Sarah Peckham – OHP Co-ordinator Jeni Malpass – Oral Health Educator

1. Oral Health Care Training & ToolkitManaging oral care for the frail and elderly in residential homes Sarah Peckham – OHP Co-ordinator Jeni Malpass – Oral Health Educator Solent NHS Trust Dental Service

2. Solent NHS Trust Dental Services • Domiciliary Care • Dental Screening for elderly residents • Oral Health Promotion Input to Staff • Assist care homes with OH Care Plans

3. Many of us have been in to a residential care home and given “The Talk” Why develop the Training & Toolkit ? Disadvantages Difficult to measure outcomes Practically impossible to evaluate Improvements in carers’ oral health but not necessarily for residents Advantages Raises awareness of oral diseases/conditions Motivates the care home staff (if only for a short while)

4. What the “new approach” aims to achieve: • Carers able to: • Demonstrate the use of an oral health assessment tool • Use the tool to identify the individual needs of residents • Develop and document individual oral health care plans • Demonstrate that they can provide the appropriate oral care • for clients requiring assistance/support • Provide evidence to meet CQC Outcomes

5. Care Quality Commission Health & Social care Act 2008 (Regulated Activities) defines personal care as: • Physical assistance given to a person in connection with……(v) oral care. • The prompting, together with supervision, of a person, in relation to the performance of any of the activities listed in paragraph (a).

6. What we can do for them – meeting outcomes: Outcome 2: Consent to care and treatment • Each resident, or an appropriate person acting on their behalf, has to give valid consent for the dental screening • The care home can provide evidence of this to help meet this outcome • If any dental treatment was required after the screening, valid consent would be sought again, providing the care home with another opportunity to collate evidence

7. What we can do for them – meeting outcomes: Outcome 4: Care and welfare of people who use the service • Staff are trained to devise individualised Oral Health Care Plans for their residents • This provides evidence for the CQC that residents’ individual needs and abilities have been taken into account • Oral Health Care Plans are based on published research evidence

8. What we can do for them – meeting outcomes: Outcome 14: Supporting workers • Staff who complete the Oral Health Care Training are given a certificate • This enable care homes to provide the CQC with evidence that staff have skills relevant to the task • Provides evidence that carers are keeping skills up to date in order to continue to carry out their role effectively

9. What we can do for them – meeting outcomes: Outcome 6: Co-operating with other providers • Supporting residents to access other health and social care services - allowing dental staff into the care home and facilitating care at local clinics when appropriate • The care home can provide evidence that any information that needs to be shared (e.g. medical history and DOB) is done so in a confidential manner

10. Oral Health Care Toolkit

11. The Toolkit contains: • Introduction • Assistance for meeting CQC outcomes • Staff’s role in supporting residents • Introduction to oral health assessments and care plans • Communication tips • Routine and planning • Oral care products • Referral guide • Resources

12. The Training : • Background knowledge to dental diseases • Choosing appropriate oral health care products

13. The Training : • Hands-on tooth brushing competencies - step-by-step task breakdowns for: • Brushing with a manual tooth brush • Brushing with a powered tooth brush • Denture care

14. Brushing someone else’s teeth with a manual tooth brush. Task Break Down.

15. The Training : • Oral health assessments and • care plans

16. The Training : • Oral health assessments and • care plans

17. The Training : • Routine and timing: • Ideally oral care should be carried out at bedtime and one other time but • Realistically – often carried out in morning only • May be due to lack of staff, lack of time • Maintaining consistent daily oral hygiene helps with residents’ co-operation • Communication between carer and resident should: • Be at a level of understanding appropriate to the resident • Be delivered in a calm and relaxed manner

19. Southampton University “Healthy Conversations” • a framework for behaviour change brief interventions • techniques to allow people to find solutions to problems • uses open “discovery” questions • “How” • “What”

20. Further resources • British Society of Gerodontology • training resources for carers: • http://www.gerodontology.com/BSG-OH-RESOURCE-July26-2012.pdf • Jeni Malpass • jennifer.malpass@solent.nhs.uk • Sarah Peckham • sarah.peckham@solent.nhs.uk

21. Thank you for listening. Any questions?