Posted tagged ‘health’

Esential Standards Outcome 5c – Nutrition

February 29, 2012

 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?

 

 

What CQC outcomes say about Eating and nutritional care:

February 15, 2012

A reminder from last time….. 

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.

Outcome 5A had so much to think about we split it it down further so here is the rest of 5A to explore further…….

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

●● They have food and drink that:
— are handled, stored, prepared and delivered in a way that meets the
requirements of the Food Safety Act 1990
— are presented in an appetising way to encourage enjoyment
— are provided in an environment that respects their dignity
— meet the requirements of their diverse needs
— take account of any dietary intolerances they may have.
●● They can be confident that staff will support them to meet their eating and
drinking needs with sensitivity and respect for their dignity and ability.

Here’s a suggestion from Social Care Institute for Excellence…

Use a ‘discreet sign’ for people who need assistance with meals

Use a discreet signal to indicate that someone needs assistance with eating, for example a different coloured tray. This saves people the embarrassment of having to ask, or of being asked, if they need help.

This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

For example, this idea has been put into practice in hospitals, where using a red tray provides an effective signal to staff without compromising the patient’s dignity. The system is being monitored and refined, but has been found helpful in promoting individual care.

A daily updated list of patients due to receive food on red trays can be included in shift handovers and provided for kitchen staff. A red tray is also a simple reminder to staff to check the patient’s notes for guidance on any specific help or nutritional needs. In several hospitals, the red tray system has been linked with protected mealtimes.
●● They are enabled to eat their food and drink as independently as possible.

There are lots of eating and drinking independent living aids available that will really support this type of independence.

●● All assistance necessary is provided to ensure they actually eat and drink,
where they want to but are unable to do so independently.

Use the ‘knife and fork’ symbol 

Placing a knife and fork symbol near someone’s bed is an easy way to help staff identify which people need support during mealtimes.

This idea can be used in different settings – so seeing how someone else has done it can be useful to you, even if they work in a different area of care.

For example, this idea has been put into practice by United Bristol Healthcare NHS Trust.
●● They have supportive equipment available to them that allows them to eat
and drink independently, wherever needed.
●● They are helped into an appropriate position that allows them to eat and
drink safely, wherever needed.
●● They are not interrupted during mealtimes unless they wish to be or an
emergency situation arises.
●● They will have any special diets or dietary supplements that their needs
require arranged on the advice of an appropriately qualified or experienced
person.
●● They have access to specialist advice and techniques for receiving nutrition
where their needs require it.
●● The service takes into account relevant guidance, including that from the
Care Quality Commission’s Schedule of Applicable Publications (see
appendix B).

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.