WIXLIB

Encouraging Best Practice Nutrition and Hydration in Residential Aged CareAppendix 1: Food Service Satisfaction Survey[Facility Name]RESIDENT FOOD SURVEYImplementing Best Practice Nutrition and Hydration in Residential Aged Care(Professors Julie Byles and Sandra Capra)Resident Food Service Satisfaction SurveyVersion1; Dated 7/08/2008This survey asks about your views of food service in this facility. This is part of a projectwhich is looking at food and nutrition at [Facility Name]. All your answers will be anonymous.You can leave blank any question you don’t want to answer.For each statement, please answer how often you feel this way:Always, Often, Sometimes, Rarely, or NeverPlease mark your answer by circling it, for example:1. I receive enough food AlwaysOftenSometimesRarelyNeverThe Questions start on the next page.There are 27 questions, and a place to write comments if you want to.Version 2 April 2008Modified July 2008 Wright, O; Capra, S; Connelly, L.Not to be reproduced without authors’ permission.Professor Julie Byles, RCGHA, level 2, David Maddison Building, University of Newcastle, ph 0249 138325

HUNGER & FOOD QUANTITY1. I receive enough timesRarelyNeverAlwaysOftenSometimesRarelyNever4. I am asked about the food anddrink that I likeAlwaysOftenSometimesRarelyNever5. I am able to choose where I sit toeat my mealAlwaysOftenSometimesRarelyNever6. I like the amount of food choice IhaveAlwaysOftenSometimesRarelyNever7. I can add salt, pepper and saucesto my food if I mesRarelyNever2. I still feel hungry after my meal3. I feel hungry in between mealsMY CHOICES8. There is enough variety for me tochoose meals that I want to eat9. I can have a snack (eg sandwich /toast) whenever I chooseMEAL QUALITY & ENJOYMENT10. The meals taste nice11. The meals have excellent anddistinct flavours12. I like the way the vegetables arecooked13. The meat is tough and dry14. The food is as good as I expected15. I really enjoy eating my meals16. I like the way my meals arepresented

17. The vegetables are too crispAlwaysOftenSometimesRarelyNever18. The hot foods are just the righttemperatureAlwaysOftenSometimesRarelyNever19. I am able to choose the portionsize of my timesRarelyNever21. I like the atmosphere in thedining room at mealtimesAlwaysOftenSometimesRarelyNever22. The crockery and cutlery arechipped and/or stainedAlwaysOftenSometimesRarelyNever23. I am disturbed by noise in thedining areaAlwaysOftenSometimesRarelyNever24. The staff who serve my meals areneat and rygoodGoodNot good orbadPoorVerypoor20. The vegetables are too softTHE DINING ROOM25. The cutlery and dining aids that Iam given help me to manageeverything on my plate26. The main meals are served attimes that are good for me27. Overall, how would you ratethe foodserviceDo you have any general comments or suggestions?Please write them below.THANK YOU VERY MUCH FOR YOUR TIME

Encouraging Best Practice Nutrition and Hydration in Residential Aged CareAppendix 2: Activity Timelines for Each Facility123F M1NM2InterviewfindingsA1, platewaste 1ActivitiesExternal Events /Challenges to orFacilitators ofProject Progress4NM389A3NM4NM5A2A3Research into pathway addressing behaviours of concern including a nutrition component.3-month trial planned in DSU.Managercovers 2facilitiesRN casemanagementintroducedAccreditationOngoing review of facility systems and staff education (including nutrition)Ongoing staff shortages – reliance on agency staffMonth123456789

197D findingsActivitiesNM3External Events /Challenges to orFacilitators ofProject ProgressNM4NM5Ulna lengthmeasured fora small groupof residentsby staffMUSTcompleted for asmall group ofresidentsClinical caremanagerresigns23910NM6A1Food recordchartscollected (totaldietary intakeover 2 days)18A3Action plan (dietarysupplement items) / flowchartand weight chart developedMonth7A2NM1Feedback54Flowcharttrialled with 5residentsStaff trainingre MUST andflowchartSquare platessourced toidentifyresidentswhose foodintake needsattentionWeight charttrialledNew clinicalcare managerappointedOrganisationreleased fkin tape5678910

242G 3FeedbackInterviewfindingsMUST scoresMUST scoresActivitiesPurchase ofchair scaleUlna lengthmeasured forprojectparticipantsby champion8910A3NM4NM5Ulna lengthused tocalculateMUST scoresandcomparedwith dietitians’scoresSupplementrecord sheetdevelopedand locatedwithmedicationchartsUse ofResourcesupplement(some snacksdeemedinappropriate)Weight chartdevelopedSupplementsinclude Marsand chipsStaffeducation recoeliacdiseasedeliveredOrganisationreleased newnutritionscreeningprotocolSome staffpoor atrecordingsupplementdistributionRN notnotified ofresidentslosing weightFlowchartdevelopedExternal Events /Challenges to orFacilitators ofProject ProgressMonth12345678910

386G FeedbackInterviewfindingsA1Plate waste 1A2ActivitiesNew menuimplemented(2 hot optionsevening meal)Considerationof puree foodmoulds (facilityvisit )Posterpromotingmoulded pureemealsdisplayedRed platespurchased toidentifyresidentswhose foodintake needsattentionRed platesexchanged –did not fitexisting platecoversAccreditation89A3NM1External Events /Challenges to orFacilitators ofProject Progress7NM5A3Puree mouldstrialled with 2residentsChampion 1on leavethroughoutmonthChampion 2on leavethroughoutmonthCare manageron leavethroughoutmonth678Champions work night shiftMonth123459

452D TimelineMonth1AxMeetings2345NM2NM3NM4NM5NM6A1A2, platewaste 1Food surveyA3Bain-marieinstalled inDSUMenu changesimplemented(additional eggdishes)Blue platespurchased forvisuallyimpairedresidentsChina replacesmelaminecrockery inDSUCommunications bookintroduced forfeedback tokitchen fromresidentsDevelopmentof snackprogramDevelopmentof snackprogramSnackprogramimplemented(n 12)“Breakfastclub” (2 mealsittings) raisedat residents’meetingNo demand for“Breakfastclub” – ideaabandonedA secondchampion isnow workingon the projectAccreditationCare manageron leave –snack programdelayedAudit 1 stillbeingcompleted dingsActivities89A3Insulated soupmugspurchasedStaff andresidentmeetings rechangesExternal Events /Challenges to orFacilitators ofProject ProgressChampion works afternoon or night shiftMonth1234589

519A k56A27891011A3NM3NM4Cost breadmakers,knives,toasters etcand spaceavailability forthese itemsMeals inrecipe bookincluded withlist ofafternoon mealoptions3 breadmakers,electric knivesand largetoasterspurchased forhostelTaste-testingsession andevaluationResident andfamily eveningmealpreferencessoughtStaff meetingre abovepurchasesKitchen liaisewith cateringcompany remenu optionsInclusion ofnew freshcooked itemson menuInterviewfindingsActivitiesPlan tastetesting sessionand contactcateringcompanyRosteringpatterns inkitchenevaluatedIdentified localprovider reeducation infoodpreparationExternal Events /Challenges to orFacilitators ofProject ProgressMonthLack ofknowledge ofcateringcompanyrepresentativere products.Requires 1weeks’ noticewhen ordering(2 week trial ofnew menu yetto beundertaken)1234567Extension ofhostel to becompleted891011

696A M2NM3InterviewfindingsA1 and A2A2Activities678NM4NM5A2bMUST trialled,developingpaperwork toenable actionplans etc to berecordedA3A2b, platewaste 1, foodsurveyConsiderationof puree foodmoulds (facilityvisit). Cateringstaff only –numberslimited bysalmonellaoutbreak9Experiment with puree mouldsto determine feasibility etcNM6A3All residentsscreenedusing MUST,revised weightchart in useWeight chartintegrated intopracticeStaff educationre weight chartPuree mouldstrialled with 2residents withgood resultsPuree mouldsorderedExternal Events /Challenges to orFacilitators ofProject ProgressProjectsuspendeduntil hampion onleavethroughoutmonthDifficultyobtainingLufkin tapeAwaitingarrival ofmoulds fromthe US89

764E TimelineMonth1AxA1MeetingsStart-up 2months nager onleaveMonth1910A2bNM3NM4NM5A3NM6Lifter weighingdevicepurchased andweighingroutinesreviewedCook-chillprocess videorecordedProposedchanges tokitchen rosters(from 4 to 5days/week)Staff membershave attendedCert III coursein hospitalityRegularweights andBMIsIdentifiedexamples ofgood and badmeals fromcateringcommitteeminutes andplate wasteNew menuimplemented –2 hot optionsmain meals,hot breakfastoptionsreduced totwice/weekReview ofdifferentoptions tomaintain foodtemperatures(e.g. heatedtrolleys)Review ofsupplementsExternalEvents /Challenges toor Facilitatorsof ProjectProgress8A2NM2Some cookfresh optionsintroduced4Considerationof puree foodmoulds (facilityvisit )Cateringmanager on 6monthsabbaticalCateringmanagerreturns andresignsFlu outbreak –lockdown inNH and DSUKitchenrecentlyrenovated –unable toincorporatevolume ofpuree mealsCateringmanagerpositionadvertisedOngoing renovations at facility2345678910

834E dback7A2InterviewfindingsActivities6Staff meetingsre DSUprogramStaff meetingsre DSUprogram“mandatorytraining”DSU programpreparationDSU programstartsComputerprogram ofweight chartdeveloped89A3NM4NM5, NM6NM7A1, foodsurvey (usedforaccreditation)A2 (NM5),plate waste 1(NM6)A3Dining roomchangesimplemented“Pamper day”implementedDSU programsuspendedDSU programrecommencedAccreditationFull capacitybut nowunderstaffed(had majorbed vacanciesin the past)Flu outbreak –DSU programsuspendedNew staffrecruited onduct foodsurveyChanged foodsupplierExternal Events /Challenges to orFacilitators ofProject ProgressMonth1234589

Encouraging Best Practice Nutrition and Hydration in Residential Aged CareAppendix 3: Summary of Facility Practice Development PlansGuidelines/evidence baseResident likes and dislikes need to beestablished, documented and reviewed every 3-6months.A system should be in place so that all staff areaware of resident food and eating issues.ObjectivesTo canvass resident preferences for teatime mealchoices.ActionsSurvey / consult with residents over evening /teatime meal preferences.To process map the progress of examples of wellreceived and less preferred meals from initialpreparation through to presentation to theresident.Taste test options from the current food retailprovider to enable residents to identify meal optionpreferences.To identify key characteristics of well-receivedand less preferred meals in both hostel andnursing home.Identify appropriate meals and menu items fordetailed study using: minutes of the CateringCommittee, menu requests, plate wastage records.Taste-test demonstration of moulded puree meals.A menu plan should ensure continued food qualityand variety.To access and provide a wider variety of menuitems for the teatime meal, in line with residentpreferences.To review the menu and develop menu planstailored to preferences of residents living withdementia who exhibit disruptive behaviours.Identify a list of quick and easy meals, and afeasible work plan for their preparation includingresource requirements, to enhance teatime mealchoices.Create new menu cycle.Develop and pilot test new menu options andevaluate new menu plans for nutritional balanceand adequacy.Utilise nutrient dense, easy to consume items(‘finger foods’) and eliminate items high incolourings and preservatives for residents withdementia.Residents and/or family should be involved inmenu planning, mealtimes, meal sizes and theuse of utensils.Introduction of a communications book to ensurefeedback to the kitchens from residents for specificmeals.