CQC reveals what care providers need to do to improve oral health in care homes

Dementia Care
March 23, 2023

On Monday the 20th March 2023, the CQC released a report of findings following the 2019 Smiling Matters campaign for care homes.

The Smiling Matters campaign was introduced to gain insight into how care homes were looking after their residents’ oral care needs. A selection of care homes were audited on things such as; if the care home had a policy to promote and protect people’s oral health, were they implementing the NICE Improving Oral Health for Adults in Care Homes framework into practice and did care plans fully cover the residents oral health needs.

The 2023 report reveals the findings of the changes that have been made since 2019 and shows improvements in many areas, but there are still areas that need more attention.

The report found that the following areas were improved:

  • 9% of care home managers were not aware of the NICE guidance in 2022, this compares with 39% in 2019
  • 53% of care home providers now have a policy to promote and protect people’s oral health, compared to 25% in 2019
  • 83% of care home providers said that people had an oral health assessment on admission, compared to 73% in 2019
  • The amount of care plans fully covering oral health needs improved significantly from 27% in 2019, to 60% in 2022
  • The percentage of staff that receive training in oral health has doubled from 30% in 2019 to 60% in 2022

The report also showed that there are areas for improvement:

  • Some care plans only included very basic information such as whether a person had teeth or dentures. People’s oral health needs change, and when their updated oral health needs are not recorded on a regular basis, it can have an impact on their quality of life, including their diet
  • Only 28% of care homes said they had a nominated oral health champion (recommended in the 2019 report). Some care home providers mentioned that staffing issues were preventing them from appointing someone for this role
  • In 2019, 6% of care home providers said that they could not access NHS dental care for the people who use their services. In 2022, this figure has risen to 25%
  • Residents and their families need to know how much their dental treatment will cost, and who is exempt and entitled to free treatment on the NHS

The CQC ask adult social care providers to follow the main learning points:

  1. Assess people’s oral health on admission to the care home. To support you, QCS provides an Oral Health Care Policy and Procedure with an Oral Health Needs Assessment template to use on admission.
  2. Make oral health part of your everyday routine. QCS provides guidance on this in the Oral Health Care Policy and Procedure.
  3. Nominate a staff member to be an oral health champion where possible and give them the appropriate training to cascade their knowledge.
  4. If a person experiences unexpected, significant weight loss, review the health of their mouth as a possible cause.
  5. Provide training in oral health to care staff.

Overall, the report shows lots of positive changes, along with areas for improvement.

Further Information

You can access the full Smiling matters: Oral health in care homes progress report here:

Smiling matters: Oral health in care homes – progress report – Care Quality Commission (cqc.org.uk)

The NICE Improving oral health for adults in care homes can be found here:

Improving oral health for adults in care homes | Quick guides to social care topics | Social care | NICE Communities | About | NICE

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