We carried out this announced inspection on 18 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a Care Quality Commission inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Crook Log Dental Practice is in Bexleyheath, in the London Borough of Bexley. It provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Three car parking spaces, including one for patients with disabled badges, are available on the practice’s premises.

The dental team includes six dentists, one of whom is completing their vocational dental training. There are seven dental nurses, four dental hygienists, two receptionists and a trainee practice manager. The practice has four treatment rooms.

The practice is owned by a company, and as a condition of registration must have a person registered with the Care Quality Commission (CQC) as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Crook Log Dental Practice was the principal dentist.

On the day of inspection we collected 36 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the trainee practice manager, three dentists, two dental nurses, and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from 8.45am to 5.45pm every Monday to Friday. Evening appointments are available from 5.45pm to 8pm every other Wednesday and Thursday with the hygienist and dentist, and from 5.45pm to 8pm every Monday with the hygienist only.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had staff recruitment procedures, though improvements could be made in ensuring that appropriate background checks were completed in all cases prior to new staff commencing employment. The practice took action to address this shortly after the inspection.
• The practice had systems to help them manage risk. Improvements could be made in documenting actions taken and learning shared, in response to incidents.

There are areas where the provider could make improvements. They should:

• Review the practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.
• Review the practice’s system for documentation of actions taken and learning shared, in response to incidents, with a view to preventing further occurrences and ensuring that improvements are made as a result.

Crook Log Dental Practice is located in the London Borough of Bexley in south-east London and provides private and NHS dental services.

We carried out an announced comprehensive inspection on 27 January 2015. The inspection took place over one day and was undertaken by a CQC inspector. We reviewed policy documents and dental care records and spoke with patients and staff including the management team.

The practice team included two full-time principal dentists, three part-time associates, three dental hygienists, four dental nurses, three receptionists and one practice manager.

The services provided included routine examination and treatment, dental implants, veneers, crowns and bridges, tooth whitening and oral hygiene.

We received 28 Care Quality Commission (CQC) comment cards completed by patients and spoke with three patients on the day of the visit. Patients we spoke with and those who completed comment cards were positive about the care they received from the practice. They commented that staff were caring and helpful.

Our key findings were:

• Patients’ needs were assessed and care was planned and delivered in line with current guidance such as that from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Staff had received training appropriate to their roles.

• Staff felt well supported and were committed to providing a quality service to their patients.

There were also areas where the provider could make improvements and should:

• Ensure the temperature of the refrigerator used to store medicines and dental products is monitored and recorded daily.

People were provided with clear information about treatment options and the cost of treatments that enabled them to make informed decisions.

People said that dentists listened to them and talked through all the possible treatment options. They told us that staff were polite and that appointments were flexible to meet their needs.