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CH197-Food and Drinks Management Policy

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Food and Drinks Management Policy

1. Purpose

The purpose of this policy is to ensure that all people using the service receive safe, sufficient, suitable and person-centred support with food, drink, nutrition and hydration, in a way that protects their health, safety, dignity, choices, independence and human rights.

This policy sets out how {{org_field_name}} will assess nutritional and hydration needs, plan care, obtain and record consent, manage risks, provide or support access to suitable food and fluids, monitor intake where required, escalate concerns promptly, keep accurate records, and work with relevant professionals and families or representatives where appropriate.

This policy supports compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including in particular Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 14 (Meeting nutritional and hydration needs), Regulation 17 (Good governance), Regulation 18 (Staffing), Regulation 19 (Fit and proper persons employed) and Regulation 20 (Duty of candour).

2. Scope

This policy applies to all employees, agency staff, bank staff, temporary staff, managers, team leaders, assessors and any other workers involved in assessing needs, planning care, preparing or serving food and drink, supporting people to eat or drink, monitoring intake, keeping records, or escalating concerns.

In a care home setting, this policy also applies to kitchen, catering and domestic staff where their role affects food safety, meal provision, allergens, texture modification, food presentation or hydration support.

It applies to people who are fully independent, people who need prompting or supervision, people who require physical assistance, and people with specialist nutritional, hydration, allergy, medical or swallowing needs.

3. Related Policies

4. Policy Statement and Principles

4.1 Person-Centred Nutrition and Hydration Assessment and Care Planning

Each person must have their nutritional and hydration needs assessed before care starts, on admission where relevant, and whenever their needs change. The assessment must identify usual eating and drinking patterns, likes and dislikes, cultural, religious and ethical preferences, allergies, intolerances, weight history, appetite, oral health, swallowing ability, communication needs, physical ability to eat and drink independently, medical conditions affecting nutrition or hydration, and any risks of malnutrition, dehydration, choking or aspiration.

Care and support must be planned in partnership with the person wherever possible. Where the person has difficulty making decisions, staff must act in accordance with the Mental Capacity Act 2005 and record how consent was obtained or, where appropriate, how best-interest decisions were reached.

The care plan must clearly state what support is required, including preferred meals, portion sizes, texture, fluid consistency, equipment required, level of assistance, timing of meals and drinks, monitoring arrangements, risks, escalation instructions, and any professional advice from the GP, dietitian, SALT or other clinician.

Care plans must be reviewed regularly and immediately after any significant change, including poor intake, weight loss, dehydration, illness, swallowing concerns, hospital discharge, medication changes, or refusal of food or drink.

4.2 Promoting Dignity, Choice and Independence

Food and drink support must be provided in a way that promotes dignity, choice and independence. Where possible, individuals are encouraged to participate in selecting, preparing, and serving their own meals. Staff must always respect preferences and routines, avoiding assumptions or imposing personal views on diet. Mealtimes should be relaxed, unhurried, and suited to the individual’s lifestyle. People we support should never feel rushed, ignored, or restricted in their eating and drinking choices unless there are valid clinical reasons assessed by health professionals. Staff must make reasonable adjustments to support informed choice, including adapting communication, pacing, utensils, meal presentation, environment and support methods to meet the person’s needs.

4.3 Safe Preparation, Handling, Serving and Storage

Food and drink must be prepared, handled, stored and served safely at all times. Staff must follow food hygiene, infection prevention and control, and allergen management requirements. This includes effective hand hygiene, clean equipment and surfaces, separation of raw and ready-to-eat foods, checking use-by dates, maintaining safe storage temperatures, ensuring food is reheated thoroughly where appropriate, and disposing of unsafe or out-of-date items.

Known allergies, intolerances and special dietary requirements must be clearly recorded in the care plan and communicated to all relevant staff. Staff must check labels, packaging and instructions before offering food or drink, and must not guess whether an item is safe.

In a care home, the service must maintain clear arrangements for kitchen-to-care communication so that changes in diet, allergies, texture or fluid requirements are implemented immediately.

Staff must only prepare texture-modified meals or thickened fluids where they have been trained, assessed as competent, and are following current professional guidance.

4.4 Swallowing Difficulties, Choking Risk and Specialist Support

Where a person is known or suspected to have dysphagia, choking risk, chewing difficulty or aspiration risk, staff must follow the latest professional guidance, including SALT recommendations and any hospital discharge instructions. The required food texture and fluid consistency must be clearly recorded in the care plan and communicated to all relevant staff.

No member of staff may alter the prescribed texture of food or thickness of fluids unless trained and assessed as competent to do so. Staff must remain alert to signs of difficulty such as coughing, choking, gurgly voice, pocketing food, distress, recurrent chest infections or refusal to eat, and must escalate concerns immediately for clinical review.

Appropriate positioning, pace, supervision, specialist utensils and oral care must be provided to reduce the risk of choking, aspiration and infection.

4.5 Monitoring, Recording and Escalation

Where a person is at risk of poor nutrition, dehydration, choking, aspiration, weight loss, pressure damage, infection, constipation, confusion, or deterioration linked to eating and drinking, the service must put proportionate monitoring in place. This may include food and fluid charts, weight monitoring, bowel monitoring, swallow observation, behaviour monitoring, and review of contributing factors such as illness, pain, medicines or mood.

Records must be accurate, complete, contemporaneous and signed or attributable to the member of staff completing them. Monitoring must not be a paper exercise; staff and managers must review the information promptly, identify trends and take action without delay.

Concerns requiring escalation include, but are not limited to, poor intake, repeated refusal, vomiting, diarrhoea, constipation, weight loss, signs of dehydration, suspected choking episodes, deterioration in swallowing, recurrent chest infections, sudden confusion, or any pattern suggesting neglect or unsafe care.

Escalation must be documented and may include informing the senior on duty, Registered Manager, GP, dietitian, SALT, district nurse, emergency services, family or lawful representative, depending on the level of risk and the person’s wishes and consent arrangements.

4.6 Specialist Diets, Medical Conditions and Clinically Prescribed Support

Where a person requires a specialist or therapeutic diet because of a medical condition, allergy, intolerance, swallowing need, religious requirement or clinician’s advice, this must be clearly documented in the care plan and followed consistently.

Staff must work within their competence and must not give nutritional or clinical advice beyond their role. They must follow the care plan, risk assessment and professional instructions, and seek further advice where there is uncertainty.

This includes support linked to diabetes, renal disease, fortified diets, supplements, modified textures, thickened fluids, weight management plans, pressure ulcer prevention, end of life care and any prescribed nutritional products. Any symptoms suggesting deterioration, imbalance, poor intake or unsafe care must be escalated promptly.

4.7 Hydration Support

People must be supported to maintain adequate hydration in line with their assessed needs, preferences and any clinical advice. Fluids should be offered regularly across the day and night where needed, with a choice of suitable drinks and support adapted to the person’s communication, cognitive, physical and swallowing needs.

Staff must be alert to increased hydration risks during hot weather, illness, infection, diarrhoea, vomiting, fever, poor mobility, use of laxatives or diuretics, and reduced appetite or cognition.

Signs of dehydration must be recognised and acted on promptly. Where thickened fluids are prescribed, only the prescribed consistency must be provided and the preparation method must be followed exactly.

4.8 Safeguarding, Neglect and Refusal of Food or Drink

Any concern that a person is not receiving adequate nutrition or hydration, is being denied food or drink, is not being supported in accordance with their assessed needs, or is experiencing neglect, self-neglect or unsafe care must be treated seriously and responded to without delay under safeguarding and risk management procedures.

Repeated refusal of food or drink must never be ignored. Staff must consider whether the person has capacity in relation to the decision, whether they are unwell, in pain, depressed, frightened, confused, approaching end of life, or experiencing swallowing problems, and must escalate concerns appropriately.

Any safeguarding concern, including suspected neglect or organisational failure to meet nutritional and hydration needs, must be recorded, reported and referred in line with local safeguarding procedures and internal policy.

4.9 Training, Supervision and Competency

All staff involved in supporting food and drink must receive induction, training and refresher training appropriate to their role. Training must cover, as relevant, nutrition and hydration, food hygiene, allergy awareness, safe feeding, dysphagia awareness, choking response, hydration risks, record-keeping, escalation, safeguarding, consent and the Mental Capacity Act 2005.

Staff must not undertake specialist tasks, including support with dysphagia, thickened fluids or texture-modified diets, unless they have received appropriate training and been assessed as competent.

The provider must maintain records of training, competency assessment, supervision and any actions needed to address gaps in practice. Staff performance in relation to nutrition and hydration support must be monitored through supervision, spot checks, audits and incident review.

4.10 Multi-Agency Working and Professional Input

{{org_field_name}} will work with relevant professionals, including GPs, dietitians, SALT, nurses, pharmacists and hospital teams, to ensure that nutritional and hydration support is safe, evidence-based and responsive to changing needs.

Where appropriate and with consent or other lawful authority, the service will also work with family members, advocates and others involved in the person’s care.

Professional recommendations, including discharge instructions, prescribed supplements, swallowing plans and risk management advice, must be incorporated into the care plan without delay and communicated to all relevant staff.

Following any significant incident or deterioration related to food or drink, the care plan and risk assessment must be reviewed promptly.

4.11 Consent and Mental Capacity

Food and drink support must be provided with the person’s consent wherever they have capacity to make the relevant decision. Staff must provide information in a way the person can understand and must respect lawful refusal, while also assessing and managing any associated risks.

Where there is doubt about a person’s capacity to make a decision about food, drink or associated care, staff must follow the Mental Capacity Act 2005 and related policy. Capacity assessments and best-interest decisions must be decision-specific, properly recorded, and involve lawful representatives, family members, advocates and relevant professionals where appropriate.

Staff must not use covert administration of supplements, thickening agents or modified food or fluids unless there is lawful authority and this has been assessed, agreed, documented and reviewed in accordance with policy and legal requirements.

4.12 Governance, Audit and Quality Assurance

The provider will operate effective systems to assess, monitor and improve the quality and safety of nutrition and hydration support. This includes regular audit of care plans, risk assessments, food and fluid charts, weights, incidents, choking events, referrals, training records, complaints, safeguarding concerns and feedback from people using the service.

Audit findings must be reviewed by management, actions must be assigned and followed through, and lessons learned must be shared with staff. Where audits identify gaps, the provider must take timely corrective action and record this clearly.

Records relating to nutrition and hydration must be secure, accurate, complete, contemporaneous and readily available to relevant staff.

4.13 Openness and Duty of Candour

Where a nutrition or hydration incident results in, or appears to result in, significant harm, distress or a notifiable safety incident, {{org_field_name}} will act in an open and transparent way with the person and, where appropriate, their lawful representative or relevant person.

This includes explaining what is known, apologising, explaining what immediate action has been taken, investigating appropriately, keeping clear records, and sharing outcomes and learning in line with the Duty of Candour Policy and regulatory requirements.

4.14 Mealtime Standards in the Home

The home will provide regular meals, snacks and drinks at times that reflect people’s needs and preferences, including access to drinks and light snacks between meals and overnight where required.

Mealtimes must be calm, respectful and sufficiently staffed so that people receive the level of support they need without feeling rushed. The dining environment must be clean, comfortable and suitable for people’s communication, mobility, sensory and cognitive needs.

Alternative meal choices must be available where a person dislikes the main option or where cultural, religious, ethical or clinical needs require this.

5. Policy Review

This policy is reviewed annually or earlier if there are changes in legislation, CQC guidance, or best practice. Staff are informed of updates and training refreshed where necessary.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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