When we inspected the service on 9 August 2013 we found areas of concern related to the storage of clinical waste and a lack of documentation demonstrating how risks had been assessed and managed. We also noted there was no cleaning schedule or procedure. Patients did not have access to a complaints procedure and staff showed poor understanding of Mental Capacity Act 2005 and how it related to their practice.

The provider sent us an action plan of how they intended to improve in these areas. We found progress had been made in all the areas we had previously had concerns about.

We found clinical waste was now stored safely. The provider had introduced cleaning schedules and a clear procedure was documented of what areas were cleaned, with what equipment. This protected patients from the risk of cross contamination and infection.

We read risk assessments and audits to ensure the safety and wellbeing of staff and patients and to monitor the quality of the service.

We saw evidence staff had undertaken training in the Mental Capacity Act 2005. They were able to describe to us how they applied to their work.

We saw how the provider had implemented a complaints procedure that was accessible to patients. The complaints policy directed staff towards dealing with complaints appropriately and in a timely way.

We spoke with three patients who were very complimentary of the service they received at the practice. One patient told us they had received a fifty minute consultation prior to any treatment commencing. Another patient told us “I don’t put up with sloppy services, the service here is very good.” Another patient told us the staff were “Very professional and very friendly and they remember who you are.”

We looked at patients' notes in relation to consent to treatment. We found everyone had a medical history assessment, but consent for treatment forms were not signed.

We examined the decontamination process and the infection control measures the provider had in place to protect patients from the risk of infection. We found there were some areas in need of improvement, for example the storage of clinical waste, and the need for a cleaning schedule and process.

We found the provider did not carry out regular audits to check systems were in place regarding cleaning of the practice, staff training, patient feedback, infection control or on the quality of the service provided. There was no complaints procedure in place that ensured patients knew how to complain or staff knew how to respond appropriately.