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Inspection report

Date of Inspection: 6 May 2014
Date of Publication: 26 June 2014
Inspection Report published 26 June 2014 PDF

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

Meeting 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 6 May 2014, observed how people were being cared for and talked with carers and / or family members. We talked with staff, reviewed information sent to us by other authorities and talked with other authorities.

Our judgement

People were protected from the risks of inadequate nutrition and dehydration.

Reasons for our judgement

Relatives that we spoke with said that the food was, “Very good. They get well fed here.” Another said, “it looks and smells good and (the person) likes it.”

They said that the kitchen staff were, “Very good” and told us that the service made a birthday cake for every person using the service. One relative told us about the special diet a person needed for health reasons and that they were happy that their needs were met with food that they liked and kept them healthy. This showed us that relatives thought the food was good and suitable for the people that they cared about.

We saw that a nutritional risk assessment had taken place for all of the people using the service. This included weighing each person, and had been repeated each month. Where people had an identified risk of malnutrition, they had been referred to a dietician. We saw that several people received prescribed nutritional supplements. Some people using the service had been assessed for the risk of choking on food by a speech and language therapist. We saw that some people needed soft or pureed diets and thickened fluids. This was shown on a notice board in the kitchen and matched the details in people’s care plans which we checked. This showed us that appropriate risk assessments had taken place and that care plans were in place when risks were apparent.

During our visit we took the opportunity to observe lunch in the dining room of Elgar floor. There was age appropriate music playing which enhanced the environment. A visitor told us that the music used to be loud and modern radio station but that it had changed to CD's that people liked. There were seventeen people in the dining room sitting around five dining tables. Each table had a tablecloth and matching napkins. Most people wore a bib which was of the same material as the tablecloth. Staff did ask people before helping them with bibs but we did not see that anyone replied. This showed us that the service tried to promote people’s dignity while preventing food from soiling people’s clothing. There was a carer at three of the tables helping a person to eat. Two relatives were helping other people. Some people were able to eat food without help and some needed prompting to eat. A registered nurse supervised lunch and directed carers to help people in the dining room and those who chose to remain in their bedrooms.

We noted that each person’s food was put on a plate individually. Food was not served for people who needed help until a carer was available to help them. The carer serving the food checked the notice board in the kitchen to ensure that each person received the appropriate meal. The notice board included details of anything that individual people could not or preferred not to eat. This showed us that people were helped to receive food that they liked, in a way that was safe for them.

We saw that people who could eat without help were encouraged to finish their meal and offered alternatives if they did not likje something. We observed that after helping a person to eat, carers completed a record of the food and fluids that the person had received. This is good practise which allows senior staff to review nutrition and hydration of people using the service and determine if people have received enough, appropriate food for their needs.

We saw that in the kitchen where food was served from, staff had access to up to date ‘texture descriptors’ for both food and fluids. This enabled them to serve food that met with the correct textures prescribed by speech and language therapists to prevent the risk of people choking on it.

We saw that fresh fruit was available in the dining room all day. People were able to help themselves, and we saw that people who were able to walk independently did this. We also saw care staff take fruit to people who could not walk alone.

We later spoke with the chef in the main kitchens. We saw that food was stored appropriately with due regard to hygiene to preventing