News Opinion

Dignity in Dining

Nutrition and hydration are one of the most important aspects of delivering care. As people lose capacity to do many of the things that they have enjoyed in their lives, mealtimes take on an even greater significance and become the high point of many peoples’ day.

We should also remember that people who have a number of health problems and maybe on several different drugs need to have a good nutritional hydration balance in order to make their drugs work effectively. We must also be mindful that people who are dehydrated will often suffer confusion and may also be subject to falls and a range of other conditions.

Over the years the care sector has worked hard to improve the nutritional balance and have also focused on the dining experience, which is so important to the quality-of-life of the residents’. I think it is important that care home staff focus on the quality of the dining experience as much as they do on the nutritional balance and hydration. Here are some top tips which will help to deliver a better dining experience and also ensure people have the necessary nutritional intake to be able to live a good quality life.

We must remember that there is no nutrition in a meal that a resident does not eat.  It is essential that residents are given the right support to eat meals and a fitting environment in which to do so.  Everybody is different and care homes need to be adequately resourced in order to cater for each unique resident and their tastes and preferences.

I have seen some excellent examples of residents’ committees who propose the changes to the menus in order that they reflect their true tastes. It is important that every resident is asked about their food preferences and care providers should do all that they can to deliver what people want, need and enjoy.

It is important that care workers should be involved in the individual residents’ selection of meals and ideally choices about what to eat should be made at meal times rather than well in advance of the meal.

Meals are a vital part of the care package and as with all elements of care they are often dependent on the training that the member of staff has received. I have seen some good examples of training, which have included staff helping to feed one another in order to understand some of the difficulties and indignities that residents may experience.

There is a market for crockery and cutlery for people with poor dexterity in order to preserve dignity and enjoyment of meals. We must never overlook the importance of both crockery and cutlery in the dining experience and we must ensure that it is fit for purpose and supports people to be able to be as independent as possible.

Some care homes have been making meal times ‘protected times’ and all staff have been working in the dining room, helping residents and chatting to them.  In an ideal world there should be a care worker on each table in order that they can facilitate residents and also boost the social aspect of the meal.

Some residents may choose to eat in their rooms or in front of the television, but just because they do it once it should not be assumed that they want to do it every day and people should be given choice whenever possible.

When you look at the price local authorities are prepared to pay you see what an incredibly difficult thing it is to provide food for such a low cost.

I do not think it is helpful to talk about the price per resident as these costs do not encompass the actual costs of catering, training and delivering meals, rather they tend to focus on the raw materials. Recruiting good chefs is equally, if not more important than the price per resident and in general care homes should be congratulated for delivering wholesome meals with fresh ingredients from a relatively small budget. On my many visits to care homes I am so impressed by the quality of the food and by the excellent dining environment.

There is an abundance of good practice in the care home sector and it needs to be acknowledged and recognised. Good practice in nutrition and mealtimes can negate the need to alter the care home standards and regulations thereby cutting the red tape. The culture of being distinctly risk averse needs to be amended for the capacity for wellbeing of residents to thrive.

Care homes often have problems obtaining access to dieticians. There needs to be a better working relationship and understanding between the NHS statutory sectors and the independent sector and dieticians need to be far more engaged with care providers to help them to understand how to deliver nutritious food that is also appetising and meets the needs of the resident.

Over the last few years I have seen enormous strides in the dining experience and nutritional standards of care home food and the sector is to be applauded for everything it is doing in this area.

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