Dental Care for Adults in Nursing and Residential Care Homes

Background: Care Homes provide long- and short-term care for vulnerable adults, particularly older people.

Objectives: To investigate Care Home Managers' views of the provision of care to meet the oral health needs and demands of their residents, across three NHS primary care organisations, and inform future planning.

Methods: Postal questionnaire survey of care home managers across three socially deprived inner-city boroughs of London, followed by telephone interviews of a sample of managers.

Results: A questionnaire response rate of 72% (n=152) was achieved, followed by 11 interviews. The majority of homes (78%) provided residential care, with 22% of homes including nursing services for more vulnerable adults.

Whilst 89% had arrangements in place for routine care, only 18% had arrangements for emergency care. General dental practitioners (41%), followed by community dentists (39%), were most frequently identified as providers of dental check-ups with hospital (44%) and community (36%) dentists providing most emergency care. Homes providing nursing care were significantly more likely to use all types of dental care on site. The majority of managers (89%) reported that current arrangements work 'well' or 'reasonably well'; however, they wanted greater access to emergency care at dental surgeries and within care homes.

Fifty-one percent of homes reported providing an oral assessment for residents on entry. Forty percent had staff trained in oral care. ‘Oral assessment' and ‘staff training' were significantly more frequent in homes providing nursing than residential care (p=0.0001; p=0.002 respectively). Most managers (87%) would welcome training for their staff.

Conclusions: Current arrangements for access to a range of providers should be maintained and pathways to appropriate care developed. Action is required to ensure an oral assessment is provided for entrants to care homes and staff receive training in oral care.

Acknowledgements: this research was funded by Lambeth, Southwark and Lewisham NHS Primary Care Trusts.