The Importance of Choice and Evidencing Nutrition in Care

Regardless of your age, good nutrition is an essential part of maintaining wellbeing. This is especially true for care providers looking after older people in a care home setting, as residents critically rely on the care team not only to provide their meals and drinks, but also in some cases assist them to eat and drink.

A Government Impact Assessment: ‘Helping older people maintain a healthy diet: A review of what works’ estimated that a greater use of healthcare as a result of malnutrition results in 65% more GP visits and 82% more hospital admissions. Therefore, good nutrition is vital in preventing unnecessary medical interventions. 

Nutrition and Hydration Week takes place every March, beginning in 2012. Its aim is to bring people together to highlight and educate them on the value of food and drink in maintaining health and wellbeing in health and social care.  

The British Association for Parenteral and Enteral Nutrition (BAPEN) and the Malnutrition Taskforce’s UK Malnutrition Awareness Week has taken place annually since 2018, and this years’ event is from 11th-17th November 2024. Its stated aim is, “raising awareness and understanding the risks of preventable malnutrition across different sectors and settings, in local communities and with the general public and health and social care professionals.”

The Care Quality Commission (CQC) has made ‘Meeting nutritional and hydration needs’ one of its Regulations (Regulation 14) which providers must meet. Its requirements go beyond merely ensuring that people have adequate amounts of food and drink, but also requires providers to ensure that they, ‘have their nutritional needs assessed and food must be provided to meet those needs and delivered through personal choice. This includes where people are prescribed nutritional supplements and/or parenteral nutrition. People's preferences, religious and cultural backgrounds must be taken into account when providing food and drink.’

Further afield, the International Dysphagia Diet Standardisation Initiative (IDDSI) framework has been adopted by many countries including the USA, Canada, Australia, and Germany. It contains levels for fluids as well as foods, meaning that the safety of patients when both eating and drinking is accounted for and assured. 

As providers know, offering residents choice in what they eat, and drink is just one part of the overall meal experience. Offering a varied menu keeps mealtimes and nutrition interesting, and introducing new foods to residents, by way of ‘themed’ mealtimes, will expand their palate. It can also be used to spark discussions on meals enjoyed during residents’ lifetimes and on holidays, and in this way can form part of reminiscence therapy activities.

During their visits CQC inspectors will examine not only the food being offered but will also speak to residents and their families about the home’s approach to mealtimes: what does a typical menu look like for the day/week, how are dietary requirements addressed, and how is food presented? Being able to demonstrate good catering practices, and having evidence to support it, will help the Registered Manager and Home Chef in this part of the inspection.

Beyond the regulatory requirements, having a seamless system on which to record the food and drink offered to and consumed by residents not only helps with catering costs but also, and more importantly, will help staff to identify anomalies in a resident’s nutrition. Residents whose nutritional intake has altered dramatically may have underlying health issues, and identifying and acting upon this quickly by seeking medical advice may prevent unnecessary outcomes. CQC addresses this action as part of its requirements, stating that: ‘Staff must follow the most up-to-date nutrition and hydration assessment for each person and take appropriate action if people are not eating and drinking in line with their assessed needs’ and ‘Staff should know how to determine whether specialist nutritional advice is required and how to access and follow it.’ Families will also be reassured that not only is their loved one receiving good nutritious food, but that their health and general well-being are monitored closely.

The new, holistic care management system offered by PredicAire has a feature dedicated purely to nutrition. The feature offers care providers a unique way to record the dietary requirements, meals being offered and consumed, thus assisting with forward meal-planning and ingredient-ordering; and also blends seamlessly with the Care Planning feature to record exactly what an individual resident has consumed using the previously mentioned IDDSI framework. In this way providers can easily demonstrate to inspectors, health professionals, and families, what has been offered to residents; what they have selected; and how much has been consumed. Changes to diet (good and bad) can be easily spotted and acted upon, predicting and preventing unnecessary outcomes. Any changes in the Nutrition segment of the care plan immediately alerts the catering team of these important changes so that nothing is missed and the resident is offered a well-balanced nutritious meal.

by PredicAire
15/03/2024
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