8. Short Debate: More than just a smile: Are care home residents getting the right dental treatment?

Part of the debate – in the Senedd at 5:55 pm on 7 July 2021.

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Photo of Baroness Mair Eluned Morgan Baroness Mair Eluned Morgan Labour 5:55, 7 July 2021

Now, we know that this has been a very challenging time, and we recognise the impact that COVID-19 has had on individual members of the dental team and on the profession as a whole. As the risks of COVID-19 reduce, more treatments will be able to be provided. Now, we need dental practices to continue to follow strict infection control measures, including social distancing, to protect practice staff, patients and the wider community. Practices are encouraged to see patients using suitable recall periods, determined by their patients' needs and risk.

Now, given the need to shield vulnerable residents in care homes, active face-to-face engagement during the initial phase of the pandemic was paused. The majority of dental care professionals were unable to directly access care home staff and residents for face-to-face contacts at the time, which is what you've noted. However, many local community dental teams remained in contact with the care homes by e-mail and phone call contact. The Care Home Cwtch—a peer support network for care home managers—was set up by Care Home Cymru and PHW to help assist care home managers during and beyond the pandemic. Now, this platform provides the opportunity for Gwên am Byth leads to integrate with care home staff to deliver oral health and hygiene information and skills-building sessions.

Infection control and isolation in care homes is much more difficult than in the controlled clinical environment of a hospital or a dental clinic. People receiving social care often have underlying conditions that make them more at risk of infection and death from COVID-19. Some people require physical help with aspects of daily living, such as eating, washing and mouth care, making complete isolation very difficult for them. Now, this has added further complexity to the provision of the programme during the pandemic.

The need for face-to-face contact in care homes is under regular review, and local teams will be guided by service providers on the level of activity in each care home. Gwên am Byth teams have maintained regular contact with care homes throughout the pandemic, whilst monitoring and managing emergent needs where appropriate. This has ensured an approach that prioritised urgent needs, as well as the wider provision of dental services in Wales. And I'm incredibly grateful to the community dental services across Wales for the efforts they've made to ensure care home residents can access the advice and interventions where appropriate throughout the pandemic.

Now, just as much as the challenges and complexity of providing dental services, I fully recognise the impact that COVID-19 has presented in care homes. And it's highlighted that care homes have different levels of workforce experience or resources to be able to fully engage in the Gwên am Byth programme. It's commendable that many care homes have already fully engaged with the programme and are achieving excellence in mouth care standards. However, our aim prior to the pandemic remains: we expect to see the programme available in and offered to all care homes for older people in Wales.

To address this inequality and widen access to the programme, I've introduced a simplified offer and approach that is intended to facilitate more care homes being able to meet the essential minimum standards and take part. This is called Essential Gwên am Byth. Those homes that are already fully engaged will continue to be supported to sustain excellence in mouth care standards. The simplified approach can be initiated in care homes that have not started the programme or have found it difficult to comply with the current all-Wales approach. By adopting this approach, all care homes across Wales can be included in the programme, and all residents can benefit from the benefits that are being offered through Gwên am Byth. The programme, including the offer of Essential Gwên am Byth, is now resuming.

With the success of the vaccine roll-out, use of digital training and the availability of lateral flow devices, the risk to community dental staff of entering care homes is now greatly reduced. The recovery is well under way, and we have incorporated learning from the pandemic into the programme as we look ahead, including the greater use of digital technology to deliver the training element, which will result in the offer being made to all residential care homes in Wales. As the services continue to recover, I hope that the simplified offer will enable all care homes to be a part of this programme, ensuring that some of our most vulnerable groups have access to the oral health they require. But thank you very much for bringing the attention of the Senedd to this really important matter. Diolch.