how food services and front-line staff can work together...
TRANSCRIPT
Improving Nutritional Standards in Care Homes
How Food Services and Front-line Staff can Work Together to Improve
Standards of Nutritional Care
Helen Ream Registered Dietitian, Compass Group UK &
Ireland
Why Work Together?
38% of Residents in Care Homes are at medium or high risk of malnutrition (BAPEN 2015)
20-45% of people with Dementia experience significant weight loss in one year (Alzheimer's Disease International)
Up to half of Residents living with Dementia in Care Homes have an inadequate food intake
Estimated 60-75% of people in Care Homes suffer from some form of swallowing difficulty (NHS England)
Food Service Roles and Responsibilities
Care Teams Understanding Residents’ dietary needs and preferences, nutrition screening and care planning, providing assistance at mealtimes, serving food, monitoring food intakes, taking action where required and team working to ensure this is delivered
Catering Teams Menus, food ordering, preparation of meals, snacks, kitchen practices and food hygiene, food delivery, budget management, special diet menus and team working to ensure this is delivered Priorities For Both Dietary needs and preferences of each Resident, menus, special diets menus and provision, food service pathway, portion sizes and monitoring intake Visitors to the Home Speech Therapists, Dietitians, GP’s, Nurses
How Do We Ensure We Meet Joint Priorities?
Understanding of Roles and Responsibilities
Well Organised Processes for Food Services
Team Working
Communication
Trust
Ongoing Review of Practices
Working Together
Multidisciplinary Team
RESIDENTS RELATIVES
NURSES CARERS
DIETITIANS SLT
CATERING MANAGER/
CHEF
MENUS AND
FOOD SERVICES
Dignified Dining Toolkit
Food Element Includes Menus Special Diets
Service Element Includes Food Service Journey Food Passports Food Record Charts
Environment Includes Noise Signage Table Settings Crockery
Tools To Support The Delivery of Nutritional Care
Food Passport
Developed by Compass Dietitian Supports the Provision of
Individualised Nutritional Care
Dietary Needs Information
Bay Bed NBM Thickened Drinks NURSE ONLY
Puree C
Soft E
Allergy Menu
Religious and Ethnic
Menu
Red Tray Other Special Diets Such as Renal, MCT
etc
• Higher energy ( E ), healthy option (H), gluten free (GF) and moderate sodium (LS) are also coded from the normal menu
Morning Afternoon Nurse/Name _______________ Nurse/Name _______________ Signature _______________ Signature _______________ Host/Name _______________ Host Name _______________ Signature _______________ Signature _______________
Ward: ___________ Date: ___________ Tick Boxes as Required
Tools To Support The Delivery of Nutritional Care
Food Service Journey A process mapping exercise allowing teams to observe all aspects of the meal service
Food Record Chart
Name J Breakfast K Breakfast L Breakfast J Lunch K Lunch L Lunch J Supper K Supper L Supper
Tick the box above which best describes how
much the person has eaten
J K L J K L J K L
ate all or most ate about half ate very little ate all or most ate about half ate very little ate all or most ate about half ate very little
Training
Training should allow time for discussion, reflection and problem solving.
Training can include:
Meal and Food Service Standards
Nutrition Care Pathway
The Dietary Needs of Different Residents
Special Diets
Use of Supporting Tools
Changes to Practice as a Result of Tools
Changes to the amount of food on the hot meal trolley Reduction in delays in meal trolley collection Changes to the way meals were served eg. salad platter, sandwich platters Changes to where Residents sit for their meals and are offered meals Increases in food related activities with Residents Improvements in the labelling of special diets Understanding in kitchen about Residents needs for modified texture meals Better communication between the teams
To Conclude….
The provision of nutritional care for the older person is complex Meeting Resident needs should be at the heart of the way we work Multi professional teams should work together in all aspects of nutritional care Use tools and processes to support good practice Continually monitor and review