The British Society of Gerondontology welcomes the report published on 24th June 2019 by the CQC on the state of oral health in care homes in England. This report comes three years on from the publication of NICE guidance on oral health in care homes and identifies that there are many people in care homes likely to be suffering as a result of poor oral health.
This report identifies two major challenges and themes for individuals in care homes:
1 Carers who support residents with mouth care often have no training and oral health is not seen as a priority
2. There are dental access issues for people who require domiciliary care and urgent dental care out of hours
Dental and social care CQC inspectors visited 100 care homesin England.The key findings and observations included:
• Low awareness of oral health NICE guidelines for care homes released three years ago with nearly 40% of care home managers unaware of the guidance
• Admission assessment packages tended to cover all aspects of personal care but not mouth care.
• 52% of care homes had no policy on oral health
• 73% of care plans did not fully cover oral health
• Almost a half of care home staff have no training in oral health
• Access to dental care can be a problem for many residents; especially those who need domiciliary care or urgent out of hours’ care
Response and Recommendations:
• Oral health training needs to become embedded for all staff in care homes. This will include practical training that helps carers and relevant healthcare workers with patients who may show carer resistant behaviour.
• Dental Care Professionals (DCPs) make strong advocates/leads for oral health in hospitals. This model could be replicated for care homes. For example, dental nurses and other members of the local dental teams can connect with and visit care homes on a regular basis to provide support and maintain consistent training.
• Introduction of a simplified oral health recording tool to compliment NICE guidance.
• Consideration of a multi-professional approach to improve oral health of all residents; to include raising awareness with other health and social care professionals of the importance of good oral health in terms of overall health and dignity
• Consideration for a national programme to raise awareness and provide a platform for training in care homes.
There are funded national programmes in Wales (Gwen am Byth) and Scotland (Caring for Smiles) that are funded, we would like to see funding for a national programme in England
Mili Doshi, President of the British Society of Gerodontology Commented: ‘The report highlights that supporting people with mouth care is not considered an essential part of personal care but an optional extra. It identifies that many care home admission assessments do not include oral health and so it is not seen as a priority. This often results in a rapid deterioration in oral health after admission to a care home which can lead to oral related pain and infection and impacts on overall health including frailty. There is an increasing evidence base of the links between oral health and general health including respiratory infections which have high mortality risk and can often lead to admission to secondary care. Residents are then faced with the problem of accessing appropriate dental care in a timely manner. As the population ages with increasing complexities there will be a greater demand for domiciliary care which is currently under resourced. It is fundamental that oral health training is mandatory for all care home staff and is part of the care certificate. Dental services for people in care homes needs to be commissioned and this should include domiciliary care and maximising the used of all dental care professionals.June 25, 2019 12:44 am