At this inspection we checked whether previous shortfalls in relation to issues regarding cleanliness and infection control and assessing the quality and safety of the service had been addressed. These issues had been identified during our last inspection at the service on 20 November 2012. We found improvements had been made to infection control and quality monitoring.

We observed staff whilst they were performing the decontamination process and found they followed the correct procedures. Staff wore the prescribed protective clothing such as: gloves, aprons and eye protection. The provider told us staff had received training regarding best practice standards.

People who used the service told us that staff always wore gloves, aprons and masks when they were treating them. One person told us, "They always wear aprons and gloves; always."

We saw that the provider was undertaking a range of checks and audits regarding the service. Audits included: people's case files to ensure the practice was assessing people's risk of oral cancer, checks on the cleanliness of the practice and audits to ensure record keeping was up to date.

We saw emergency drugs were checked monthly and found all the medicines were in date and fit for use.

We noted that the practice carried out random satisfaction surveys. One person who used the service told us, “It’s always been very good. I’ve never had a problem.”

People told us they were involved in planning their treatment as they were given information and options for treatment. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People made positive comments and people described the treatment as, "Always been first class". We considered that people experienced care, treatment and support that met their needs.

We found that people who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People told us the practice was always clean. We saw that the treatment rooms, decontamination room and waiting area were clean and tidy. However, infection control policies and procedures were unclear and Department of Health guidance which tells dentists how they should decontaminate dental instruments was not being followed. We found people were not protected from the risk of infection because appropriate guidance had not been followed.

People told us that they thought staff knew what they were doing. We found that people were cared for by staff who were skilled and supported to deliver care and treatment safely and to an appropriate standard.

We found that the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.