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CQC Regulatory Viewpoint on Dysphagia

CQC Regulatory Viewpoint on Dysphagia

Dysphagia, or swallowing difficulties, poses significant dangers in the UK, particularly in care settings, and is a major focus for the Care Quality Commission (CQC). Dysphagia can lead to choking, aspiration pneumonia, malnutrition, and dehydration, all of which impact quality of life and can be fatal. The CQC emphasizes the importance of proper management, including training for staff and individualized care plans, to mitigate these risks.

Dangers of Dysphagia:

  • Choking: Dysphagia can increase the risk of choking, which can be fatal.
  • Aspiration Pneumonia: If food or liquid enters the lungs, it can lead to pneumonia, a serious and potentially life-threatening condition.
  • Malnutrition and Dehydration: Difficulty swallowing can make it hard to eat and drink, leading to malnutrition and dehydration.
  • Reduced Quality of Life: Dysphagia can impact enjoyment of food, social interactions, and overall quality of life.
  • Increased Hospital Admissions: Dysphagia can lead to avoidable hospital admissions for conditions like dehydration, constipation, and aspiration pneumonia.

CQC’s Role and Standards:

  • Regulatory Standards: The CQC sets standards for dysphagia management, focusing on safe swallowing practices and preventing complications like choking and aspiration pneumonia.
  • Emphasis on Safe Care: The CQC emphasizes the importance of safe care for individuals with dysphagia, including training for staff and individualised care plans.
  • Monitoring and Enforcement: The CQC monitors care providers’ compliance with these standards and can take action, including prosecution, if standards are not met.

Examples of CQC Reports:

  • In 2017, the CQC prosecuted a care home provider for failing to manage risks to people’s safety, including a choking incident (fining the care home group £82,000}. 
  • CQC reports often highlight failures in managing dysphagia, such as inconsistent records, inadequate training, and failure to follow clinical recommendations. 
  • The CQC’s guidance on dysphagia and thickeners emphasizes the importance of ensuring safe swallowing practices, including the proper use of food and drink thickeners. 

Addressing the Risks:

  • Comprehensive Staff Training: Staff need to be adequately trained to identify dysphagia, manage coughing and choking, and understand good practice guidelines.
  • Individualized Care Plans: Detailed care plans and risk assessments should be in place for individuals with dysphagia, including tailored food and drink preparation instructions.
  • Collaboration with Professionals: Speech and language therapists (SLTs) are key in assessing and managing dysphagia, and their recommendations should be followed.
  • Personalized Approaches: Catering for dysphagia diets should be individualized to meet the specific needs of each person, rather than relying on a “one-size-fits-all” approach