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Archived: Royal Mencap Society - 12 Wales Street Requires improvement

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Inspection report

Date of Inspection: 3 February 2014
Date of Publication: 4 March 2014
Inspection Report published 04 March 2014 PDF

Food and drink should meet people's individual dietary needs (outcome 5)

Not met this standard

We checked that people who use this service

  • Are supported to have adequate nutrition and hydration.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 3 February 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

The provider has not met this regulation. People were not fully protected from the risk of inadequate nutrition.

Reasons for our judgement

We spoke with two people. They said that the food they got was good.

We spoke with a relative. The relative said there had been no concerns about the food; ‘I have never heard anything bad about the food’.

We saw a staff member giving people the opportunity to help to prepare a meal. This told us that people’s independence was encouraged.

We looked at a care plan for a person with nutritional needs. This person had been assessed as at risk of losing weight. There was detail in the plan regarding a referral that had been made to the dietician to meet this need.

The dietician had recommended different things to meet the person's needs. For example, there was encouragement to eat a healthy diet. The plan contained details of types of food that the person disliked. However, there was no information about food that the person liked. This may have helped staff to encourage the person to eat more food. Staff told us they knew what the person liked eating. However, there was no evidence of this. The manager later sent us information about foods that the person liked to eat.

We saw the person eating her breakfast. Staff had encouraged her to eat scrambled eggs on toast. However, this encouragement was only carried out once, because the staff member was busy. We saw that over half of the meal had been left uneaten.

We found that there were occasions when there had only been one staff member on duty. The manager stated that another person was to be admitted into the home the following month. There would then be two staff members on duty during the day and evening, when everyone was in the home. He agreed to review this issue. The manager later sent us information that two staff members would be on duty in the early morning period. This will help to ensure people's needs can be fully met.

There was other relevant information available to meet this person’s needs. This included having a food diary to see what the person ate and drank. However, on occasion, this only recorded that the person had a hot drink. The information did not include the reason why the person had not eaten food at these mealtimes, which may have helped the dietician to provide a more comprehensive care plan to staff to me this person's needs. The manager agreed this was needed and this would be followed up. The diary had also not measured actual food intake. This would indicate when staff needed to make a swift referral to medical personnel to obtain further support. We were later sent information contained in the person's health action plan, to instruct staff to record all food that was eaten.

Charts to record the person’s weight had been in place. However, this did not include a direction as to when staff should refer to medical services if the person had lost a certain amount of weight. For example, over a seven week period from October 2012, the person lost seven pounds in weight. There was no indication as to what action was taken to refer this issue to the appropriate medical professional, although we saw evidence that the person had been properly referred on a number of other occasions.