Calls to improve oral health care of people living in residential homes

Nearly half of care homes do not train staff on looking after residents' oral health needs, according to the national body that inspects NHS and social care services.
Black elderly woman ina nursing home being spoken to by a nurse

People in care homes are missing out on oral health care that is needed to keep them pain-free and respect their dignity, according to the Care Quality Commission.

The findings come five months after Healthwatch Reading revealed that only 21% of people we spoke to in care homes said they could access an NHS dentist when they needed to. 

The CQC’s review, published on 24 June 2019, says that three years on from the publication of national guidance on oral health in care homes, steps are often not being taken to ensure that people get the oral health care they need.

The CQC's review found:

  • The majority (52%) of care homes visited had no policy to promote and protect people’s oral health
  • Nearly half (47%) of care homes were not providing any staff training to support people’s daily oral healthcare.
  • 73% of residents’ care plans only partly covered or did not cover oral health at all – homes looking after people with dementia being the most likely to have no plan in place
  • 17% of care homes said they did not assess people’s oral health on admission.
Oral health cannot be treated as an afterthought. 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.
— Kate Terroni, Chief Inspector for Adult Social Care at the Care Quality Commission

The CQC has recommended mandatory staff training in oral care, oral health check-ups for all residents upon admission, better signposting to local dental services and the convening 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.

The CQC said whilst two-thirds (67%) of the care homes said residents could always, or nearly always, access NHS dental care, the review revealed a lack of dentists who were able or willing to visit care homes. Other challenges people faced involved local dentists not accepting new patients and the length of time it took to get an appointment with an NHS dentist – even for a procedure such as getting dentures fitted.

Of the homes visited, 10% reported they had no way of accessing emergency dental treatment for people, 34% of homes said they had no or limited access to out-of-hours services. Some care home managers stated that they had to call GPs, NHS 111, or even take the person requiring emergency care to A&E.

Charlotte Waite, from the British Dental Association, added that the report "shines a light on services that are failing some of the most vulnerable in our society. There are residents left unable to eat, drink and communicate, as an overstretched NHS struggles to provide the care they need."

Find out more

Share your thoughts

You can help make health and care services better by sharing your experiences and ideas.

Talk to us