How well are dental health services working for care home residents?

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We have been carrying out engagement with care home residents, their family and friends, and staff across Westminster and Kensington & Chelsea, to find out how well dental care services are working for residents. Our engagement found mixed results. Residents, family, and friends understand that staff have been working incredibly hard during a challenging two years to ensure that residents have access to good quality care. However, we found that many care homes do not have adequate dental health guidelines in place and that residents do not always receive the dental care they need.  

Our full findings will be published in a detailed report later this month.

Background to our dental health engagement

As part of our statutory powers as a local Healthwatch, we regularly carry out ‘enter and view’ visits to health and social care services, to see how well services are working for local people. Before the COVID-19 pandemic, these visits, carried out by a group of Authorised Representatives called Dignity Champions, took place in person. As access to care homes and other health settings has been restricted over the past two years, we have been monitoring services in different ways. Despite these physical challenges, we retained an important role in ensuring positive health and care outcomes for local people.

‘Smiling Matters’, a 2019 report by the Care Quality Commission (CQC), found that people’s dental health rapidly deteriorates once they move into a care home. During the COVID-19 pandemic, we were concerned that care home residents would not be able to properly communicate any concerns about their dental care. We also felt there was a lack of clarity around dental health provision for residents while access to care homes was restricted. We met with Central London Community Healthcare NHS Trust (CLCH), who talked to us about what they were finding in care homes. While we couldn’t physically enter care homes and speak to residents, we found other ways to assess how well dental health services were working.

Our engagement project

To engage with care home residents, their friends and family, and staff, we carried out a survey across care homes in Westminster and Kensington & Chelsea. We wanted to find out how residents were finding accessing dental care, and what the quality of that dental care was. Our survey asked residents what kind of dental care they had received during the pandemic, whether they had any longstanding issues, and if they were happy with the care they received. We asked staff if care homes had dental health policies in place, what arrangements care homes were making to ensure residents received the care they need, and if they, too, had any concerns. We offered all respondents the choice of filling out the survey on paper or online, and we arranged to speak to people via video or the telephone if they wanted additional support.

Our findings in brief

Our engagement revealed a mixed picture. While there was an acceptance that delivering good dental health services to care home residents had been particularly challenging during the pandemic, many residents were not getting the care they needed.

We found that care homes need more home visits from dentists. It can be challenging for many residents to visit a dental practice in person, which is preventing residents from receiving care. This is particularly the case for people receiving end of life care, or those with dementia. We also found that residents did not see a dentist often enough. Many residents told us they only saw a dentist if they have a problem, rather than receiving routine check-ups.

Residents told us that most care home staff are knowledgeable about dental health and support them to maintain good dental hygiene daily. Residents also told us that many staff were doing their best under very difficult circumstances. However, we found that many care homes did not have dental health policies. Even where care homes did have relevant policies, many staff were unaware of them. This is a key issue which needs addressing.

Later this month, we will be publishing our full report. It contains a comprehensive set of recommendations for care home providers and local public health bodies, designed to improve the quality of dental care for residents.