Care home staff need better mandatory training to protect people’s oral health, the Care Quality Commission has warned, after its latest series of inspections found services with no policies or training in place to support this type of care.
The health watchdog also wants to see healthcare professionals, including community nurses, GPs and dentists, to work together to “elevate the importance” of oral health in care homes.
The call comes in a new report, titled Smiling Matters, in which the CQC highlighted that it found that, out of 100 inspections across care homes, 52% had no policy to promote and protect people’s oral health and 47% did not provide any staff training in this area.
“Oral health has a huge impact on our quality of life and we need professionals across a number of sectors to make changes”
In addition, 73% of residents’ care plans reviewed by the CQC were only partly covered or failed to cover oral health at all. Inspectors noted that homes looking after people with dementia were the most likely to have no plan in place.
Meanwhile, 17% of care homes reported they did not assess people’s oral health on admission.
The regulator also found that 10% of care homes stated they had no way of accessing emergency dental treatment for residents, while 34% said they had no or limited access to out-of-hours services.
The CQC said its report revealed that three years on from the publication of National Institute for Health and Care Excellence guidance on oral health care in homes, steps were often not being taken to ensure that residents get the care that they need to ensure they are pain-free and that their dignity is respected.
“The changes needed can only happen with the efforts of all parts of the health and care system coming together”
In the wake of its findings, the CQC has recommended mandatory staff training in oral care, oral health check-ups for all residents upon admission and better signposting to local dental services.
Under the recommendations for staff training, the health watchdog added that local social care commissioners should introduce the need for oral health training, as part of their assessment frameworks, and that all care home staff should be routinely trained in the basics of daily mouth care.
The regulator is also calling for a cross-sector approach to tackle the concerns about oral health raised in the report.
The CQC recommended for the setting up of a multi-agency group tasked with raising awareness among people living in care homes, their families and carers of the importance of day-to-day dental hygiene and the need for routine check-ups.
It wants care home managers to recognise the significance of oral health and the need for professionals, including community nurses, to work together.
Chief inspector for adult social care at the CQC, Kate Terroni, said: “Oral health has a huge impact on our quality of life and we need professionals across a number of sectors to make changes to ensure it is given the priority it needs in care home settings.
“Oral health cannot be treated as an afterthought,” she said. “It can make the difference between someone who is free from pain, enjoys eating and is able to confidently express themselves through talking and smiling – and someone who is in pain, unable to enjoy their food and who covers their mouth with their hand when they smile because of their poor oral hygiene but unable to address it themselves.”
“Care home managers must recognise the significance of oral health – and professionals including GPs, dentists, dental hygienists and community nurses need to work together to elevate the importance of oral health in care homes and to prioritise this as part of their work,” she added.
“The changes needed can only happen with the efforts of all parts of the health and care system coming together, supporting people who use services, their families and carers to be aware of the importance of oral care,” said Ms Terroni.
“By working in partnership, we can make a positive impact on the quality of life of people living in care homes,” she said.
“From the report, it’s shocking that nearly half of care home staff haven’t had any training in oral healthcare”
Director of policy and campaigns at Alzheimer’s Society, Sally Copley, said: “Mouth pain can have a huge impact on people with dementia, and can lead people to stop eating completely.
“Looking after a person with dementia’s oral health is vital, especially in the advanced stages when they might have trouble communicating if something is wrong, or if they are in pain, and where they may have other symptoms that affect their ability to eat or drink,” she said.
Ms Copley said it was great to see the CQC “shining a light” on poor practice in care homes to drive up standards.
“From the report, it’s shocking that nearly half of care home staff haven’t had any training in oral healthcare, and that people affected by dementia are struggling to access dental care they are entitled to,” she added.