We carried out an inspection to follow up on outstanding issues which we found during our previous inspection in February 2013.

We saw systems in place to monitor patient’s views and experiences. There was a system in place to check that appropriate standards of cleanliness were maintained. Staff had received appraisals, and staff meetings were now taking place regularly. Some training had taken place with further training opportunities scheduled.

We reviewed documentation relating to the assessing and monitoring of the service, this included audits and updated policies. We saw that records of treatment and documentation had been reviewed and updated. Patient records were stored securely in a locked cabinet and on a password protected computer system.

We spoke to four patients who all expressed satisfaction with the services provided. One

patient, "Best dentist, I have ever had." Another patient said, "I have been coming here for 10 years and am very happy with the dentist."

We saw that all patients were asked to complete a medical history questionaire. We viewed computer records that confirmed the medical histories had been updated. There were suitable arrangements in place to deal with foreseeable emergencies with

a new system for checking the emergency drugs and equipment on a monthly basis.

We spoke to three patients who all expressed satisfaction with the services provided. One patient attending for a second visit for treatment was not sure what the cost of his treatment would be. We were told that new patients were asked to complete their medical histories. However we saw that these were not always updated at subsequent visits.

We saw that instruments were decontaminated in the surgery. The nurse explained that instruments were rinsed first and then cleaned in an ultrasonic bath, followed by examination under an illuminated magnifier then sterilised in an autoclave. We asked how infection prevention had been monitored and were told that an Infection Prevention Society audit was completed in 2011, but there had been no further monitoring since. We saw no evidence that staff had received training in infection control.

We did not see that all staff received appropriate professional development and appraisal.

Records kept on computer were secure, but we saw that medical histories were placed in an unsecured cabinet at the reception. We could not be confident that records were kept securely and could be located promptly when needed.

There were not suitable arrangements in place to deal with foreseeable emergencies with some emergency drugs found to be out of date with no regular system for checking them or the emergency equipment.