CQC Parallel Universe for Oral Health in Care Homes
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- Published: Tuesday, 28 March 2023 07:44
- Written by Peter Ingle
- Hits: 1313
GDPUK readers opinion of the CQC may be influenced by their own interactions with the organisation. Those who have had reasonable inspection experiences and received a fair report may be mystified to see the not infrequent criticism of the CQC.
Some of this may be specific and even reflect discomfort in the face of justified criticism, but some may be more fundamental. A selection of headlines, remarkably based upon the same report, suggest that the CQC remains seriously out of touch when it comes to dentistry.
First the CQCs view. In a feature published on their website headlined: “CQC finds improvement to oral health in care homes” the Commission reported on their recent follow up to their first review of this in 2019. At that time the CQC found that: “steps were often not being taken to ensure that people get the oral health care they need to ensure that they are pain-free and their dignity is respected.”
Now, the CQC was “pleased to find that improvements were being made.” These included care homes being more aware of the NICE oral health guidelines. This they reported, had risen from 61% to 91%. Double the number of care plans covered oral health needs compared to 2019. Also doubling was the number of care home providers saying that “staff always (or mostly always) receive specific training in oral health.” The report did go on to say that inspectors were concerned that residents were still missing out on care from dental practitioners and that care home providers highlighted that there were not enough dentists “able or willing” to visit care homes.
Recommendations included, care home providers raising awareness of what people should expect when they enter a care home, including getting an oral health assessment on admission, how much treatment should cost and NHS exemptions, and that commissioners promote cross sector integration between homes and dental professionals, and use funding to improve care in homes.
Those wishing to follow the CQC advice and raise their awareness of what people should expect when they enter a care home were not short of material. The same day the BDA provided its view, in a story headed, “England: Ministers have a moral duty to act on access crisis in care homes.” Despite the very different headline the BDA quoted the CQC report, however the figures that they found painted a very different picture to the CQC one of “improvement.”
Provider’s feedback had shown that since 2019 the proportion of residents never accessing NHS dental care routinely, had gone from 6% to 25%. Those stating that the residents were always or mostly able to access care fell from 67% to 35%. The BDA also noted that the access gap for care home residents was worse than that for the general population. They went on to point out that only 5% of English NHS dental contracts included domiciliary care in 2021/22.
Meanwhile in The Mail their headline spoke of leaving thousands of care home residents “in excruciating pain and unable to eat.” The CQCs own report had referred to residents suffering with, “badly fitted dentures, no access to a toothbrush or are ignored when they ask for a soft food diet,” according to the paper.
LocalGov, a dedicated local government news website led with, “Care home residents struggle to access NHS dental care” and that the proportion of care home providers saying that people who use their services could ’never’ access NHS dental care had increased fourfold. This was also taken from the CQC report.
On twitter, Simon Wheeler, Senior Knowledge Officer for the Alzheimer’s Society tweeted: 25% of care homes now reporting that they NEVER have access to community dental care. Email this morning: dental abscess being treated by GP with ABs but no chance of accessing NHS community dentist so they’re not even trying. Food changed to mush instead.
25% of care homes now reporting that they NEVER have access to community dental care.
— Simon Wheeler (@WheelerSimon) March 20, 2023
Email this morning: dental abscess being treated by GP with ABs but no chance of accessing NHS Community Dentist so they’re not even trying. Food changed to mush instead.https://t.co/7NKuLCm4iP
The BDA, Mail and LocalGov mentioned the reported improvements in training, and awareness of guidelines, but were able to recognise that this was not the main story. It was one of care home residents suffering from a lack of actual dental care and its consequences, rather than staff not being able to complete care plans to show visiting CQC inspectors. That the CQC regard an increase in measureable compliance as trumping residents actual dignity and nutrition, says more about the state of the CQC than oral health in care homes.
CQC finds improvements to oral health in care homes - Care Quality Commission
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