Untitled Flashcards Set

• GDC standards

• Raise concerns

• Sharing information

  • Multidisciplinary/multi-agency approach

• Escalating concerns

• Oral health promotion

• Every contact counts

  • May be only regular health professional contact

Local support → you should have an understanding of the process in your local region.

In your practice

• Safeguarding policy

• made aware of this at induction

• Named safeguarding lead

• Regular safeguarding training

• Whole tema

• Level 2(minimum 3 hours) [Level 3 if specialising in Paeds]

• Three yearly update

On clinic

• A patient presents with concern

• Inform tutotr of your concerns in an appropriate way

  • The tutor will support/lead the following BEFORE THE PATIENT LEAVES:

• Documentation

  • Documentation of facts in a contemporaneous way

  • If disclosure, then important that patients own words used where possible

• Raise concern with safeguarding team - ICE and telephone call

• Completion of datix

• Logbook for safeguarding incidents

• Debrief

Making disclosures/sharing ideas

• Assessment of capacity

  • If patient lacks capacity, appropriate level of information can ba shared with others, if it is in the patients best interests (in line with the MCA 2005)

  • If the patient has capacity, where possible their wishes should be respected

  • Exception include legal issues (e.g. court orders) or public interest (e.g. matter of safety)

• The proportionality principle - information shared should be proportional to situation and your response proportional to risk

• Can be a challenging conversation

• Do you always inform the patient/carer/family?

Assessing the patient

history:

• details from the child and carer of any injury or presenting complaint

• Past dental history

• medical history

• family and social circumstances

Features of concern would include:

• a delay in the presentation (e.g. previous trauma not addressed)

• Discrepancies between the history and examination findings

• Developmentally inappropriate findings (does not fit with the age of the child)

• Previous concerns about the child or sibling

Examination

• Any dental, oral of facial injuries, their site, extent and any specific patterns

• The general appearance of the child, their state of hygiene, whether they appear to be growing well or are failing to thrive

• Their demeanour and interaction with their parents or carers and others (e.g. look for signs of ‘frozen watchfulness’ - where the child seems to take in everything going on, but in a detached, wary or fearful manner.

Managing dental neglect

• Recognise and record concerns - clear case notes and maintain clinical correspondence

• record dental history

• Record UTA/WNB/FTA

• Raise concerns with parents, don't blame, offer support, set targets, keep records, monitor progression

• Preventative multi-agency response 0 liase with other professionals

• Discuss with senior colleague/names professionals

• Inform GMP and other relevant professionals

• Assess whether there are signs of general/ wilful neglect/ risk of significant harm and refer to social services if so/ the situation is deteriorating

Escalating concerns

• important that patients are provided with safe and effective car within your practice

• There should be robust measures in place to ensure your environment is safe e.g. Ensuring waters are run through, cleaning schedule, dating of instruments, electric equipment checked annually and documented.

• There are external agencies who are involved in regulation

• Documentation of concerns

• Follow local policy for raising concerns

  • This should be discussed at induction

  • Actions that will be taken

  • Timeframe

• Escalating concerns

  • Local area team

  • CQC

  • GDC

Case

Case RED FLAGS

• Poor OH despite OHI/NSPT has been given/completed

• New carious lesions

• Unkempt appearance Inappropriate clothing

• Uncomfortable relationship with carers

• Disclosure by patient

What to do?

• Complete treatment planned (if patient happy/able)

• Ask the patient is she feels able to return to the home Contact her NoK (with the patients consent) and others involved in her care

• Alert safeguarding team at LUHFT

• Documentation

  • notes

  • logbook

  • datix

• Write a letter to care home manager