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Airedale General Hospital Requires improvement

All reports

Inspection report

Date of Inspection: 13 April 2011
Date of Publication: 2 June 2011
Dignity and Nutrition Report published 2 June 2011 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

Our judgement

Staff are ensuring that patients receive a full assessment of their nutritional requirements and that these are addressed and regularly reviewed. Staff we spoke to are well trained to provide support for patients to eat and drink and were attentive and considerate in providing this support. Adherence with the protected mealtime policy was good.

User experience

Patients were happy with the quality of food overall and commented that staff were always at hand to assist them if required. They told us that there was a good choice of food and staff had asked about their food and drink likes and dislikes. One person commented 'good food, plenty to eat and nicely presented'. Staff always checked if they have had enough to eat and often second helpings were offered.

Other evidence

We observed the protected meal-time in two wards. We saw that patients on both wards were prepared ready to receive their lunch and staff members encouraged patients to get out of bed where possible and ensured they were sitting comfortably while eating lunch. We saw that the opportunity for patients to clean their hands prior to and following lunch was only offered on one of the two wards we visited. We also saw prior to and during the serving of the lunches, the majority of staff washed their hands appropriately and wore protective clothing correctly throughout. However two members of staff on one ward were not seen to wash their hands prior to serving the lunches and another staff member of staff on the same ward failed to put on an apron prior to entering an isolation room.

We were told that patient transfers are avoided during protected mealtimes wherever possible. The managers on each ward produce daily figures on the numbers of patients requiring assistance with feeding and these figures are submitted to the acting chief nurse. As a result a team of staff are mobilised to the area with greatest need to ensure that all patients receive adequate dietary and fluid support at mealtimes. We saw evidence of this on one of the wards we visited. The majority of staff assisting patients with their meal undertook this duty with dignity and respect; however we did see one member of staff remain standing this was due to the fact that this was a 'trial feed' and required the patient to be supervised rather than assisted with feeding.

All of the care records we looked at provided details on the assessment of the individual's nutritional health, swallowing SIP assessments and described the feeding plans. We saw evidence of referrals and involvement of clinical specialists, for example dieticians and speech therapists as a result of these assessments.

Staff told us they use bespoke food and general fluid balance charts to monitor the patients daily nutrition and hydration intake. The malnutrition scoring tool (MUST) is used weekly for nutritional screening and monitoring and patient weights are recorded weekly. We saw evidence of this recorded within the multi-disciplinary care plans. Staff also told us that they undertake monthly audits on a minimum of twenty fluid balance records set against a number of key priorities and the outcomes from these audits are fed back to each area for action as required.

Information that the trust provided shows guidelines and audits used for nutritional screening and monitoring and included outcomes from their nutrition screening assessments and annual nutrition survey.

There were no concerns highlighted in the patient survey data for this outcome and the trust was given a Food Hygiene Rating of good 4 stars, by Bradford Metropolitan District Council on the 15th June 2010.