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Nutritional Screening in Care Homes (Wales) Policy

Policy Statement

The home’s policy is aimed at ensuring 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 considers any specific medical or other factors that could affect the quality of their nutrition and wellbeing.

With regard to the nutritional screening of people who use the services, the home aims to be legally compliant with the relevant Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017 and accompanying statutory guidance particularly:

• Regulation 15: Personal Plan, which stresses the importance of meeting individuals’ needs and preferences in respect of their diet
• Regulation 21: Standards of Care and Support — Overarching Requirements, which provides guidance on how people who use the services in a care home can be supported to maintain a healthy diet and fluid intake.

Regulations 21 and 22 on Safeguarding are also relevant where people are assessed as being nutritionally at risk through neglect or self-neglect.

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 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 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.
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 who use the services’ 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, 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 plan, including revisions to the risk assessment, will be agreed, recorded and subsequently monitored and reviewed in accordance with review policies.

Training

New staff receive training in the home’s approach to nutrition in line with the Social Care Wales: All Wales Induction Framework for Health and Social Care.

All staff receive specialist training, appropriate to their roles and tasks, in food handling and in aiding people who use the services with eating difficulties. All catering staff are appropriately qualified and offered ongoing training to develop their catering skills and ensure that their infection control techniques are up to date.

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