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Delivering nourishment from the frontline

Jane Clarke BSc (Hons) SRD DSc, Dietitian and Founder of Nourish by Jane Clarke

It was a chance meeting on a train, many years ago, that changed my professional life direction. I was lucky enough to sit opposite a wonderful man named Derek Doyle, who I found out was a key campaigner for hospice care. Derek and I immediately clicked and a few weeks later I visited him at St Columba’s hospice in Edinburgh. There, he inspired me to follow my passion to nourish those people who are vulnerable and in poor health, and most need expert nutritional care.

I recall Derek saying that everyone always talks to the tea lady in the hospice. The simple gesture of giving a cup of tea, with a biscuit or piece of cake, breaks down barriers and teases conversations out of even the most reticent. It’s just one example of the key role of ancillary staff within care settings.

By recognising the nurturing connections that frontline workers make with residents and patients, and by encouraging catering assistants to talk to those that eat the meals they prepare, you empower them to take an active role in the nourishment and wellbeing of those who are cared for. And that drives better outcomes and experiences for everyone.

Every mouthful counts, every person matters

This is the ethos behind my Nourish Drinks, the nutritional shakes that I created as a delicious, all-natural alternative to the synthetic and unappetising supplements on the market. It’s also a useful mantra for any care provider considering the value of their ancillary staff in promoting wellbeing through food and nutrition.

I was fortunate enough to work with Jamie Oliver as the nutritional adviser on his school meals campaign. At the time, school cooks and dinner ladies weren’t respected for the roles  they play in our children’s wellbeing. But from the start, Jamie and I knew it was these key staff who would drive the success of our school food revolution. The project really did make a difference to our schools and our society, and now school chefs and lunch room staff are rightly recognised for their work, and even win awards from the likes of Radio 4’s Food Programme.

We’re seeing a similar desire for change in the care sector. For this to happen, it is essential to inspire tea volunteers, chefs, kitchen assistants and social care staff – those delivering nourishment at the frontline – and show how the food they cook and serve can make a dramatic difference to the lives of those they look after. Just as importantly, managers must support their staff with training and empower them to deliver the nutrition and care they truly want for those they look after, whether that’s in a care setting or in their own homes. It’s time to respect what ancillary care staff can bring to the table.

Food for thought: how frontline staff can promote wellbeing through nutrition

Communicate Talk to those you look after and find out what they really want to eat. Can you tap into memories of favourite foods and home-cooked meals to make menus more appealing? Are they struggling with the texture of certain foods? Or do they not get on with the person sitting next to them? Simple fixes may make for happier mealtimes and boost appetite, delivering better nourishment.

Entice The taste, texture and look of food all contribute to its appeal, and there are ways to make even low-fibre foods or purees more appealing. In the kitchen, consider how food is cooked and plated up. In the dining room or when delivering meals, think about how you can make sitting at the table a more pleasant experience.

Notice It’s the staff who help to serve or feed individuals, or the kitchen assistants who clear and wash plates, who notice if food is going uneaten. Look out for changes in appetite or difficulties in eating in individuals, or if a certain recipe hasn’t gone down well generally. Regular debriefs or a system of note taking can make sure crucial information isn’t lost in the rush of serving and clearing up after mealtimes.

Help It’s ancillary staff and caregivers who can give assistance to those who find it difficult to chop up food or feed themselves. Mealtimes may be slow and that can be frustrating when there’s a lot of other work to do, but trying to rush through the process can mean individuals don’t eat enough and can become undernourished, leading to health problems that can quickly become serious. Try to view mealtimes as vital check-ins, when you have a chance to talk and enjoy spending time with those you care for.

Nourishing environment: how care providers can support staff

Listen It’s the ancillary staff who offer personal care and mealtime support who may notice that a person is struggling before the medical team spots a problem. They can identify changes in mood, weight, physical ability and appetite, so enable communication between staff and management and listen to any concerns.

Training When staff have an understanding of good nutrition and eating challenges that affect the elderly, unwell or those with disabilities, they are able to identify any potential problems and also provide suggestions and solutions that will benefit the wellbeing of those they look after. Training and resources around choking difficulties, food refusal, loss of appetite and elements of a healthy diet will empower staff and give them more confidence in their roles.

Time No one likes a meal to be rushed. Conversations around the table create a vital sense of community in a care setting, while eating challenges such as swallowing difficulties need to be managed with patience. Make sure there’s adequate time built into the day’s routine to take the pressure off mealtimes, making them an enjoyable experience for all.

Kirsty

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