Oral Health Care Training

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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

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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

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Why develop the Training Toolkit ?
Many of us have been in to a residential care
home and given The Talk
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)
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• 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

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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).

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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

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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

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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

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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

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Oral Health Care Toolkit
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• The Toolkit contains
• Introduction
• Assistance for meeting CQC outcomes
• Staffs role in supporting residents
• Introduction to oral health assessments and care
  plans
• Communication tips
• Routine and planning
• Oral care products
• Referral guide
• Resources

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

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• 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

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Brushing someone elses teeth with a manual tooth
brush. Task Break Down.
1. Gather items for tooth brushing.
2. Squeeze a pea sized blob of toothpaste on to the toothbrush.
3. Ask the resident to relax their lips and cheeks.
4. Work from the front of the mouth to the back.
5. Concentrate your brushing on one or two teeth at a time.
6. Position the bristles of the toothbrush on the part of the tooth where the gums and teeth meet and brush using a gentle, methodical approach.
7. Brush all surfaces of each tooth systematically.
8. Be aware of any loose teeth and brush with care.
9. Dont avoid brushing if you notice bleeding gently massage the gums with the bristles of the brush using circular motions.
10. If the resident wishes to spit after brushing, let them do so. It is not necessary for the resident to rinse. The resident can drink a glass of water if it is safe to do so.
11. If it is through the day replace any partial dentures and pat dry the lips
12. If it is the evening store dentures safely in a denture pot with water.
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• The Training
• Oral health assessments and
• care plans

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• The Training
• Oral health assessments and
• care plans

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• 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

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• 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

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Further resources

• British Society of Gerodontology
• training resources for carers
• http//www.gerodontology.com/BSG-OH-RESOURCE-July2
  6-2012.pdf
• Jeni Malpass
• jennifer.malpass_at_solent.nhs.uk
• Sarah Peckham
• sarah.peckham_at_solent.nhs.uk

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Thank you for listening. Any questions?