When we completed our last inspection in July 2013 the provider was not meeting all of the regulations. The provider sent us an action plan telling us how they would improve. This was a follow up inspection to check that improvements had been made. During this inspection we spoke with the dentist, dental nurses, the manager and people who used the service.

People told us they were pleased with the care and treatment they received. Comments included: "I'm very happy with the care" and "I have no concerns".

People said that the practice was always clean and that they had no concerns about the standard of hygiene. Policies and procedures were in place to ensure that the practice was kept clean and people were protected against the risk of the spread of infections.

People said and we observed that all the staff were friendly. Staff were supported and trained to provide people with an appropriate standard of care.

The practice had systems in place to review and monitor the quality of care that people received. The views of people were obtained by user questionnaires that they completed following a course of treatment.

This was a scheduled inspection. We told the practice two days in advance that we were visiting. This was to make sure the appropriate staff were available to speak with us. We checked whether the practice had made the improvements needed following the last inspection. During the inspection we spoke with the dentist, the provider's representative, the hygienist and a dental nurse and seven people that used the service.

We found that the provider had not fully addressed the issues identified at the last inspection.

People were happy with the dental care they received. They said that the dentist always fully explained their treatment. People's individual needs were taken into account when care and treatment was provided. The records we looked at confirmed that people received continuity of care and that information was available to the dentist about people's specific medical condition.

People were not fully protected against the risks of the spread of infections as the practice did not have appropriate systems in place to make sure that the practice was kept clean and hygienic.

People told us that the dental staff were polite and friendly. The practice did not have systems in place to provide staff with the support and supervision to provide care to the required standard.

Effective systems were not in place to monitor and review the quality of care. This meant that the provider could not be assured that people received safe and appropriate care.

This inspection was undertaken to review the improvements that had been made following our previous inspection of the service in January 2012.

During our visit we looked around the premises. We spoke to the dentist, two dental nurses and the nominated individual, who was the person the provider had identified to have the responsibility to check that the dental surgery provided safe and appropriate care. We spoke with two patients who attended for treatment during our visit and looked at the records of four people.

People we spoke with during this visit told us, that they had no concerns about the treatment they received. One person told us, "I was frightened of the dentist before I came here, but they sorted my teeth out and I now come regularly for my check ups". Another person told us, "The dentist here is very good and I have recommended the practice to others".

Evidence that we gathered during this inspection confirmed that people received the dental care they needed. Treatment that people may need was discussed and agreed with them before the treatment programme commenced. One person told us, "All treatment is discussed and agreed with me, I have no complaints whatsoever". Improvements had been made since our previous inspection in planning and organising of dental care.

The dental surgery had made improvement to reduce the risk of cross infection, although we identified that further improvement was needed. The dental had also identified a programme for further improvement to be made to ensure that people receive an examination and treatment in a safe and clean environment.

We conducted telephone interviews with five people who use the service and spoke with one person during our visit. A number of the people we spoke with had been using this dentist for many years, so they knew the dentist well. People told us that they had no concerns about the care and treatment they received. They made some of the following comments:

“They are very good and polite. I have been going since 1983 and have never had any problems.”

“I have no complaints whatsoever about the treatment I receive. All treatment is discussed and agreed with me. They always ask after each treatment if I am happy.”

“The surgery is clean and spotless, easy to get to by bus and it has a good layout. The dentist always wears gloves and masks. I have never caught an infection.”

The facilities and resources offered at this practice include three surgery rooms, a full time dentist, a part time hygienist and four dental nurses. The reception entrance and one surgery room are on the ground floor. The registered provider has recently modified the premises to ensure the practice is accessible to people with mobility restrictions.

During our visit we looked around the premises. We spoke to the dentist and the two dental nurses that were on duty and looked at the records for three people who use the service.

Evidence that we gathered during this review confirmed that people receive the dental care that they need. Treatments that people may need are carried out in a satisfactory way. We found shortfalls in the systems for planning and organising people’s dental care and treatment, which needed to be improved in order to ensure people receive safe care at all times.

We found that people were not fully protected from the risk of cross infections. Improvements were needed to ensure that people receive examination and treatment in a safe and clean environment.