruments packaged correctly and staff wore clean uniforms daily. Sharps bins were signed and dated.

However we found that decontamination procedures for used instruments were not being undertaken in line with published guidance. Staff did not routinely wear personal protective equipment and were not sufficiently aware of the procedures to follow. Daily, weekly and monthly checks of equipment were not recorded or audited. An infection control lead had not been appointed and there were no infection control audits taking place.

We found that staff members were not sufficiently supported. The induction programme for new staff was not being followed and their competency was not formally supervised. Team meetings now took place but minutes were not taken.

The provider did not regularly monitor and assess the quality of the services provided. There was an absence of audits and an incomplete analysis of complaints and surveys.

We spoke with five people who were using the service. All of these said that they were very happy with the care and treatment they received at Stanford Dental Practice. They said they would recommend the practice to others.

Two of the people we spoke with had just had a consultation but said they had not been asked for an updated medical history by the dentist during the consultation.

One person said they thought Mr Kafian was a “brilliant dentist”. They also said, “He is very good with my daughter, and she hates coming to the dentist!”

Another person told us that Stanford Dental Practice had been recommended to them and that they had transferred to the practice as a result of this. They said, “It’s a good little surgery; I love it.”

We observed a consultation and found that the dentist was very respectful and listened to what the patient had to say. They were caring and ensured that the person was comfortable. Treatment choices were given and explanations were clear.