We carried out this inspection to check on improvements made since our last inspection, which was carried out in November 2013.

We carried out the follow up inspection on 12 September 2014. We found that the required improvements to the service had been implemented.

The practice had suitable policies and procedures for safeguarding children and adults against the risk of abuse, harm or neglect. The policy provided details of who staff should report concerns to. Staff had undertaken training in safeguarding children and adults from abuse. Staff we spoke with were aware of their responsibilities to safeguard patients against abuse or harm and how to report concerns.

The practice had arrangements for supporting staff to deliver safe and appropriate care and treatment. Staff had access to training courses in order to meet the continuous professional development and maintain their registration with the General Dental Council. Staff told us that they were supported by the principal dentist and that they met regularly to discuss their work performance, training and development needs. Newly appointed staff underwent a period of induction to help familiarise themselves with the practices' policies and procedures.

We looked at six care plans, spoke with three people who used the service, the dentist and two members of staff. The dental treatment plans were up to date and contained information about the treatment that had been provided.

We looked at how the service kept people safe with regard to the policy and staff knowledge of safeguarding and how staff were supported to provide the service. We found for both safeguarding and staff support the service was non-compliant. The safeguarding policy had incorrect information about the reporting of safeguarding. The provider was not able to demonstrate that they had robust staff support processes in place or evidence of staff's planned learning and professional development.

We inspected this service on 5 September 2012 and subsequently took enforcement action relating to infection control practices and safety and suitability of premises.

We inspected this service again on 21 November 2012 we found some improvements but there were still some shortfalls with regard to infection control. We also found that records and assessing and monitoring the quality of the service needed to be improved.

At this inspection we saw there that infection control procedures were in place and the practice was very clean. The premises were well maintained and fit for purpose. We found improvements to staff understanding of infection control procedures to ensure people’s safety.

We identified improvements to record keeping. Equipment was serviced as required and the premises were safe because essential checks had been carried out.

The provider was not able to demonstrate that they had robust staff recruitment processes in place or evidence of staff’s learning and professional development. Management systems for the safe and effective running of the business were poorly developed and required improvement.

On the 5 September 2012, we visited the service to follow up areas of non compliance identified at an earlier inspection in April 2012. During the inspection we identified continued breaches with regulation which posed a significant risk for people using the service. We served two warning notices in accordance with our enforcement policy. The purpose of the inspection on the 21 November 2012 was to check compliance with the warning notices.

We did not speak with people using the service during this inspection as the purpose of the inspection was to follow up what improvements the provider had made in specific areas.

The provider had made improvements to the safety and suitability of the premises and had reduced the risks posed from unsafe premises and, or equipment.

Improvements to infection control procedures had been made. However there were still some areas of concern identified which require further actions from the provider.

We identified concerns with record keeping and assessing and monitoring the quality of the service provision.

We did not speak with people using the service. The purpose of the visit was to follow up areas of non compliance directly with the provider.

We were unable to speak privately with people using the service during our visit. One person commented that they had been attending the service for a number of years and were happy with their care and treatment. They told us that the dentist and the dental nurse always wore gloves, an apron and a mask during their check ups. They told us they felt comfortable in the way they were treated.

Because we were unable to speak with people in private we also gathered evidence of people’s experiences of the service by observing how they were treated during their visit and looking at records. We saw that people were seen promptly and spoken with in a polite and friendly manner. Records showed that their treatment was recorded and options discussed.

Information was shared with us from other professional bodies. NHS Suffolk had been closely monitoring the service after concerns were raised. In addition professional advisors from The National Clinical Assessment Service (NCAS) had been working with the provider to improve clinical and administrative practices. NCAS had undertaken surveys of people using the service to find out what people thought about the service in 2011. The provider told us they had not undertaken any of their own quality assurance with people using the service.