By Debbie le Quesne

Food for thought . . . but what else might be on the menu?

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Residents in care homes are happier and more alert if they are well fed.

But according to one report in the Press this week this week there is a growing problem of older people becoming malnourished in care because ”many residential care homes are small family-run establishments.”

Already I am struggling to make the connection here.

Now the Food First project, led by two registered dietitians based at Bedfordshire primary care trust (PCT), now part of South Essex partnership trust (SEPT), aims to address the root causes of the condition.

Quoted in The Guardian on Tuesday, Cathy Forbes, an advanced specialist dietitian and Food First project lead, says: “Over the last few years, the medicines management team at the PCT realised that spending on oral nutritional supplements [for older people], which are mainly prescribed by GPs, was increasing steeply, and we were looking for ways to control costs.

“We realised that the best way to reduce the need for oral supplements was to ensure that care homes were providing a high standard of dietary intake for residents.

“We also quickly understood that in only tackling the issues around inappropriate prescribing, we were just ‘sticking a plaster’ over the problem of malnutrition and not addressing the real issues.”

Ms Forbes helped to set up a scheme to support staff working with vulnerable people across health and social care. It includes drawing up individual nutritional care plans for people in care homes and allowing staff to change a person’s diet.

I can’t help feeling we are trying to re-invent the wheel here. Already nutritional screening in all care homes exists – a demand by CQC.

As I understand it, anyone who loses weight in care gets an automatic referral to a dietician. And don’t most homes use the MUST tool as a matter of course in helping to assess the dietary needs of residents?

I need some more evidence how the new mechanism can help . . . and maybe this is it:

Nympha Castillo, a senior carer at the Little Bramingham Farm care home in Luton, which has 24 residents, says it has benefited hugely from working with the Food First team.

She is quoted as saying: “We have a number of residents who are regarded as at high risk from malnutrition, and in the past we’ve used oral supplements with these residents.

“But since we’ve redesigned our menus to give better nutritional content, we’ve had to use these much less. Our residents also seem much more alert and enjoy their food more.”

As part of the programme, the Food First team has a regular system of inspections of care homes’ food standards. Working with the managers and they visit homes on a weekly or fortnightly basis to check that standards are being maintained and to advise on solving any problems.

Homes which offer good nutritional practice are given a certificate.

And who is footing the bill? The project has been funded by the medicines management teams in Luton and Central Bedfordshire PCTs, which oversee prescribing in the residential and nursing home sectors.

Already in 2011-12 SEPT some £200,000 has been saved in prescribed supplements.

The programme, which was set up in 2009, has now been extended to three PCT areas. As a result of working with the team, 95 per cent of care homes in the three areas have improved the nutritional standards of their food and have seen improvements in residents’ health.

While I welcome this initiative, I must air my concerns that the term inspection is used when referring to the delivery of advised dietary programmes. Inspections by definition carry a weight of authority. With moves afoot for CQC to delegate some of its responsibilities, it this yet another tier of regulation in the making? I sincerely hope not.


Written by debbielq

October 3, 2012 at 9:19 pm

Posted in Uncategorized

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