Mealtime Management Policy
| Policy area | Mealtime Management |
| Document type | Policy |
| Applicable to | Beyondlimits Care & Support Services |
| Version | 001 |
| Date approved | 19/08/2024 |
| Approved by | Managing Director |
| Next review date | Every 12 Months |
| Related policies | Client Health and Wellbeing Policy Food Safety Management Policy Duty of Care Policy Client Advocacy Policy Consent Policy Support Planning Policy Service Access and Exit Policy Service Delivery Policy Emergency and Disaster Management Policy Transition of Care Between Different Environments Policy Client Living Alone and Receiving Personal Care from Sole Worker Policy Client Feedback and Complaints Management Policy Continuous Improvement and Quality Management Policy Risk Management Policy Incident Management Policy Privacy Policy |
| Authority | NDIS Act 2013 NDIS Practice Standards and Quality Indicators Aged Care Act 1997 Aged Care Quality and Safety Standards International Dysphagia Diet Standardisation Initiative |
PURPOSE
The purpose of this policy is to explain our organisation’s commitment and approach to mealtime management.
SCOPE
This policy applies to all our workers (employees, contractors and volunteers) who support clients with their food, hydration and nutrition.
DEFINITIONS
| Term | Definition |
|---|---|
| Dietitian | An allied health professional who supports people to improve their nutrition and dietary habits. They also support people with health conditions such as diabetes, heart disease and eating disorders. |
| Dysphagia | The medical term to describe difficulty swallowing. As well as swallowing, it includes problems with eating, drinking, chewing, sucking, dribbling saliva and closing your lips. |
| Mealtime Management Plan | This is a document written by a health practitioner (dietitian, speech pathologist) which includes instructions and recommendations to ensure safe and nutritious meals for a client requiring mealtime management (food and fluid modified textures, seating and positioning, feeding equipment, choking risks). |
| Speech Pathologist | An allied health professional who supports people with communication and/or swallowing difficulties. |
CONTEXT
Our organisation recognises that everyone has a right to enjoy their food and their mealtime experience. We are committed to planning, preparing and providing safe, nutritious and enjoyable meals for our clients.
POLICY STATEMENT
#1
Identifying and Assessing Clients with Mealtime Management Requirements
- We will identify clients requiring mealtime management and/or experiencing difficulties swallowing in the intake process, at client reviews and during support provision.
- We will refer clients identified as having mealtime management needs and/or difficulties swallowing to a qualified health practitioner (dietitian, speech pathologist), with the consent of the client or their family/alternate decision-maker/advocate.
- We will organise for the client to be assessed annually by a qualified health practitioner, and more often if required.
- We will ensure the health practitioner:
- undertakes a comprehensive assessment of the client’s nutrition and swallowing;
- assesses the client’s seating and positioning requirements for eating and drinking; and
- develops/reviews the client’s mealtime management plan detailing their mealtime management needs, risks and required response actions.
#2
Mealtime Management Plans
- We will follow all instructions and recommendations in the client’s mealtime management plan developed by the qualified health practitioner, including food and fluid texture modifications and/or seating and positioning requirements if required.
- We will ensure the client, with their consent, has an active role in assessing and developing their mealtime management plan.
- We will ensure the client’s mealtime management plan is available and accessible to the client, to workers providing mealtime management support and to others as required during transitions of care (hospital, short-term accommodation/respite).
#3
Meal and Menu Planning, Preparation and Provision
- We will partner with the client, ensure the client has informed choice and is actively involved in menu planning and the meals prepared and provided (including for texture modified diets).
- We will plan menus at our service(s) with input from chefs/cooks and an accredited practising dietitian, taking into account clients with specialised dietary needs.
- We will regularly change our menus, to optimise nutritional needs, offer variety and enable clients to make choices about what they eat and drink.
- We will arrange for our menus (including for texture-modified diets) to be reviewed at least annually by an accredited practising dietitian.
- We will take into consideration any allergies the client may have and cultural and religious preferences in the meal and menu planning and preparation process.
- We will make reasonable efforts to provide (either prepared or bought) meals that are safe, nutritious, offer menu variety, are well presented and would reasonably be expected to be enjoyable.
- We will partner with clients at our service(s) to provide a quality food service which includes appealing and varied food and drinks and an enjoyable dining experience.
- We will, where possible, offer clients choice at each meal for what, when, where and how they eat and drink.
- We will provide meals, drinks and snacks to clients (including those with specialised dietary needs and/or requiring support to eat) that are:
- appetising;
- flavourful
- presented in an appealing way (including using tools such as moulds to present texture-modified foods);
- prepared and served safely and at the correct temperature;
- in accordance with each client’s assessed needs and preferences; and
- reflect the menu provided.
- We will provide a dining environment that supports reablement, social engagement and a sense of belonging and enjoyment.
- We will provide a dining environment that enables clients to share food and drinks, and their dining experience with visitors, if they choose to.
#4
Food, Hydration and Nutrition
- We will, where possible, encourage and support each client to adopt good nutrition, hydration and lifestyle habits to maximise their health and wellbeing.
- We will ensure clients are offered and able to access nutritious food snacks and drinks (including water) at all times.
- We will support clients to eat and drink adequately by:
- ensuring sufficient workers are available to provide the support;
- prompting and encouraging clients to eat and drink adequately and regularly;
- identifying clients who require support to safely eat or drink;
- physically supporting clients who require physical support to safely eat and drink as much as they want, at their preferred pace (and not rushing them to eat and drink).
- We will implement and maintain processes to assess (and regularly reassess) each client’s nutrition, hydration and dining needs and preferences, including:
- specific nutritional needs (e.g. focus on protein and calcium-rich foods for older people);
- what and when the client prefers to eat and drink;
- what makes a positive, comfortable and joyful dining experience for the client; and
- identified clinical and/or other physical issues impacting the client’s ability to eat and/or drink.
#5
Risk Management
- We will escalate any health-related risks and concerns (including unexpected significant weight changes, change in mood, alertness, general ‘wellness’) immediately to a qualified health practitioner
- We will manage emerging and chronic risks related to mealtime (dysphagia, anaphylaxis, food allergies, obesity, being underweight) in accordance with the mealtime management plan and escalate to the health practitioner as required.
- We will ensure our workers have the knowledge and training to:
- identify, monitor and respond to swallowing and choking risks, including when the client is eating, drinking, taking oral medications and during oral care; and
- apply the appropriate emergency response if a client is choking, in accordance with their mealtime management plan and the Practice Guidelines - Choking.
#6
Monitoring and Continuous Improvement of Food Services
- We will implement and maintain a system to monitor and continuously improve our food service(s) in response to:
- client feedback and satisfaction in relation to the food, drink and dining experience;
- the nutritional needs of our clients (including review of identified and unplanned client weight loss or malnutrition);
- the impact of food and drink on client health outcomes; and
- contemporary, evidence-based practice regarding food and drink.
#7
Food Storage
- We will store food/meals for clients with mealtime management plans safely and in accordance with health standards.
- We will label food/meals which are part of a client’s mealtime management clearly so they are easily identifiable and differentiated from other clients’ food/meals.
#8
Information and Record-keeping
- We will ensure information and records are accurate and up to date.
- We will ensure the client has provided us with all required written consents.
- We will store the information securely to ensure client privacy, dignity and confidentiality and make sure it is accessible to the client and only other stakeholders authorised to access it.
#9
Worker Training and Supervision
- We will maintain a skilled and trained workforce which is aware of the importance of following a client’s mealtime management plans, the risks involved and how and when to escalate to a health practitioner.
- We will maintain processes to adequately monitor and supervise workers.
SUPPORTING DOCUMENTS
Related procedures and forms include:
- Mealtime Management Plan
- Nutrition and Swallowing Risk Checklist
- Practice Guidelines – Choking
- Practice Guidelines – Food Preparation
- PEG Feed Care Plan
- PEG Tube Feeding Assessment
- Mealtime Management Procedure
- Severe Dysphagia Management Procedure
- Infection Management Procedure
- Risk Management Procedure
- Emergency and Disaster Management Procedure
- Client Advocacy Procedure
- Transition of Care Between Different Environments Procedure
- Client Living Alone and Receiving Personal Care from a Sole Worker Procedure
- Oral Health Procedure
- Support Planning Procedure
- Service Access and Exit Procedure
- Service Delivery Procedure
- Incident Management Procedure
- Reportable Incident Management Procedure
RESPONSIBILITIES
Managing Director is responsible for:
- maintaining this policy, its related procedures and associated documents;
- ensuring the policy is effectively implemented across the service;
- monitoring workers compliance with the requirements of this policy; and
- ensuring training and information is provided to workers to carry out this policy.
All workers are responsible for complying with the requirements of this policy.
COMPLIANCE
Deliberate breaches of this policy will be dealt with under our misconduct provisions, as stated in the Code of Conduct Agreement.
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