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Vitamin D supplements - supporting people who receive adult social care

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Meeting nutritional and hydration needs

Meeting nutritional and hydration needs is governed by regulation 14 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People who use services must have adequate nutrition and hydration to sustain life and good health. This regulation aims to reduce the risks of malnutrition and dehydration for people who receive care and treatment.

Providers must make sure that people have enough to eat and drink to meet their nutrition and hydration needs. This includes support to take nutritional supplements.

What is vitamin D?

Vitamin D is a fat-soluble vitamin made in the skin by the action of sunlight. This is the main source of vitamin D for most people. Vitamin D is also present in some foods such as egg yolks, oily fish, mushrooms, red meat and fortified breakfast cereal or margarine.

A lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain in adults.

Some people may be prescribed a high dose vitamin D to treat deficiency or in combination with calcium to treat osteoporosis. People who have been diagnosed as deficient in vitamin D and prescribed a high treatment dose should continue to take their prescribed vitamin D.

Over the counter vitamin D supplements

To protect bone and muscle health, Public Health England (PHE) recommends an average daily intake of 10 micrograms.

Some people will not get enough vitamin D from sunlight because they have little or no sunshine exposure. PHE recommend that some people take vitamin D supplements throughout the whole year, including:

  • people who live in a care home
  • people who are not often outdoors, for example because they are frail or housebound
  • people whose clothes cover most of their skin when outside

People from ethnic groups with darker skin pigmentation may also need to take vitamin D all year, as they may not produce enough vitamin D, even if they spend time out of doors.

There have been some reports about vitamin D reducing the risk of COVID-19. There is not enough evidence to prove that it helps prevent or treat COVID-19. But as more evidence is gathered national guidance may change.

Care at home

People on the clinically extremely vulnerable list will be invited to opt in to have a supply delivered to their homes.

For people who cannot get this supply, you should support them to self-care. Help them to access over the counter products and nutritional supplements.

You must assess and meet the person’s individual support needs for them to be able to take a vitamin D supplement.

Care homes

In early 2021, all care homes in England will get four months' worth of vitamin D supplements. Find out more about the government's announcement

You should consider how to support people to continue to take vitamin D when the free supplies end.

Considerations for providers

CQC expects providers to support people’s full nutritional needs. This includes supplementation with vitamin D throughout the year as recommended by PHE.

You may need to speak to a GP or healthcare professional to check if vitamin D is safe for some people. You should do this at their next appointment. Find out how to take vitamin D supplements safely.

Make sure you have a policy to support people to take a vitamin D supplement. The policy should include how staff record the support they give people to take vitamin D. Examples of where to record administration include:

  • medicines administration record (MAR)
  • daily notes
  • nutrition or dietary records.

Care plans should include how staff will support people to take vitamin D. Staff should consider people’s religious beliefs, dietary preferences, intolerances or allergies, and swallowing difficulties.

People should be supported to self-administer vitamin D supplements if they want to and it is safe for them to do so.

Care staff must only administer vitamin D to people when they have agreed to take it. Some people receiving care may not be able to make an informed decision. You should use the five key principles under the Mental Capacity Act 2005 and apply the Code of Practice to make a best interest decision.

Last updated:
18 January 2021