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Nutritional Screening in Care Homes (England) Policy

Policy Statement

The home’s policy ensures that all people who use the services always have their full nutritional needs met. We respect each person’s right to choose what he or she does and does not eat and drink, but there is a clear duty of care on us to ensure that they are offered a nutritious diet that takes into account any specific medical or other factors that could affect the quality of their nutrition and wellbeing.

This policy is in line with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 14: Meeting Nutritional and Hydration Needs, which requires care providers to carry out nutrition and hydration assessments to ensure the needs of people who use the services are fully met. Such assessments must be carried out in line with recognised guidance by competent persons and identify, as a minimum:

• requirements to sustain life, support the agreed care and treatment, and support ongoing good health
• dietary intolerances, allergies, medication contraindications, etc
• how to support people who use the services’ good health including the level of support required, timing of meals, and sufficient quantities of food and drink.

Guidance accompanying the Regulations suggests that reassessments of nutrition and hydration needs should be carried out during the course of care and any changes in individuals’ needs responded to in a timely manner.

Assessment

We aim to ensure that all people who use the services maintain an adequate level of nutrition by:

• providing a wide range and variety of food and drinks at mealtimes and other times that enable anyone to follow a varied and balanced diet in accordance with their preferences, likes and dislikes, including the provision of snacks and drinks outside of mealtimes as people who use the services require
• ensuring that each person’s dietary needs are fully assessed together with their food preferences, which then form an integral part of their service plan
• catering for specific dietary needs that are medically based, such as gluten-free food, or those based on individual preferences, such as non-meat-based diets
• ensuring that full nutritional balance values are provided for every person’s dietary plan
• regularly monitoring and reviewing each person’s dietary plan
• encouraging and involving people who use the services to seek and receive help with any eating and drinking difficulties
• fully assessing any risks that people might face through receiving inadequate and insufficient nutrition, and taking appropriate actions to reduce the risk to the person’s welfare and general sense of wellbeing
• involving GP and other professionals such as dieticians and Speech and Language Therapists (SALT), in nutritional assessments and the preparation and implementation of a dietary plan where this is indicated or needed as a result of current or emerging medical conditions or observed changes in eating and drinking behaviour.

Procedures

1. On referral, we note each person’s dietary history and current needs in order to identify the home’s capability to address and meet these. Our ability to do so may influence our ability to accept the person for entry to the home.
2. We ensure that personal dietary preferences and any special needs are identified in the initial assessment and care plan and that arrangements to address these are made. This will include the details of any food allergies or intolerances.
3. We also identify any risk factors associated with the person’s dietary history and current eating and drinking patterns based on, for example:
   a. current conditions
   b. recent illnesses
   c. recent weight loss or gains or fluctuations
   d. evidence of nutritional advice having been given
   e. physical difficulties in eating and drinking.
4. Depending on the person we may seek medical and professional dietary advice to help with the nutritional assessment.
5. Also depending on the outcome of the assessment a nutritional risk management plan is devised and included in the person’s care plan.
6. Key workers and care staff are briefed to monitor, observe, record and report any significant changes or variations in eating and drinking behaviour and patterns that occur in relation to the identified dietary plan.
7. Interventions may be made to address any particular problems that arise such as persistent refusal to eat, overeating or behaviour that goes against medical advice. These will always involve discussion with the person receiving care, and possibly relatives and representatives to identify the source of any difficulties and how they can be resolved.
8. Any such changes to the person’s care plan, including revisions to the risk assessment, will be agreed, recorded and subsequently monitored and reviewed in accordance with review policies.

Training

All staff receive training in healthy eating and drinking and to observe, report and record any risks to people who use the services from poor eating and drinking, which might lead to weight loss and malnutrition, including signs of self – neglect.

Staff carrying out nutrition and hydrations needs assessments and risk assessments receive the appropriate training and h guidance.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next review date: this policy is reviewed annually (every 12 months). When needed, this policy is also updated in response to changes in legislation, regulation, best practices, or organisational changes.

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