New questions to improve oral care in care homes have been added to the Care Quality Commission’s ‘effective’ key line of inspection inquiry.
The new questions are:
1. Do all staff have training in oral health care?
- Is oral health covered in induction?
- Is oral health a mandatory component of regular training?
- Do staff feel confident in supporting oral health care?
- Do staff know what to look for to identify deterioration in oral health?
- Do staff consider poor oral health when assessing reasons behind weight loss, infection, or tissue viability?
2. How do you ensure oral health care is assessed, considered and delivered as a part of a person’s care plan?
- Is the service aware of the NICE Guideline NG48?
- Is oral health assessed fully on entry to the care home in line with this guideline?
- Is there a detailed oral health care plan in place?
- Do people have easy access to toothpaste, toothbrushes, denture cleaning fluid?
- Do people have access to routine and emergency dental care?
Dentist leaders have welcomed the new questions being posed by inspectors but they warn that support and resources are not yet in place to help homes provide dental care to their residents.
NHS dentists across England now anticipate high demand for dental visits to meet the new standards, but are unequipped to assist owing to NHS England’s failure to commission dedicated services for residents. The BDA understands local authority funded oral health promotion teams will also struggle to meet new training needs, owing to sustained cuts to public health budgets.
Before 2006 NHS dentists in England could provide domiciliary care as a matter of routine. Since then reform has left practitioners unable to make visits without a dedicated contract.
Charlotte Waite, England community dental services chair for the British Dental Association, said: “Care homes finally have a responsibility to protect the oral health of their residents. It’s not before time, but staff picking up the phone for help will find they have nowhere to go.”