Please note: This referral process and associated resources form part of a pilot project. Please only access and use these materials if you have been advised to do so by your Speech and Language Therapist.
The Adult Speech and Language Therapy Service is pleased to introduce the Care Home Dysphagia Self-Management and Referral Pathway.
Developed by Speech and Language Therapists, this pathway is designed to support care home staff in delivering safe, high-quality care for residents experiencing eating, drinking, and swallowing difficulties. It promotes a collaborative approach between care homes and Speech and Language Therapy services, helping staff to identify concerns early, implement appropriate management strategies, and access specialist support when required.
By using this pathway, your team will be able to:
1. Recognise
- Common signs of swallowing difficulties
- Changes in eating and drinking behaviours
2. Respond
- Implement immediate safety strategies where appropriate
- Support residents effectively during mealtimes
- Develop clear care plans to evidence the rationale for implemented strategies
3. Review
- Monitor whether swallowing difficulties improve, remain unchanged, or worsen
- Use structured checklists to support decision-making
4. Refer
- Identify when specialist support is required
- Make timely and appropriate referrals to Speech and Language Therapy or relevant medical services
Getting Started
To begin using the Care Home Dysphagia Self-Management and Referral Pathway, please access the Referral Form for Nursing and Residential Homes below and follow the instructions provided within the document.
If you have a question that cannot be answered using the Referral Form or the accompanying guidance documents, please contact the Adult Speech and Language Therapy Team on 01752 434301.
Please note: We no longer accept referrals through the previous referral route.
Referral Process for Nursing and Residential Homes
The new referral pathway provides immediate advice and guidance, where appropriate, enabling a quicker response to a person’s needs.
Referrals for the following are not appropriate and will not be accepted:
- Patients with a learning disability.
- Repeat referrals where there is insufficient evidence of a change in the swallowing problem.
- Repeat referrals arising solely from non-compliance with previous swallowing recommendations, where the person has capacity to make their own decisions and already has an eating and drinking at acknowledged risk plan in place.
- Requests for review where there has been no change in presentation or environment.
- Oesophageal disorders.
- Patients already on a pureed diet and thickened fluids who are not suitable for gastrostomy (alternative feeding).
- Referrals relating to saliva management or difficulty swallowing medication in the absence of specific swallowing difficulties.
- Patients who do not consent to referral (excluding those who lack capacity to do so).
- Patients who are unable to participate in assessment due to reduced alertness.
- Patients who are at, or rapidly approaching, last days of life.
- Referrals requested solely to update care plans where there has been no change in the patient’s presentation.
