Call for dental revolution in care homes

The CQC has published its own analysis of official figures indicating funding is currently supporting access for as little as one in a hundred of those who, due to limited mobility, may require access to domiciliary services.

Based on findings from 100 care homes, the CQC found that 52% did not even have an oral health plan for residents and 47% of staff never receiving training specific to dental care. 73% of care plans only partly covered or did not cover oral health at all, with homes specialising in dementia less likely to do so.

The CQC reports that one of the main challenge in providing access to NHS services was lack of domiciliary care provision. Freedom of Information requests by the BDA suggest levels of commissioning are low and falling, equivalent to providing coverage to under 1.3% of the population whose activity is significantly limited by disability or ill health.

Dentist leaders have backed CQC calls for swift implementation of NICE guidelines among care home providers, and for comprehensive training for staff. The BDA has stressed that appropriate commissioning, underpinned by robust needs assessment is now key to ensure all those most in need of NHS care can receive it, in the right place and at the right time. In light of the CQC findings this would need to cover mainstream, urgent and domiciliary care.

NHS services have been struggling to meet the demand of an ageing population who are keeping their teeth longer, and often have complex medical histories. While some local initiatives such as the innovative Residential Oral Care Sheffield (ROCS) scheme have delivered comprehensive dental coverage for adults in care homes, the BDA has expressed concern over the postcode lottery of provision and the horrific cases that have emerged from the sector [3].

The NHS Long Term plan has committed government to adopt an 'ageing well' model but has offered scant detail on the place of oral health.