use of puree moulds to present modified diets in a dignified and appetising way. The costs of these moulds and the freezer space required to store them can sometimes be prohibitive in smaller services. So, the provider decided to send the home’s chef on a piping course and this enabled them to present the pureed food professionally in an attractive way but at a greatly reduced cost.

Some care homes have also adopted a more homely way of promoting a positive mealtime. This can take the form of household-style meals, sitting in smaller groups, staff eating around the tables with the residents and providing support where required. This format promotes a more dignified experience and enhances the social occasion of the meal itself.


Services need to gather as much information about individuals’ eating and nutritional needs and preferences as possible. This formulates the foundation for a good nutritional care plan that covers both diet related health issues such as diabetes, coeliac and allergies whilst incorporating likes, dislikes and any potential risks around eating and drinking. As with all good care planning, updating and regularly reviewing these documents is essential in ensuring staff have the correct guidance to support people in the safest and most person- centred way.

It is important that catering and care staff continue to receive up-to-date training around nutrition, hydration and risk management too, so that both preventative and responsive actions can be taken in a timely way. The International Dysphagia Diet Standardisation Initiative (IDDSI) has recently released some comprehensive guidance around food modification and offers free resources here.

The introduction of a specific nutrition ‘champion’ can also help services to keep

nutrition and hydration at the very top of the care home’s agenda. By developing and sharing skills and knowledge the champions can cascade information, updates and best practice opportunities to the staff team.


The use of technology in assessing, identifying and managing nutritional needs, risks and preferences can be a very effective way of ensuring people’s needs and wishes are met. Electronic care planning soſtware can also become a useful tool in helping to maintain records relating to food and fluid, giving staff prompts where required and ensuring that relevant data is not omitted. Regular reviews of nutritional care plans and risk assessments mean that care services can make referrals as necessary to professionals such as speech and language therapists and dieticians.

Thematic nutrition and catering audits can be carried out in a service and is something that all providers should consider. These audits should be inclusive in their nature and need to involve care, catering staff, residents, relatives, local suppliers and healthcare professionals. Outcomes of such audits will provide a positive benchmark in order to develop better nutritional provision and mealtime experiences for residents in care. For something so important on so many different levels, it is certainly food for thought.

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