When we inspected Crocus Dental Care on 09 January 2014 we found that the provider was not meeting three of the essential standards. There was no oxygen available for use in an emergency. There were a number of shortfalls in relation to the provider's observance of the Department of Health (DH) guidance on decontamination of instruments. The provider did not have an effective approach to monitoring quality.

When we inspected the location again on 26 September 2014 we found that emergency oxygen was in place, accessible and checked regularly to ensure it was working correctly.

We found that the provider had taken steps to meet the shortfalls in the instrument decontamination process in relation to the use of appropriate equipment and the arrangements for a 'dirty' to 'clean' workflow.

Since our previous inspection the provider had carried out a survey of people using the service and had plans to act on their feedback about the standard of the décor at the practice. The provider had also commissioned a legionella risk assessment and had acted on the findings by introducing water temperature monitoring.

When we inspected Crocus Dental Care on 09 January 2014 we found that people were provided with information about their treatment and they were asked for their consent. One person told us, “I was given information about either having [the treatment] or leaving it and was told how much it would be. I said what I wanted and [the dentist] went ahead.”

Treatment was planned according to an oral examination and an assessment of people's needs. One person we spoke with said, “I was asked to complete a form about my medical history and we discussed it during my examination. I didn’t get an x-ray first time but they took one today. I explained what the problem was and [the dentist] examined me and then explained the options.”

The arrangements for responding to a medical emergency were incomplete. There was no access to emergency oxygen.

The procedure for the safe decontamination of instruments was not in accordance with the Department of Health guidance.

Staff members undertook continuing professional development that maintained their professional registration. Staff also had opportunities to take part in other relevant training but they did not receive a regular, formal appraisal.

The provider did not have effective audit systems in place. Shortfalls that had been identified during an infection control audit had not been rectified. There was no legionella risk assessment in place.