Archive for the ‘actions’ category

Essential Standards Outcome 5 Nutritional Standards

February 8, 2012

What CQC outcomes say about Eating and nutritional care

What should people who use services

experience?

 

People who use services:

  • Are supported to have adequate nutrition and hydration.

This is because providers who comply with the regulations will:

  • Reduce the risk of poor nutrition and dehydration by encouraging and supporting people to receive adequate nutrtion and hydration
  • Provide choices of food and drink for people to meet their diverse needs, making sure the food and drink they provide is nutritionally
    balanced and supports their health.

Prompts for all providers to consider
The following prompts relate to all registered providers where they prepare,
or support people who use services to prepare, food and drink. The term
‘provide’ means the preparation of food and drink and includes where the
service gives support to people to eat and drink. The food and drink used may
be purchased either by the provider or by the person using the service. These
prompts do not cover the administration of artificial hydration which may be
essential to maintain hydration.

I thought it might be useful to go through the sections of the outcome individually over the coming weeks so here is section  5A

Ensure personalised care by providing adequate nutrition,
hydration and support

5A Where the service provides food and drink, people who use services
have their care, treatment and support needs met because:

  • Staff identify where the person who uses services is at risk of poor nutrition, dehydration or has swallowing difficulties, when they first begin
    to use the service and as their needs change.

  • Action is taken where any risk of poor nutrition or dehydration is identified
    including any difficulty in swallowing or the impact of any medicines, and a
    referral is made to appropriate services.
  • They know that their medical dietary and hydration requirements are identified and reviewed.
  • Their plan of care includes how any identified risks will be managed.
  • Relevant staff know what a balanced diet is.

 

All the food we eat can be divided into five groups. In a healthy diet you eat the right balance of these groups.

They are:

  • Fruit and vegetables.
  • Starchy foods, such as rice, pasta, bread and potatoes. Choose wholegrain varieties whenever you can.
  • Meat, fish, eggs and beans.
  • Milk and dairy foods.
  • Foods containing fat and sugar.

Most people in the UK eat too much fat, sugar and salt, and not enough fruit, vegetables and fibre.

To maintain a healthy diet, the eatwell plate shows you how much of what you eat should come from each food group.

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February 3, 2012

What CQC outcomes say about Eating and nutritional careselection of fruit

The outcome that relates to eating and nutritional care is:

Outcome 5: Meeting nutritional needs – Requires services that provide food to ensure:

  • a choice of suitable and nutritious food and hydration, in sufficient quantities to meet people’s needs
  • food and hydration provision meets any reasonable requirements arising from a person’s religious or cultural background
  • support, where necessary, for the purposes of enabling people to eat and drink sufficient amounts for their needs.

Regulation 14 of the Health and Social Care Act 2008

So here are some interesting facts from the Social Care Institute for Excellence

Eating and nutritional care and dignity – key points from policy and research

  • Food, nutrition and mealtimes are a high priority for older people and a top priority for older people from black and minority ethnic groups (PRIAE/Help the Aged, 2001).
  • Malnutrition affects over 10 per cent of older people (British Association for Parenteral and Enteral Nutrition, 2006).
  • Between 19 and 30 per cent of all people admitted to hospitals, care homes or mental health units are at risk of malnutrition (British Association for Parenteral and Enteral Nutrition 2007).
  • The UK Home Care Association estimates that up to 90,000 people who receive home care services could be at risk of malnutrition (Grove, 2008).
  • Public expenditure on disease-related malnutrition in the UK in 2007 has been estimated at in excess of £13 billion per annum (Elia.M, Russell, C.A. Combating Malnutrition – Recommendations for Action BAPEN 2009)
  • Malnourished patients stay in hospital longer, are three times as likely to develop complications during surgery, and have a higher mortality rate (Age Concern, 2006; BBC, 2006).
  • The needs of people from black and minority ethnic groups, including ‘basics such as food’ are not always met by mainstream services (PRIAE/Help the Aged, 2001; Afshar et al, 2002).
  • Key points in bringing about a culture change in food, nutrition and mealtimes are: good leadership, staff induction and training and adequate staffing levels (Commission for Social Care Inspection, 2006).
  • The NHS Standards for Better Health requires healthcare organisations to ensure that patients have a choice of food that is prepared safely and provides a balanced diet; and that ‘individual nutritional, personal and clinical dietary requirements are met, including any necessary help with feeding and access to food 24 hours a day’ (Department of Health, 2004e).
  • In February 2006 the National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Acute Care launched clinical guidance to help the NHS identify patients who are malnourished or at risk of malnutrition.
  • The NHS Essence of Care benchmarks for food and nutrition include attention to nutritional assessment, the environment, presentation of food and appropriate assistance (Department of Health, 2003c). These can be used by care homes, as well as healthcare providers, to benchmark services.

Hydration

  • The evidence suggests that good hydration can help prevent falls, constipation, pressure sores, kidney stones, blood pressure problems and headaches (Ellins, 2006).
  • Poor hydration has been shown to contribute to obesity, depression, inactivity and fatigue and to prolong healing and recovery (Ellins, 2006).
  • There is some evidence to suggest that dehydration can increase mortality in stroke patients and prolong hospital stays for patients with community-acquired pneumonia (Water UK, 2005).
  • For some older people the sensation of feeling thirsty may be impaired and may not be an accurate indicator for good hydration (Kenney et al, 2001; Caroline Walker Trust Expert Working Group on Nutritional Guidelines for Food Prepared for Older People, 2004) particularly for people who have had a stroke and those with dementia (Albert et al, 1994; Water UK, 2005).
  • Following a study of four care homes, Anglian Water has launched the Health on Tap campaign (Anglian Water, 2008) to improve hydration for older people in care homes. The key findings of the study were:
    • Availability, visibility and reminders were some of the key factors to drinking more water.
    • After a regime was introduced and a water cooler installed, anecdotal evidence from one home reported: a 50 per cent reduction in falls; a greater than 50 per cent reduction in the number of residents taking laxatives; and a decrease in GP call-outs and urinary infections.
    • There were language barriers for some staff, with 50 per cent not having English as a first language.
    • Hydration does not feature as a specific training topic in its own right.
    • Residents’ fear of increased toilet trips was the main barrier to drinking more water (the report states: ‘Once the bladder had adjusted and was able to hold more volume, toilet trips soon settled down to pre-trial levels.’)
    • Peer-to-peer learning, rather than formal training, plays a large role in the knowledge and working habits of staff.
    • Knowledgeable and committed managers generate positive results.
    • Visual and mental impairments were a problem for many residents, with a high dependency on care staff to instigate water intake.
    • Staff said they would like promotional materials for themselves, residents and their families, to remind them of the importance of hydration.
    • The ability to spread and share good practice was seen as very important
      (Anglian Water, 2008).

Who can do that for you?

December 4, 2009

Here’s a little observation….and I think that it’s more noticable at this time of year as we rush into the busy festive season.

We get so caught up in what we have to accomplish today,we write the list and never seem to get to the bottom of it cos we keep thinking of stuff to add on 😛 and we never seem to have a minute to spare or a minute to think……chance woud be a fine thing! Some days we feel as though we hardly get a moment to breathe let alone anything else.

And then there are those of us who, as if we didn’t have enough to do, we go and set goals……dream bigger dreams….and so we should….and now we have to fit those into the plan for today too. And as if that’s not enough….well it’s coming up to Christmas and there’s dinners to go to and parties to attend and there’s presents to think about and then to shop for…and we need to plan who’s going where this year and is it my turn to entertan…what will we eat? drink? do?????

Phew! There’s such a lot to get done and so little time.

And then the feeling of overwhelm sets in….followed by panic…..followed by stress and fatigue and when the Day finally arrives you’re too exhausted to enjoy it….or you get the dreaded bug!

Blast!

How would it be if you could just stop…..just for a moment or two….and re-think this whole thing?

Ask a better question……

Who else could help me with this?

Just because they are you To Do’s or Goals…..doesn’t mean that YOU have to be the one who does everything to make them happen. If there was someone else who could do that thing for you…who would it be? How would I ask…..do I have to go shopping or could I do it on-line and have it delivered?

Hmm……You still get to enjoy the achievement – without the stress?

How would that feel differently?

So go through your list and delegate or find another way that would save you running around like mad……ask a better question 🙂

You’ll be glad that you did!

What is Confidence?

August 6, 2009
How would that extra confidence feel?

How would that extra confidence feel?

Confidence, we all talk about it, we all have it and we all generally would like more of at certain times in our lives, but what actually is it?

Quite simply, confidence is just a set of skills that can be learned by anyone to give them the feeling that they can succeed in any given situation or circumstance.  That’s Great News!  Why? Because it means that we can all learn to have more whenever we need it, it’s not genetic, it’s nothing to do with how much money we have, it’s nothing to do with upbringing, it’s not for a select group – it’s there for us all!!! Hooray!!

Very often we are confident in some areas of our lives and not others for example you might be confident at home with your family but not so confident in meetings with those above you at work, you might be confident in your job but not good at making friends easily, you may be confident with your friends but not in dealing with children.  In order to learn the skills we need it’s useful to identify which specific areas do you lack confidence and why and how would life be different if you had more confidence in this area? So go ahead and answer these questions for yourself right now.

What areas of my life do I lack confidence in?

Why?

How would it be different if I had more confidence in this area of my life?

Congratulations! You have just begun the process of being more confident by taking the first steps in identifying what can be improved and importantly why you want to improve it.  So for your chosen situation can you think of someone that you know or have seen who has the kind of confidence that you would like in that situation? Write down their name andCB022665 then list what you admire about them in that situation? How do they walk, stand, breathe, speak, what is their body language, what questions do they ask, what sort of words do they use? Imagine what it’s like to be them. If you have the opportunity, why not ask them? One of the best things to do to learn to be confident is to model someone who is already great at it. Ask them if they are always confident, chances are they feel a little nervous at times too, they just do it anyway and that’s the key. Confident people still feel a bit scared – they are just prepared to give it a go anyway.  That’s good news for the rest of us J We’ll look at some of the other ways to help us just do it anyway in future articles. For now, just take the actions above and you’re well on your way to a more confident you.

How to Build Rapport with anyone Instantly!

April 1, 2008


Rapport It’s my experience that people do business with people that they know, like and trust. If you could build stronger relationships with your potential clients faster –would that be of value to you and to your business?

Yes? Then read on.

People like people who are like themselves or who they aspire to become.

Have you ever met a perfect stranger and yet felt instantly comfortable with them? As if you’ve know them for ages.

Have you ever though, met someone for the 1st time and instantly disliked them or felt uncomfortable with them for no apparent reason?

Lots of sales people will say to me …well I’m already pretty good at rapport, I get on with most people….there’s always going to be a few that you don’t hit it off with.

I want to show you how you can get on with anyone, quickly and effectively so that you can do business with them. Even with the ones you wouldn’t normally hit it off with. This is important because they are the extra sales for your business and will give you the edge over the competition.

What is Rapport?

Rapport is that feeling of being comfortable with someone and trusting them.

A crucial component in any interaction particularly a sales interaction. It’s the first thing we need to establish and the most important thing to keep all the way through the presentation to the client.

We often don’t know WHY we like or dislike someone which makes me ask the question then “Where does rapport take place?”

In our minds we have two components – The conscious mind and the unconscious mind. The conscious mind likes to think it is in control. It’s the logical mind, the rational mind, the goal setting mind.

However, the unconscious mind is that part of us that runs the body. It’s the part that stays awake when we’re asleep, listening for the alarm clock. It’s the part that keeps us breathing without thinking about it, it keeps our heart beating and our spleen, dare I say it, spleening!

The conscious mind may set the goals but the unconscious mind is the part that gets the goals. It filters out irrelevant information and makes you take notice of the things you need to look out for, opportunities to meet your goal.

Rapport happens at the level of the unconscious mind so how can we use it consciously to help us build strong relationships quickly and easily?

How do you get into rapport with someone?

How To Get In Rapport

Start with the chit chat – Look for common interests, hobbies, acquaintances, places you have been to, styles of clothing you might like etc. Find some things in common by having a little chat before the sales process begins. You are looking to put them at ease and enjoy having you there.

In order to have this conversation and find the common experiences we have to exchange words AND you need to have good listening skills to notice what information they are giving so that you can use to good effect. You need to be ACTIVELY listening – all too often we’re so busy thinking about what we want to say next that we are not concentrating on what the other person is saying. Key point – be present with your client at all times.

Notice also the language that people use when they talk.

Now obviously I don’t mean are they speaking English or Portuguese here! I mean how do they choose to internally represent the world outside?

People tend to have what is called a dominant or preferred thinking style.

People prefer to communicate in one of three ways:-

Visual

Auditory

Kinaesthetic

We all use all three – we just have one that we prefer to use one more than the others.

What to look for……

If someone likes to communicate using their auditory senses they might use phrases such as

“I hear what you’re saying”

“That rings a bell”

“Tell me more”

If someone likes to communicate using their visual senses they might use phrases such as

“I get the picture”

“I see what you mean”

“Can you imagine that?”

If someone likes to communicate using their kinaesthetic senses they might use phrases such as

“I get the feeling that…”

“I need concrete evidence”

“Give me hard facts”

If you are talking to a client and you just don’t seem to be getting the connection or the understanding that you need – stop and ask yourself – how am I different to them?

It may be that you are speaking a “foreign” language perhaps by noticing their preferred style of communication and adjusting yours to match you’ll achieve rapport.

It’s Not Just The Words You Use

Studies have shown that only 7% of what is communicated between people is transmitted through the words themselves.

38% comes through the tone of the voice, the tempo, the volume and the timbre – or individual characteristics of the voice and

55% of communication, by far the largest part is a result of physiology or body language.

Let’s first understand what is meant by the characteristics of the voice.

You could mirror the tonality and phrasing, the pitch, the speed, volume, tempo – what sort of pauses does that person make?

What about the BIG bit though?

Body language or physiology – one of the fastest ways to build rapport with another person is to mirror and match their body language.

What aspects of another person’s body language could we mirror or match?

The facial expressions,

The gestures,

The quality and type of movements,

Mirror or copy posture….do they stand or sit up straight or are they slouched? Do they have their legs crossed or not? Do they have there hands in their lap or their arms folded or resting their hand on their chin?

Do they make lots of eye contact? What are their facial expressions….if they are looking sad – you wouldn’t want to be sitting there with a big grin on your face!

How do they breathe………long deep breaths, short shallow breaths?

Do they tilt their head to one side……you can mirror all of these things.

Obviously you might want to be a little subtle at times, mirroring and matching some part of their physiology not copying every posture and move – if they notice you’ve blown it! So use it wisely.

Combine that with matching the words or language that they use and you will have them as your friend in no time because whilst the words are working on the persons conscious mind, the physiology is working on the unconscious minds and the brain starts to think WOW! They’re like me!

Practice it, master it and watch your business grow!!

Watch for my next article – I Am In Rapport, Now What? Eliciting Buying Strategies.

For further information on this subject and to discover how coaching and training n this subject can help you and your business grow contact Tracey Dowe at Momentum People Ltd

Email tracey.dowe@momentumpeople.co.uk

www.momentumpeople.co.uk

tel: 01793 700929

Visualisation – Your Amazing Mind!

February 19, 2008


j0433055.jpg Your mind is an amazing, powerful and creative tool. With it you have an awesome capacity to change how you feel long-term by creating your future right now.

If you can imagine it, you can achieve it. If you can dream it, you can become it. – William A. Ward

You not only have the ability to remember events and re-run them in your mind, but you are also capable of creating events or feelings in your imagination before they actually occur. You do this all the time; when you are looking forward to a holiday you have booked or when you have planned a night out. You think about how it’s going to be and build up an expectation of how it will play out don’t you?

Athletes use this ability to practice their techniques and to run the races before they have even stepped out of the starting blocks. Golfers use it to practice their swing, musicians use it to practice their performances before the big day. The incredible thing is — and I love this – the mind can’t tell the difference between what is real and what is imagined visually.

Wow! How cool is that?! If you imagine your future vividly – it becomes your reality.

So if you want to feel fantastic, have tons of energy, be happy, successful and abundant in every good way, the secret is to start that process right now in your imagination. How?

Everyday set aside ten minutes each morning and ten minutes every night to do this. Sit quietly, close your eyes and let the process begin.

In your imagination see yourself as the person you would LOVE to become. Where are you? Who are you with? What are you doing? How does it feel? Breathe deeply and soak it all in. Now make the picture brighter, add more colour to it. What are you saying to yourself or others around you? Make the feelings stronger, feel the emotions you’re feeling more intensely. Smile as you see yourself being amazing, as you feel an incredible inner strength, joy and confidence! Now turn the sound up. Make the vision even more real!

As you experience the joy and passion of who you are, give thanks for it as if it has already happened, as if it is happening right now in this very moment. Celebrate the new you! Celebrate the moment and make it real. Do this over and over again, for all the ways you want to change, for all the new things you want to do, for all the new, powerful feelings you want to experience. Live the life you deserve the way you want to NOW and you will be well on your way to making it your reality!

 

To find out more about your amazing mind contact tracey.dowe@momentumpeople.co.uk or log in to http://www.momentumpeople.co.uk

SWISH!!!!

January 31, 2008

j0341393.jpgA fantastic way of changing your focus INSTANTLY is by using something called a swish. The Swish Pattern was developed in Neuro Linguistic Programming (NLP) to develop self-esteem and it can be used at will whenever you want to replace an undesirable state with an empowering one.

The swish conditions your brain so that as soon as you start to think about something you know makes you feel a certain way, e.g., lonely or sad – as soon as those thoughts and feelings begin, your brain instantly recognises them and replaces them with an empowering set of thoughts, feelings and visions of the new energetic you!

How cool a tool is that to have at your disposal?! And the beauty of it is you can use it for so many thoughts and feelings, it’s really quick and easy to do, and it can be a permanent fixture once installed! So, how to create a swish pattern?

You may need to read through the instructions a couple of times to understand them fully before trying it, and practice makes perfect – repeat it over and over and over to make sure it gets anchored in. It may sound silly and feel strange at first, but if you do this and really get it fixed it will happen naturally when you choose to use it. Often this occurrence will be very powerful.

  1. Identify a habit or feeling that you would like to change. Maybe it’s biting your nails, maybe it’s over eating, maybe it’s feeling a lack of confidence. Whatever it is for you.
  2. How do you know it’s time to do or feel that thing? I mean, what is the point of no return for you – that action or thought that triggers be behaviour and you just can’t stop yourself? For example with a nail biter – is it lifting your hands to your mouth? Or is it when your fingers touch your lips? Or, is it when you have the nail between your teeth?? What IS that point of no return for you?
  3. Do you have a picture of yourself looking through your own eyes, doing this behaviour of feeling this feeling? See that picture now as if you are in it, doing it.
  4. Now – what is the behaviour you would rather have? Or the feeling you’d rather feel? Do you have a picture? See yourself in the picture doing this new behaviour of feeling the new feeling.
  5. See the image of you as BIG, BRIGHT and COLOURFUL! Hear this ‘you’ say, “I feel good about myself” (or even stronger, inspiring words), and let the words wash over you, let them echo around you. Make it strong enough that you can FEEL THE GOOD FEELINGS!
  6. Excellent. Now, close your eyes and see the old picture of you as you do the old habit big and clear in front of you.
  7. Shrink the WONDERFUL YOU image down until it’s a sparkling dot and place it in the bottom left hand corner of the image of the negative you.
  8. Reach down with the opposite hand and grab the corner of the small picture of you in the corner and pull it up diagonally in front of you. Notice that as you bring it up and across the old picture the sparkling dot containing the WONDERFUL YOU begins to grow, enlarging until it becomes full size and in full colour. Meanwhile the negative image is shrinking, fading, becoming duller. It finally disintegrates (with a ‘Swisssh’) while you hear the positive words reverberate around you and you feel the positive empowering feelings inside.
  9. Next open your eyes to blank the ‘screen’ and repeat the above (step 4), starting with the sparkling dot in the corner 20 more times, faster and faster each time. (I said 20 and I mean 20!!! Don’t be cheating yourself by thinking you can do fewer!!)
  10. Test yourself. Does thinking of the unpleasant image automatically bring on the positive image and feelings? If not, repeat another 10 times, and test it again.
  11. Let the positive image be multiplied. Create thousands of copies, one behind another. Then, leaving one image right in front of you, toss the rest into the air and let them settle down all around you in concentric circles as far as you can see, in the past, present, and future. Hear them all say, “I feel good about myself” “I am confident and successful” “I passionate and positive” “I am a winner”. Allow those good feelings to wash over you.

Practice –

Test it!

Use it!