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Dimensions 2 Buckby Lane Good

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Inspection report

Date of Inspection: 3 July 2014
Date of Publication: 19 August 2014
Inspection Report published 19 August 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 3 July 2014, observed how people were being cared for and spoke with one or more advocates for people who use services. We talked with people who use the service, talked with carers and / or family members and talked with staff.

Our judgement

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

Reasons for our judgement

We found that people had been supported to receive adequate nutrition and hydration. The manager told us that a nutritional assessment had been completed to establish people’s dietary and hydration needs. We saw these recorded in people’s nutrition plans. This meant that the provider had identified where people were at risk of poor nutrition and dehydration.

Relatives of people told us that staff knew what people liked and disliked and always listened to them. Staff told us that the menu was reviewed frequently. Choices were made by people on a weekly basis with their key worker using photographs of their favourite foods. On the day of our inspection we observed people choosing and eating their breakfast. We saw that each person made a choice which they communicated to staff in different ways. For example one person indicated their choice using facial gestures, another person communicated their preferred option using sign language, whilst another went into the kitchen and was supported to prepare their chosen breakfast. This meant that the service had ensured that people could choose a balanced diet relevant to them.

We saw menus showing the meals that were offered. These showed that consideration had been given to the variety of different needs of people living in the service. Where people had difficulties with eating or swallowing the menus had been tailored to reflect this. We saw that the menu readily identified who enjoyed which meals and where people required a different alternative. We saw that the service had nutritional profiles of each person, which identified their preferences and any particular food allergies.

During the inspection we observed people communicated with staff to request drinks and noted that staff provided these or supported the person to make them. This meant that people were given a choice of suitable and nutritious food and drink, which met their diverse needs.

Care records we read showed that people had dietary plans which had been reviewed by speech and language therapists to ensure people’s health and wellbeing. They also demonstrated that people had been weighed monthly to monitor any significant weight gain or loss. We noted that the weight charts had been analysed by the service and that any concerns had been raised with the person’s GP.

Staff told us how they recorded what people had consumed, which we saw in their daily records. We also noted that staff had recorded when meals and fluids had been declined and the reasons for this. We saw that where people had a risk of choking, this had been identified in their care plan. There was clear guidance for staff on how to support this person to minimise the risk of choking. We saw staff providing support to this person in accordance with this guidance whilst they were eating their breakfast and lunch. This meant the provider had identified any nutritional risks and had implemented measures to manage them.

People were supported to be able to eat and drink sufficient amounts to meet their needs. We observed staff supported people with sensitivity and respect during the lunchtime meal. We saw one person enabled to use supportive equipment, in accordance with their nutrition plan. We found that people had been enabled to eat and drink as independently as possible. For example, we saw one person identified at high risk of choking, was supported to eat and drink safely. We noted that this was in accordance with guidance within their nutrition plan. We saw a person who could not communicate verbally inform the care worker that they were not enjoying their meal. The care worker then discussed other options with them before preparing a different meal of their choice.

We observed that meals had been presented in an appetising way to encourage people’s enjoyment. The staff involved in food preparation knew about the benefits of a balanced diet and had read the guidance within people’s nutrition plans. We found that all staff had completed t