Archive for the ‘health’ 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.

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).

Weighty Words

March 5, 2008

scales Weight Loss and dieting are something that will be on the minds of many of you as the weather starts to get better and our thoughts turn to those summer holidays. There are hundreds of diets and exercise programs out there to choose from yet it’s more a function of how we think than what we eat. ‘Yo-yo’ dieting is an all too common occurrence. Why do we eat foods we KNOW add weight and inches to our waist and hips? Why do we sit in front of the tube for hours at a time instead of going for that wonderful walk in the park? The answer lies in our MINDS.

You’ve all heard of the saying “You are what you eat”

WRONG!

You are what you think.

It’s not just what you put in your mouth that affects how you look, it’s the words that you put in your head that does it. We all have conversations with ourselves though we don’t all like to admit it and how often do you take the time to really analyse that self talk? Stop and notice, are the words positive or negative? Do they make us feel fantastic or faulty? Do we tell ourselves how great we are? How awesome we feel? Do we tell ourselves “Hey – I love you, you’re amazing!!”

Take a minute now and tell yourself what you like about yourself. You will be amazed how difficult it is to do. We’re just not used to it. We’re used to putting ourselves down instead. “Look at me still fat” “I can’t believe I can’t lose the weight” “I can’t believe I put it all back on again, I’m hopeless.”

If you talk to yourself in a positive way, what do you think happens to your state? What happens to your confidence? It soars doesn’t it? Your unconscious mind then hears how great you are and must do what ever it takes to be congruent with your identity, therefore it has to do what it takes to make you great. If it hears that you’re a failure, it has to make you a failure.

So the words that you speak to yourself with are absolutely key in every area of your life, including your body shape and weight.

The unconscious mind needs to be spoken to in the positive as it does not recognise negatives. Let me demonstrate that to you really quickly. Right now don’t think of a pink elephant. Don’t think of it. What did you immediately think of? Yep, right before you switched your thoughts you thought of a pink elephant! So, when setting targets be sure to tell it what you want not what you don’t want otherwise what you don’t want is what you’ll get.

Set clear goals for your health and weight. For instance I want to be Xstone and Ylb instead of I want to lose xxxx lbs. I want to be able to run this distance instead of I don’t want to be tired any more. Get the idea? Great. Along side those clear goals write down what it means to have achieved those goals, as if you already have. What has it given you? How do you feel? How does it affect those around you?

Equally, if you don’t reach them what will it cost you in terms of who you are, how you feel? How you look? How is your self-esteem now? Really get some leverage on yourself here.

Finally, only share your goals with people who will support you through the ups and downs, cheer you on and challenge you, remind you why you’re doing it and tell you how proud they are of you. You become the people that you spend the most time with so pick your peers carefully.

There is so much more to learn about how your unconscious mind can support you in reaching your health and weight goals. I hope that you’ll look out for more information here and ask me about it if we meet.

For further information about this subject, coaching on health issues or training events contact:-

Tracey Dowe

Email Tracey.dow@momentumpeople.co.uk

www.momentumpeople.co.uk

Tel: 01793 700929