Esential Standards Outcome 5c – Nutrition

 Promote rights and choices

5C Where the service provides food and drink, people who use services can make decisions about their food and drink because they:


●● Have accessible information about meals and the arrangements for mealtimes.


●● Have a choice for each meal that takes account of their individual preferences and needs, including their religious and cultural requirements.

Do your menu’s offer the client a choice in meal or dictate what they will have?

Are there vegetarian, vegan or halal choices as appropriate for  someone?

Do you have clients with special diets that require them to be nut-free, gluten-free, lactose-free etc.?  


●● Have access to snacks and drinks throughout the day and night.


●● Have mealtimes that are reasonably spaced and at appropriate times, taking account of reasonable requests including their religious or cultural requirements.  

Meal times are perhaps easier to plan for and accommodate in residential and nursing care than within domicilary care. Never the less, the client should be eating at times that are reasonably spaced and should have an idea of when those times are. Particulary relevent at the moment are religious and cultural requirements as we go into a fasting time for many muslims for Ramadan. 


●● Have information on what constitutes a balanced diet to help them make an informed decision about the type, and amount, of food they need to address any risk of poor nutrition and/or dehydration.

 This information is equally relevent and important for the care team as well as the clients themselves. All too often we hear that carer’s preparing food for client’s that is not well balanced because they do not understand what a balanced food intake is either. 


Here’s some useful information about healthy eating and malnutrition taken from the leaflet produced by Leeds NHS:-


What is malnutrition?
Malnutrition is when a person is not eating enough of the right foods. This means they don’t get all the nutrients, such as proteins,
vitamins and minerals, they need.
Being malnourished can make you ill as your body does not work as well as usual. Being ill can also lead to malnutrition as this often
results in poor eating habits. Malnutrition is not just something which happens as you age. It is important that you don’t dismiss the signs as being a part of ‘old age’. There is much that can be done to
help prevent malnutrition. The key is to ensure that the underlying causes are assessed.

Who is at high risk?
· those with reduced mobility which affects shopping / cooking;
· if you are housebound;
· if you are living alone;
· if you are showing symptoms of depression; and
· those with dementia.

Dental / mouth problems can cause malnutrition because they can make eating difficult and painful –

Spotting the signs and symptoms:
· losing weight unintentionally;
· eating/ drinking less than usual;
· experiencing any choking or swallowing problems;
· constipation or diarrhoea;
· unable to keep warm;
· loss of muscle;
· dizziness (prone to falls);
· difficulties recovering from illness;
· pressure ulcers, dry skin;
· recurrent infections;
· difficulties chewing or swallowing; and
· sore mouth, or tongue, bleeding or swollen gums. 


What to do if you are concerned?
You can help prevent malnutrition in yourself or others:
· recognising the early warning signs;
· supporting access to both social and health services;
· planning visits around mealtimes to get a sense of what you / they are eating and if you / they have any difficulties eating;
· sitting down and eating socially with friends or relatives;
· having a look in the fridge or cupboards. A lackof food, too much of the same foods or foods past their sell by date may signal a problem;
· encouraging extra snacks and drinks; and
· keeping active, as it stimulates an appetite and maintains muscle mass.

How can you improve access to food?
· Sharing meals with others / going to relatives or informal carers.
· Attending local cafes / pub lunches /visiting voluntary, community or faith organisations with luncheon clubs.
· Using private shopping services and / or meal preparation services.
· Using online supermarket home delivery services (including frozen meals).


Well worth sharing some of this information with your care teams. Maybe copy and paste the bullet points where useful as reminders for staff. How many of thier suggestions could you  adopt or adapt to meet  the needs of the people you look after?



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