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Registration Number: {{org_field_registration_no}}

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Mealtimes Policy

1. Purpose

The purpose of this policy is to ensure that all residents at {{org_field_name}} experience enjoyable, nutritionally balanced, and person-centred mealtimes that respect their individual dietary needs, cultural preferences, and personal choices. This policy sets out how our care home supports residents to have safe, social, and dignified mealtimes, promoting well-being and independence in line with Care Inspectorate Wales (CIW) regulations.

This policy aims to:

• Ensure nutritional and hydration needs are met, supporting overall health and well-being.
• Create a positive mealtime experience that enhances quality of life.
• Promote resident choice and independence, considering individual dietary preferences.
• Maintain high standards of food hygiene and safety.
• Provide staff with clear guidance on assisting residents with eating and drinking.
• Comply with The Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 and best practices in nutrition and hydration.

2. Scope

This policy applies to:

• All residents, ensuring meals are tailored to their needs and preferences.
• All staff, including care workers, kitchen staff, and management.
• Visitors, ensuring mealtime arrangements accommodate family engagement.
• External professionals, such as dietitians and speech therapists, where required.

3. Related Policies

This policy aligns with:

• Meeting Nutritional and Hydration Needs Policy (CHW12)​.
• Safe Care and Treatment Policy (CHW11)​.
• Infection Prevention and Control Policy (CHW17)​.
• Dignity and Respect Policy (CHW08)​.
• End of Life and Palliative Care Policy (CHW38)​.

4. Mealtime Experience and Environment

Mealtimes are a social and enjoyable experience for residents. Staff must ensure that:

• Dining areas are clean, comfortable, and free from distractions.
• Tables are set attractively, using appropriate cutlery and tableware.
• Assistance is discreet and respectful, maintaining residents’ dignity.
• Residents are given ample time to eat without feeling rushed.
• Where possible, residents are encouraged to eat together to promote social interaction.
• Residents who prefer privacy may eat in their own rooms.

Residents are encouraged to be involved in menu planning, table setting, and choosing where they sit, where appropriate.

5. Choice, Independence, and Personal Preferences

5.1. Resident Preferences and Cultural Needs

• Menus reflect diverse cultural, religious, and personal preferences.
• Residents can choose from multiple meal options at each mealtime.
• Meals are prepared in accordance with dietary restrictions, including vegetarian, halal, kosher, and allergen-free options.
• Residents can request alternative meals if they do not like the main choices.

5.2. Encouraging Independence

• Adaptive cutlery and crockery are provided for residents with mobility difficulties.
• Residents are supported to eat independently where possible.
• Hand-over-hand support or assistance is provided only when required.

5.3 Language and Communication Needs

The service will take reasonable steps to meet each resident’s identified language and communication needs when supporting them to choose food and drink and during mealtimes.

• Information about menus, meal choices, dietary requirements and eating and drinking support must be communicated in a language, style, presentation and format that the resident can understand.
• A resident’s preferred language and communication needs, including Welsh-language needs, must be identified and recorded in their personal plan.
• Residents who wish to communicate in Welsh must be supported to do so in accordance with their identified language needs and the service’s Welsh-language arrangements.
• Where a resident requires communication aids, equipment, pictures, symbols, easy-read information or another communication method to understand meal choices or communicate their preferences, these must be made available as required.
• Staff must use the resident’s identified communication method when offering meal and drink choices and when providing eating and drinking support.

6. Nutritional and Hydration Support

6.1 Assessment and Nutritional Support

Each resident’s nutritional and hydration needs must be assessed as part of their assessment and personal planning arrangements. Where assessment of nutritional or hydration risk is required, this must use a nationally recognised, evidence-based assessment or screening method appropriate to the resident.

The resident’s personal plan must clearly record their identified nutritional and hydration needs and any support required, including:

• normal dietary requirements and preferences;
• food allergies and intolerances;
• cultural, religious or ethical dietary requirements;
• support required to eat and drink;
• risks of malnutrition, unintended weight loss or dehydration;
• swallowing difficulties and any associated choking or aspiration risk;
• required food texture or fluid consistency;
• prescribed or professionally recommended specialist diets;
• requirements for fortified food, nutritional supplements or additional snacks and drinks, where applicable; and
• any monitoring or professional follow-up required.

Meals and drinks must be provided in accordance with the resident’s assessed needs and personal plan. Healthy choices of food and drink must be available and promoted while respecting the resident’s individual choices, preferences and personal outcomes.

Where specialist dietary treatment, food preparation, nutritional supplementation, modified food texture or modified fluid consistency has been prescribed or recommended by an appropriate healthcare professional, staff must follow the current instructions recorded in the resident’s personal plan.

6.2 Monitoring Nutritional and Hydration Risk

Where a resident has been identified as being at risk of malnutrition, unintended weight loss, inadequate nutritional intake or dehydration, the service must ensure that appropriate monitoring arrangements are implemented.

Depending upon the resident’s assessed needs, this may include monitoring and recording:

• weight and changes in weight;
• food and nutritional intake;
• fluid intake;
• signs and symptoms of dehydration or deterioration;
• the resident’s ability to eat and drink safely; and
• the effectiveness of any nutritional or hydration intervention.

Monitoring must be undertaken at a frequency appropriate to the resident’s assessed level of risk and in accordance with their personal plan and any professional advice.

Staff must take timely remedial action where monitoring identifies concerns or where concerns persist. Appropriate medical or specialist advice must be sought without unnecessary delay where required.

Any significant change in the resident’s nutritional or hydration needs must trigger a review of the relevant assessment and personal plan.

Residents must be offered drinks regularly and must have access to suitable fluids throughout the day and night, taking account of their individual needs and preferences. Staff must provide assistance where required.

Where a resident requires thickened fluids or another modified fluid consistency because of swallowing difficulties, these must be provided strictly in accordance with the current assessment and recommendations of the appropriate healthcare professional.

7. Supporting Residents with Eating and Drinking

7.1. Assistance with Eating

Some residents may require assistance with meals. Staff must:

• Offer support in a respectful and patient manner.
• Position residents correctly to eat comfortably and safely.
• Encourage self-feeding where possible, providing prompts instead of direct feeding unless necessary.
• Be trained in dysphagia (swallowing difficulties) and how to support residents safely.

7.2. Dysphagia and Modified Diets

• Residents with swallowing difficulties are assessed by a Speech and Language Therapist (SALT).
• Food textures and fluid consistencies are adjusted following International Dysphagia Diet Standardisation Initiative (IDDSI) guidelines.
• Staff are trained to recognise signs of choking and how to respond.

7.3. Supporting Residents with Dementia

Residents with dementia may need extra support to eat and drink, including:

• Visual meal presentation (contrasting plates, finger foods for easier handling).
• Gentle reminders and encouragement throughout the meal.
• Minimising distractions to help residents focus on eating.

8. Special Dietary Requirements

Each resident’s dietary requirements must be assessed and clearly recorded in their personal plan. The personal plan must provide sufficient information to enable staff involved in preparing, serving or supporting the resident with food and drink to meet the resident’s assessed needs safely.

Where applicable, the personal plan must record:

• medical or health-related dietary requirements;
• diagnosed food allergies and intolerances;
• cultural, religious or ethical dietary requirements;
• any prescribed or professionally recommended specialist diet;
• food fortification or nutritional supplementation requirements;
• required food textures and fluid consistencies;
• eating and drinking assistance required;
• identified nutritional or hydration risks;
• relevant monitoring requirements; and
• current instructions or recommendations from relevant healthcare professionals.

Where specialist advice or treatment has been prescribed or recommended by an appropriate healthcare professional, including a dietitian, Speech and Language Therapist, registered nurse, GP or other relevant healthcare professional, the service must ensure that the current instructions are accurately reflected in the resident’s personal plan and followed by staff.

The resident’s personal plan must be reviewed whenever required and at least every three months. It must also be reviewed sooner where there is a significant change in the resident’s health, weight, nutritional intake, hydration, swallowing ability, dietary requirements or other assessed needs.

Following any relevant professional assessment or change in professional advice, the resident’s personal plan and associated dietary instructions must be reviewed and revised as necessary.

9. Food Hygiene and Safety

9.1 Food Preparation, Storage and Allergen Management

Food must be stored, prepared, handled, cooked, cooled, reheated and served in accordance with applicable food safety and food hygiene legislation and the service’s documented food safety management procedures based on Hazard Analysis and Critical Control Point (HACCP) principles.

Appropriate controls must be maintained for:

• safe food storage;
• prevention of contamination and cross-contamination;
• separation and handling of raw and ready-to-eat foods;
• appropriate cooking, cooling, reheating and holding temperatures;
• temperature monitoring and recording where required;
• cleaning and disinfection;
• safe management of food allergies and intolerances; and
• traceability and food safety information where applicable.

The service must identify and record residents’ known food allergies and intolerances and ensure this information is available to staff who purchase, prepare, serve or assist residents with food.

Accurate information about the presence of any of the 14 allergens required to be declared by food-information legislation must be available for food provided to residents.

For non-prepacked food, allergen information must be provided in accordance with the applicable legal requirements. Where allergen information is provided verbally, the service must ensure that appropriate written signposting is displayed and that the information provided is accurate, consistent and capable of being verified.

Where food is produced and supplied in circumstances in which it meets the legal definition of prepacked for direct sale food, it must be labelled with the name of the food and a full ingredients list, with allergenic ingredients emphasised as required by applicable food-information legislation.

Staff must ensure that information regarding a resident’s allergy or intolerance is checked against current ingredient and allergen information before food is provided. Changes to ingredients, recipes or substitute products must be checked before use.

9.2. Staff Training in Food Safety

• All kitchen and care staff complete Level 2 Food Hygiene Training.
• Staff handling food must follow strict hand hygiene and infection control measures.

10. Residents’ Rights, Choice, Consent and Dignity

Residents must be treated with dignity, respect and sensitivity and must be supported to exercise choice and control over their meals and dining experience.

Subject to any lawful restrictions arising from the resident’s assessed needs, capacity and applicable legal framework, residents must be supported to:

• express their food and drink preferences;
• choose between the meal options available;
• choose when and where they eat, where reasonably practicable;
• choose whether they wish to eat with others or privately;
• refuse food or drink;
• receive appropriate assistance to eat and drink while maintaining dignity and independence; and
• have their cultural, religious, ethical and other relevant dietary requirements respected.

Staff must not assume that a resident lacks mental capacity because the resident makes a decision that staff, relatives or others consider unwise.

Where there is concern about a resident’s ability to make a particular decision concerning food, drink or nutritional care, the principles and requirements of the Mental Capacity Act 2005 must be followed. Capacity must be considered in relation to the particular decision that needs to be made and at the time the decision is required.

Before concluding that a resident lacks capacity to make a particular decision, all practicable steps must be taken to support the resident to make the decision themselves. This may include providing information in an accessible form, using the resident’s preferred language or communication method, allowing additional time, using communication aids or choosing an appropriate time and environment for the discussion.

Where a resident is assessed as lacking capacity to make the specific decision, any decision made on their behalf must be made in accordance with the Mental Capacity Act 2005 and in the resident’s best interests.

Family members, friends and others who know the resident well should be consulted where appropriate as part of the best-interests process, but they must not be treated as having authority to make the decision unless they hold the relevant lawful authority, such as an applicable and valid Lasting Power of Attorney or deputyship.

The resident’s wishes, feelings, beliefs, values, previously expressed preferences and any relevant advance decisions or other lawful arrangements must be considered as required by law.

Any significant decision concerning nutrition or hydration made under the Mental Capacity Act 2005, together with the assessment, consultation, decision, rationale and any professional advice obtained, must be appropriately recorded.

Where refusal of food or drink creates a risk to the resident’s health or well-being, staff must respond promptly in accordance with the resident’s assessed needs and personal plan and seek appropriate healthcare advice where required.

11. Monitoring and Continuous Improvement

To ensure high standards in mealtime services:

• Resident feedback is collected regularly on food quality and menu options.
• Staff meetings include discussions on meal provision and resident nutrition.
• Audits on food safety, portion control, and meal satisfaction are conducted.
• Dietary changes or interventions are reviewed quarterly or as needed.

12. Compliance with CIW Regulations

To comply with CIW guidelines, {{org_field_name}} ensures:

• Menus and nutritional plans align with Public Health Wales and CIW standards.
• Meal assistance and dietary needs are recorded in care plans.
• Food hygiene policies are strictly followed.

CIW inspectors will review mealtime procedures, ensuring residents receive appropriate nutrition and hydration.

13. Policy Review

This policy will be reviewed annually or sooner if:

• CIW regulations change.
• New dietary guidelines emerge.
• Resident feedback suggests improvements.

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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: {{next_review_date}}
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