Smiling Matters: Oral Health Care in Care Homes

In June 2019 the Care Quality Commission (CQC) published their review report, ‘Smiling Matters: Oral health care in care homes.’
The National Institute for Health and Care Excellence (NICE) had produced guidelines (NG48) recognising the importance of good oral care for adults in care homes. The aim is to maintain and improve oral health and ensure timely access to dental treatment.
The NICE guidelines include recommendations for care home managers, staff and people who use services and their carers, focusing on:

• Care home policies on oral health and providing people with support to access dental services
• Oral health assessment and mouth care plans
• Daily mouth care
• Care staff knowledge and skills

CQC, during their discussions at the Regulation of Dental Services Programme Board and with other stakeholders across adult social care and primary care, highlighted that awareness and take-up of the NICE guidelines were still low.

CQCs review included dental inspectors attending 100 routine planned inspections of care homes alongside inspectors from their adult social care team. They spoke with managers and senior staff members as well as people who use services, and their relatives, to find out about their experiences of care.
Smiling Matters is a report of what was found in those homes, conclusions and recommendations for action.

In Apple House care homes, we have used the report to raise awareness of the importance of clear guidance within our own homes to ensure that access to regular dental check ups, care plan guidance and daily mouth care is and continues to be an important part of a person’s person-centred support. We have found that staff training is crucial and this goes hand in hand with the understanding of creative support plans which reduce barriers to people receiving oral healthcare. An area of action will be to include how people find this experience within our annual service user survey to gain the views of the people we support. An area of excellence was found to be specialised training received by members of staff which has been rolled out to the teams. The report has been discussed and communicated throughout the organisation at senior, team and service user meetings.
One of the recommendations from the CQC report is:
That NHS England and local commissioners:

• Work with the care home sector to avoid lengthy waiting times for appointments and treatment and provide emergency appointment times. 

• Work with GP practices and other primary care contractors, such as community pharmacists, to establish local arrangements to signpost people to dental provision. 

• Provide adequate capacity to provide routine and emergency treatment to people in care homes. This should be linked to a clear, measurable outcome around avoidance of GP appointments and A&E attendances resulting from dental crises.

You can read the full CQC report ‘Smiling Matters: Oral health care in care homes’ here.

Romaine Lawson, Director of Operations, Apple House care home group.