Getting focused and committing time: promoting mouth care for people living in a care home

Mouth care is central to good general health throughout the life-course but particularly as we grow older. When oral health is poor, problems with nutrition, pneumonia and mortality are more likely. A person with poor oral health may experience embarrassment, reduced self-esteem and as a result impacts on their ability to communicate and socialise.
In care homes, oral health has increasingly become a focus for practice guidance. For example, the Care Quality Commission has undertaken a mapping of existing problems related to supporting residents with their mouth care and has provided recommendations. Mouth care is also a focus of research; with many studies suggesting ways to provide better oral care in this care setting. Despite a wealth of recommendations and suggestions, mouth care remains an ongoing concern.
Our work seeks to address the gap between guidance, research and practice. The COMMIT study (Caring Optimally: promoting effective Mouth MInuTes in care homes) originated from a conversation with care home staff who asked how they could help residents with their mouth care. The study has been summarised https://enrich.nihr.ac.uk/blogpost/new-care-home-study-caring-optimally-promoting-effective-mouth-minutes-the-commit-study/ .

What helps staff to support residents with oral care

In the COMMIT study, we are bringing together evidence from previous research studies to provide an overview of what helps staff to support care home residents with mouth care. We are also identifying potential barriers, or what might get in the way of supporting mouth care.
Our work has been systematic and provides one of the most comprehensive summaries of this literature. It has enabled us to develop a list of what care home staff have said either helps or hinders them to support residents with mouth care. There are 3 key areas of interest: (1) what a staff member can do to support mouth care for residents;(2) their motivation to provide this care; and (3) environmental influences that support (or not) the resident or staff. Suggesting solutions that are acceptable for people living and working in care homes are likely to require recommendations at different levels:

• Individual level, such as using a specific toothpaste type;
• Organisational level, such as collaborative working between care home and dental professionals;
• Political level, such as addressing oral health inequalities.

We are now at a stage where we are ready to share what we have learnt with care home staff, residents, and their family and friends to discuss the meaning and relevance of these findings for everyday experiences of care. Would you like to hear about what we have found and help us?

Ensuring our work is useful for people living and working in care homes

We are keen to ensure that our work has maximum impact for people living and working in care homes and so we invite you to get in touch if you would like to join one of our discussion groups to hear more about what we have found, tell us what this means for you and/ or your experiences, and what you think might be missing from our work that would benefit people living in care homes.
The discussions will be taking place October to December 2022 (online or in-person depending on your location/preference). Please get in touch with m.jordao@leeds.ac.uk if you are potentially interested in supporting us with this work.

Other COMMIT Study team members include:
Karen Spilsbury, Professor of Nursing at the School of Healthcare, Faculty of Medicine & Health, University of Leeds. Tweets @SpillersK
Gail Douglas, Professor of Dental Public Health at the School of Dentistry, Faculty of Medicine & Health, University of Leeds
Reena Devi, Senior Research Fellow, School of Healthcare, University of Leeds Tweets @_DrReenaDevi
Magda Duzniak, Clinical Lead Nurse, Pennington Court, Westward Care, Leeds
Sakina Edwebi, Research Fellow, School of Dentistry, University of Leeds
Edna Feenan, a member of the public with personal experience of care homes
Alys Griffiths, Lecturer, Institute of Population Health, University of Liverpool Tweets @alysgriffiths_
Natalie King, information specialist at the Leeds Institute of Health Sciences, University of Leeds
Karen Vinall-Collier, Lecturer in Dental Public Health, School of Dentistry, University of Leeds Tweets @KarenVinallColl
Paul Wilson, Senior Lecturer Implementation Sciences, Alliance Manchester Business School, The University of Manchester Tweets @pmw777
Karen Winterburn, a member of the public with personal experience of care homes
Judy Wright, Senior information specialist at the Leeds Institute of Health Sciences, University of Leeds. Tweets @jmwleeds

Disclaimer
This study is funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR131506). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.