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Food Allergies in Care Homes (Wales) Policy

Policy Statement

This policy describes how {{org_field_name}} assesses risks to people who use services from food allergies and the procedures followed in the event of anyone suffering an allergic reaction or illness.

Every person has the right to a varied and nutritious diet that provides for their dietary needs and offers health, choice and pleasure. However, the home also recognises that 1–2% of adults in the UK have a food allergy, which means that there will be certain food items containing allergens that they cannot eat.

The home understands that an allergic reaction can be produced by even a tiny amount of a food ingredient that a person is sensitive to. Symptoms of an allergic reaction can be very serious, ranging from mild itching around the mouth to vomiting, diarrhoea, wheezing and, on occasion, potentially fatal anaphylactic shock.

The home will therefore act to ensure that, with respect to food provided within the home, people who use services are given appropriate food information to warn them when foods contain potential allergens. They will also be provided with a range of allergen free food choices and menus so that their nutritional intake is not compromised and their enjoyment of food and mealtimes is not diminished.

Those people who suffer from allergies but lack the capacity to be able to choose safe food options will be protected by staff helping them to achieve a healthy diet.

This policy is in line with the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, which require service providers to ensure that their care users experience high quality safe, person-centred care, which entails assessing all possible risks to their safety and wellbeing.

Other Legislation and Guidance

{{org_field_name}} will comply with all aspects of other relevant legislation and guidance, including:

• Food Safety Act 1990
• Food Information (Wales) Regulations 2014
• Food Information (Wales) (Amendment) (No. 2) Regulations 2020.

The home understands that the principal effect of the food information regulations is to place a duty on food businesses, including care homes, to provide mandatory food allergy information relating to 14 specific allergens. The information must be provided clearly on all foodstuffs, including pre-packed and non-prepacked food. Pre-packed food must have an ingredients list present on the packaging. For loose foods the information should be clearly displayed on the menu, for example. If not provided upfront, people will need to be told where it can be obtained.

In an amendment regulations (referred to as Natasha’s Law) {{org_field_name}} understands that the requirements have been extended to “pre-packed for direct sale” or PPDS foods.

Current UK legislation stipulates all ingredients contained in an item should be listed on a food label in a clear and concise ingredients list, with allergens being highlighted — in most cases they’re listed in bold and accompanied with a statement: “For allergens, see ingredients in bold”.

Procedures

In {{org_field_name}}:

• All people who use services will be subject to a needs assessment which will include asking them about their nutritional and mealtime needs, including food preferences and dislikes, sensitivities and any food allergies. These will be recorded in an individualised and personalised plan of care. People who use services will also be subject to nutritional and hydration screening using recognised tools to make sure that they are receiving a healthy and well balanced diet that promotes their health and wellbeing.
• Each person will be offered three full meals each day, at least one of which will be cooked. They will also have hot and cold drinks and snacks available at all times and offered regularly. Menus will offer a choice of foods, and people who use services will be asked which choice they would prefer at every meal. All of these food choices will be offered with clear nutritional information, presented in a format that people who use services can understand, to help them make informed choices about their food and diet, including information about potential allergens.
• Information will be provided about any possible foods or ingredients within foods which may produce an allergic reaction. This will include the list of 14 allergens specified in the Food Information Regulations 2014:
  • celery
  • cereals containing gluten (such as barley and oats)
  • crustaceans (such as prawns, crabs and lobsters)
  • eggs
  • fish
  • lupin
  • milk
  • molluscs (such as mussels and oysters)
  • mustard
  • nuts (such as almonds, hazelnuts, walnuts, brazil nuts, cashews, pecans, pistachios and macadamia nuts)
  • peanuts
  • sesame seeds
  • soya
  • sulphur dioxide and sulphites.
• Menus will be reviewed on a weekly basis and feedback from people who use services, carers and families will be encouraged, including feedback as to the clarity of the allergen information provided. Menus will be planned with reference to the preferences and choices of individuals and with any known food allergies in mind. The home will plan to ensure that any person who has a food allergy has a full range of alternative food choices that meet their preferences.
• Allergen information will be provided in a range of different formats to meet the communication needs of people who use services. Our aim is to ensure that the information is clear and can be understood by all individuals, relatives, carers and advocates. Where necessary, care staff will read through the daily menu with the people who use the services, describing their choices and informing them of the allergen information.
• Where a person may lack the capacity to understand the information given, or to make choices based on the information provided, care staff will be expected to comply fully with the requirements of the Mental Capacity Act 2005. Every effort will be made to help the person understand their choices and no assumption of incapacity should be made. Where necessary, best interests decisions will be made to help people with allergies avoid foods that may make them ill.
• Sample menus will be referred to an external dietician to ensure that their dietary value is being maintained and to obtain specialist advice about our approach to allergen information.
• Special allergen free therapeutic diets will be provided when advised by healthcare or dietetic staff.
• All food will be prepared, cooked, stored and presented in accordance with the high standards required by food hygiene regulations and the food allergy legislation. Catering staff in the home will be fully trained to have an in-depth understanding of food allergies and will be careful in the use of ingredients and in the prevention of contamination of different foods with foods that might produce an allergic reaction.
• Caterers are expected to know the ingredients in all meals served and to ensure that this information is as described on menus and other allergen information sources.
• It is understood that the need to identify any potential allergens applies not only to the main ingredients of any dish or meal but also to any additives, processing aids and any other substances which may be present in the final product.
• Catering teams must take all reasonable actions to prevent allergen cross-contamination, including:
  • cleaning utensils before each usage, especially if they were used to prepare meals containing allergens
  • washing hands thoroughly between preparing dishes with and without certain allergens
  • storing ingredients and prepared foods separately in closed and labelled containers
  • keeping ingredients that contain allergens separate from other ingredients.
• The home will ensure that all prepacked foods and pre-packed for direct sale foods are properly labelled and have information about allergens clearly set out on their labels. The home understands that “Pre-packed for direct sale” (PPDS) items must be labelled in compliance with Natasha’s law. PPDS items include food which meets all of the following criteria:
  • food fully or partly enclosed by packaging
  • food that cannot be altered without opening or changing the packaging in some way
  • food that must be ready for final sale to the consumer.
• In all aspects of food preparation and serving, the home will comply with the latest best practice guidance published by the Food Standards Agency. This should include the updated Food Allergen Labelling and Information: Technical Guidance which provides best practice guidance in England, Wales and Northern Ireland.

Training

Induction training for new staff on fluids and nutrition will include allergy risks and how to assess and manage them.

All staff will receive specialist training on nutrition appropriate to their roles and tasks. This will include training in food allergies and allergic reactions. All catering staff are appropriately qualified and offered ongoing training to develop their catering skills in a care setting, including the preparation of therapeutic diets and allergen free food.

In {{org_field_name}}, a qualified first aider trained in the immediate management of allergic reactions and anaphylaxis will be on duty at all times.

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

Reviewed on: {{last_update_date}}

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