Action Note
Oral Health Improvement MCN Operational Group Meeting
Thursday 15th January 2015
Meeting Room 2, Summerfield House
12.00pm – 2.00pm
Present: Karen Tosh (Chair), Carole-Ann Duff, Shirley Beattie, Brian Dawson, Elaine Gray, Diane Milne,
Ann Ovall, Rosemary Hutcheson, Kim Penman, Bruce Archibald (VC) and Indyia Bradley (Minute Taker)
Item
1.
Subject
Welcome, Introductions and Apologies
Action
Apologies received from Linda Chessor, Carol Craig, Angus Henderson, Jackie Park,
Barbara Smith, Jane Smith & Diane Trigger.
2.
Action Note of Last Meeting
The Action Note from the meeting held on 3rd September 2014 was approved by
the group.
3.
Caring for Smiles – Updates
Training
NES launched the accredited training version of Caring for Smiles. This training is
based on the training currently being delivered throughout Grampian, but with
slight amendments and learning outcomes against it (SCQF Accreditation – 2 x
Levels; Foundation and Intermediate). NES will be administering the accreditation
but each HB will be responsible for recruiting people to attend, administration
linked to it (relaying information to delegates etc), room bookings, delivery of
training, monitoring and evaluating DOPs etc. Those wishing to take part would
attend the training course, they then have to go away and do a series of direct
observations (very similar to Childsmile – practice what they’ve learnt) – 10 of these
are required with the final practical observation being observed by the Tutor who
delivered the initial training. This must be completed within 10 weeks of the initial
training course date and once completed it is sent off to NES for accreditation. All
resources are hosted on the Knowledge Network – presentation, paperwork,
certificates etc. These are currently in the process of being updated – due to the
quality – there will be no changes to the learning outcomes. The visual side &
grammar will be changed to ensure it looks and comes across more professional.
This will not be a compulsory course, but it was felt that the majority of care
assistants are working towards qualifications so it was felt that this would be an
additional bonus and beneficial to them. The course will need to be staggered &
time managed to ensure that there is not too much pressure put on the Tutor who
will be delivering the course and carrying out the final assessments. Care Homes
need to be made aware that this will be available to them & their staff.
Team Leads will be meeting on 4th February and will be spending the day going
through the documentation. Consistency will be required – particularly regarding
the DOPs and to help with this a list of observations has been provided so will need
to ensure that all CHP areas are referring to the same list. Discussions will be
needed with all dental teams to ensure all teams are doing it the same way. Sharing
the information throughout Grampian will also be discussed at this meeting.
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Discussions surrounding launching this training to the Care Homes – managers
attend a workshop in June – but unfortunately the format has been changed this
year so a presentation is not possible at this moment however we have been offered
a stand to talk to people on a 1 to 1 basis, hand out flyers etc. The programme for
this event will be finalised end of January / February. Looking to roll out training by
the end of June / Start of July – NES must be made aware when dates begin to get
booked for this training.
Lanarkshire was used as a pilot – they were unsure of how popular / successful this
would be – however it has now been delivered in 30 care homes with a variety of
staff. Beneficial to ensure the care homes Oral Health Champion and Manager to
carry out this training in the first instance, this could then be built upon.
Discussions surrounding promoting this in colleges – so whilst care assistants are
undertaking their training they could also take part in this additional training. The
college asked for the pack to be sent to them & they would deliver it however this is
not able to happen – NES want us to keep control and for someone with an oral
health background to deliver the training.
It was felt that it would be beneficial to keep to smaller numbers in the first instance
to help meet deadlines and improve delivery.
KT & Team
Leads
Discussions surrounding advertising / college etc. at Feb Meeting – feedback at
the next OHI MCN Meeting.
Leaflets
2 x Other resources are still to be released by Health Scotland– Advice Leaflet for
Relatives & a Guide to Dental services, Treatments, charges and exemptions for Care
Home Residents – resources to help support the Care Homes.
Training DVD
Previously looked at a Training DVD for staff who may be unable to attend training
or to be used as a refresher for staff. Spoke to Sheila Welsh (National Older
Persons Coordinator) and NES have agreed to fund a Training DVD – unsure of
release date.
4.
Caring for Smiles Award Scheme
Caring for Smiles system is currently in care homes – however it was found that
some were more proactive than others. Karen has circulated the Awards booklet
for Tayside and it was felt that it would be more beneficial to amend it to be more
suitable for Grampian. Linking up with care homes to promote the Award Scheme.
There are still a few questions surrounding the wording for some parts of the
documents;
Title Page
Currently ‘NHS Grampian Oral Health Award’ – the other option would be to link it
to Caring for Smiles even more by calling it ‘NHS Grampian Caring for Smiles
Award’. Unsure if this would be authorised on a National prospective. It was felt
that by having a different name to Caring for Smiles that this may cause confusion
within organisations / establishments and to keep it more streamline it would be
beneficial to link up the names.
Award Criteria (page 4)
No. 2. Initially stated 1 week to complete a Risk Assessment but this has been
changed to 48hours to be in line with Caring for Smiles Guide.
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No. 5. 24 months to be changed to 12 months or as deemed appropriate by the
dentist.
No. 6. Number of residents to be examined to be removed from care home copy
but included in staff version for guidance.
Karen to Update.
KT
Support from the Caring for Smiles Team
It was felt that if we were to go with calling the award ‘Caring for Smiles’ it would be
beneficial to refer to the teams involved as ‘Caring for Smiles Teams’.
No. 1. Needs changed to ‘A named Dentist and Oral Health Promoter allocated to
each care home’.
No. 2. ‘Assistance in accessing dental services, appointments and patient transport
if appropriate’ – this is to be left as it is.
No. 4. Needs changed to ‘Dental screening by a dentist every 12 months
Karen to double check with Angus in regards to this & update document.
KT
Access to Dental Services
Adults in care homes are treated as a priority group by NHS Grampian Community
Dental Department –to be changed to ‘NHS Grampian Public Dental Service’
Also remove the list of Dental Services and just input DIAL details.
Karen to update.
KT
Care Home Oral Health Policy
No. 1. 24 months to be changed to 12 months.
No. 2. 1450ppm to remain the same.
Karen to Update.
KT
Grampian Oral Health Award Process
4. Unannounced Assessment – some questions surrounding the legality surrounding
this in regards to consent from families / residents etc.
Karen to check with Tayside.
KT
Initial Assessment
Currently states 10 residents will be selected at random – questions surrounding
whether this would be feasible during 1 visit – remove number from care home
version but keep the staff version stating ideally 10 residents’ dependant on
circumstances on the day.
Karen to update.
KT
Caring for Smiles Team Members
Title to be renamed to include ‘may be involved’. List is to include Nurse and Oral
Health Team Leaders.
Karen to Update
KT
Once this document has been completed, it will be need copies printed and also
discussions will be needed surrounding how to advertise to care homes.
Staff awareness will need to take place also – will require dental health support
workers to be in place (currently recruiting).
It was discussed whether it would be beneficial to select care homes who are pro-
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active to be pilots for the award. Perhaps 2 x care homes in each area – if successful
expand on this and ensure good publicity follows.
A staff explanation will need to be created to ensure all staff are aware of the
process and on board – all staff / teams are to be made aware of this award.
If staff are currently undertaking training they are to be offered the option to
undertake accredited training also.
Assessment to be carried out with care homes already implemented Caring for
Smiles– if already at a standard ensure all paperwork is in place and offer them the
chance to just undertake the assessment – save repetition with training.
Karen to circulate a staff explanation to Team Leads who in turn will circulate
to all teams.
5.
KT / All
Karen to draft an up-to-date version of the award & a staff version to circulate
to Team Leads who in turn will share with teams for feedback – feedback to be
sent to Karen.
KT
Award to be added to each CHP area agendas.
All
Assessment of current care homes to be carried out.
All
CHP Staffing
City
Advertising next week for Dental Support Workers
Shire
Opting for mixture of Oral Health Support Workers and Dental Nurses – risk
identified earlier in 2014 that some Dental Nurses may have needed redeployment. Currently trying to see if there is oral health support work that these
Dental Nurses can undertake instead of re-deployment, if this was to take place
then advertisement for other positions could take place. 2 x additional positions in
the process of being advertised – discussion whether they focus on Childsmile or
Caring for Smiles – ultimately would like them to focus on both aspects. Was felt
that this would depend on where they are established – Skill Sets (elderly / young
people). It was felt that this could be managed within teams, with flexibility within
workforce.
Training requirements would be linked to the recruitment of people and their
requirements. It was felt that everyone should be trying to do the same.
Health Support Workers in City will be undertaking Childsmile training.
6.
Screening Paperwork
400+ patients have now been screened on the new document. Currently available
on the shared drive. Dentists use this as a screening form to help measure levels of
oral health, identify residents in a care home e.g. also gives them a chance to
register / etc.
Currently requiring web support which would enable the form to be updated live
electronically as currently done on paper and then info uploaded to excel
spreadsheet. This would eliminate repetitive work – can complete the form whilst
with the patient and it automatically updates the database to show this information
– rather than completing a form in the care home and then having to input the
information on your return to the office.
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The form is very straightforward with drop down boxes / tick boxes etc.
Able to carry out quick searches through this database – search by care homes /
individuals / dentures etc. with the data being linked to the patient.
Accessible system – all dentists in Aberdeenshire will be able to access this system.
Currently just being trialled – filling out the forms and manually entering the data
on to the system – now it has been shown to work it is in the process of being rolled
out. Training exercise is available.
Discussions surrounding whether it would be beneficial to work offline and then
merge the information on return to the information – ongoing issues surrounding
NHS IT firewalls.
IT Support is currently being undertaken by Optometry IT – who helped finalise this
current version. Discussions surrounding whether it would be beneficial to take this
to an external IT department to help speed up the process. Development will be
ongoing this year. Access to iPads / tablets will be required to help with this –
funding issues. Perhaps one / two for each area not necessarily needing each
dentist to have their own. All information will be password protected due the
sensitive nature of the information.
Currently need to have access to NHSG LIVE to be able to update the system.
Push IT to get system LIVE.
Brian to discuss tablet requirements with Karen.
7.
BD
BD & KT
Teeth TLC Website
All information regarding Caring for Smiles, Teeth TLC, Childsmile etc. are up on the
website – currently in the process of moving this website to an external host this is
due to ongoing issues with its current base. It was felt that by transferring to this
external site we would receive a better service – will be able to do updates
themselves and these will be online within 24hours. They will be able to upload
videos etc. which will make it a more streamline service.
Videos
Scripts are currently ongoing for the videos – Medical Illustrations helping in March
2015. Currently waiting on photographs (unable to gain access at present) Karen
has been in touch with Claudia Cunningham – she has agreed to come back to
Karen next week in regards to the consent issues.
These videos can be used in training, TLC website; presentations etc. help to
demonstrate some of the basics that are asked on a regular basis for example ‘how
do I brush other people’s teeth’ etc. These will be short videos 4th February – to find
the right balance for the videos and to finalise the scripts.
Karen to update the group once website is up and running.
8.
KT
Registration
This was chosen as one of three priorities at previous meetings – registration
campaign has taken place (advertising availability and how to access etc.) currently
looking at stage 2 which is a more targeted approach to the areas that have a low
registration rate. Karen is having an ongoing discussion with Jonathan, who is the
new Consultant for Public Health, in regards to research around this – to ensure
feedback is received.
Campaign results received showed results – additional 20+ calls received through
DIAL and over 3000 people accessed the website for further information but not
sure if followed up any further.
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Biggest unknown area is those patients who are registered privately – unable to
gain access to the actual numbers.
9.
Homeless – Smile 4 Life
Training Package that has been discussed previously – has different elements ––
discussions ongoing between Karen and Eleanor Bull surrounding this.
CPD event taking place at the end of February – one in Dundee and one in Glasgow
– Team Leads and Karen to attend this event to see if there have been any further
developments. This training is to be delivered to those who work with homeless
people.
3 Elements;
- Basic (access to dentists / toothbrushes etc)
- Supporting
- Ready to make changes – motivational interviewing etc.
Following the event in February will re-evaluate the use of this training
package– feedback within the group.
10.
KT & All
National Group
We currently have National Groups who look at oral health for prisoners, homeless
and older people – current ongoing discussions surrounding a potential new group
being created that will look at Adults with additional care needs - have been asked
to nominate a person to attend any future meetings and provide feedback to the
group - Iain Bovaird will attend on our behalf. Consultant who is currently leading
on this potential new group has informed Karen that additional people can be
copied in to minutes from meetings. Work is currently ongoing with this group.
Karen to update when further information is available.
11.
KT
AOCB
Action Plan
The group have been together 2 years – an action plan was put in place and due to
the amount of work that was going to be involved it was beneficial to choose 3
priorities, these were; Increasing registrations, Caring 4 Smiles and Special Needs.
First 2 have had the most work input. Discussions surrounding whether the action
plan should be updated to pin point other priorities to action.
KT to update this to ensure we have feedback in place in regards to assessments.
Karen to re-look at the action plan over the next month or so.
KT
Bariatric Chair
Rosemary informed the group that a Bariatric Chair has been put in Frederick Street
– communications have been issued to all dentists in Grampian & also through
newsletters – with only a small number of referrals received so far. It was felt that
promotion was required.
Karen and Carole-Ann are currently in the process of creating a mail out for dentists
/ pharmacy / GP surgeries etc. detailing all the resources that they have available –
was discussed that it may be beneficial for Rosemary to have a slot in this to send
out to a wider audience.
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Will also be receiving a portable hoist – which has been funded by the Disability
Group – this will be based in Argyll Dental Practice. This will be available to Dentists
/ GDens / Students etc. Training will be provided.
There are currently ceiling hoists in place at Frederick Street & Marcus Street.
Rosemary to email wording for document to Karen.
Karen / Carole-Ann to input wording in to document.
RH
KT / CAD
Pamphlet
There is currently a pamphlet being produced via the Government ‘A guide to
dental services, treatment charges & exemptions for care home residents’ this is due
to be released imminently.
Karen is due to be informed once this has been released and she will inform the
group once this happens.
Karen to inform group.
KT
Integrated Learning
There is currently an opportunity within the City & Shire – via Sharon Southern –
they allocate a care home that has a training home (not directly involved with the
care home) and you can have a 30 minute slot where you can choose what you
show (denture care etc.) – there are 25 places on each course.
Unsure of the uptake at the moment – but this will become a regular thing with
dates currently in place up to June 2015.
Elaine to forward initial email to Karen.
Karen to speak to Liz Towsley in regards to this.
13.
EG
KT
Date of next meeting
To be confirmed – will be approximately every 3 months.
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