issue 5 Nutrition News: The quarterly newsletter for care homes and care at home services across the Highlands Produced by Evelyn Newman, Nutrition and Dietetic Advisor for Care Homes. Designed by Medical illustration, Raigmore Hospital, Inverness Autumn edition 2017 in this edition New breakfast club in Dornach The Corbett centre, Inverness New developments with the care inspectorate Reflect on training opportunities Tweeting - social care dietetic placements Focus on a proactive FoodFirst approach Christmas is coming: what will you be eating? Catering for service users who prefer a plant based diet Say hello to Mrs Mary MacIver Social care dietetic placements Following on from the success of our social care student placements, I have now become a co-author for an international journal! If you d like to read it in more detail, this is the link. MACKENZIE, M. and NEWMAN, E. 2017. Future proofing the dietetic profession: Exploring social care placements in preregistration dietetic education. International Journal of Practicebased Learning in Health and Social Care. Vol 5,no.1, pp.65-76. For those of you who, like me, enjoy most things that twitter has to offer, keep your eyes peeled for lots of news about our placements in November. NHS Education Scotland, The Care inspectorate and others will be actively sharing the success of the student placements in Highland. Please re-tweet anything I post to help the word spread to all of your followers so that we can encourage other areas of the UK- and beyond- to develop a workforce for the future in social care. Thanks again to everyone who has made this possible for our students: residents, their relatives, carers, managers and dietitians. Focus on vegetarian and vegan service users. More people are now choosing to follow a vegetarian or vegan diet as a way of life. Some people just enjoy a meatfree meal: who doesn t like macaroni cheese?! Nowadays it s so much easier to be able to have a much more varied plantbased diet because we have so much more choice in the supermarkets, better recipe options and a greater awareness of what constitutes a balanced diet. If you re planning on updating your menus to include more vegetarian or vegan choices, don t forget to include a protein source such as lentils, chickpeas, beans, eggs, tofu, Quorn or cheese. These will also provide additional minerals such as calcium and iron, which are beneficial to health and well being. Further information can be found in this really useful food fact sheet from The British Dietetic Association www.bda.uk.com/foodfacts Plant based diets. Nutrition News is a quarterly publication, which is developed with and for social care staff working in the Highlands to understand and improve nutrition and hydration for service users. Please pass it onto any colleagues who may find the information helpful.
We now have a new Nutricia nurse Heather MacKay - who is able to deliver MUST training. She is already booked up to deliver a number os sessions for homes across the north Highland area. Peter Berrie has reduced his hours to work 3 days a week and will be focussed on delivering training in the Lochaber area, as well as Argyll and Bute. Training News 2017 has been a very busy year, supporting learning and development of social care staff and I have tried to use a variety of methods for this to accommodate: geographical limitations; learning styles and managers requests. I have delivered training sessions on nutrition and hydration as well as texture modification to individual homes across all areas of Ross-shire and Inverness, supported in some cases by colleagues from SLT. The final texture modification training event took place at Smithton church Inverness on the 23rd of November but we had a really good event in Invermorriston in the summer, with a different care chef who delivered a great presentation on techniques for preparation of appetising modified textured meals. We will be planning more dates for next year but I am always interested to understand if you would like a different topic or format to be delivered. I m very grateful for all who have contributed to Nutrition News this year especially the residents - and hope that you are sharing copies of it with staff, residents and relatives, generating lots of discussion and new ways of delivering good food, fluid and nutritional care. The Breakfast Club Matron, Jackie MacKenzie has noticed a huge, positive, change in residents lives and daily routine since starting a breakfast club at The Meadows, Dornoch, a few months ago. Staff had been noticing that more people were choosing to miss breakfast in the dining room, staying in bed later and spending much more time in their rooms. This was resulting in some becoming more isolated and lower in mood and had a knock-on effect on the overall atmosphere of the home. After consulting with residents, staff decided to brighten up the morning with a buffet - style breakfast, which wouldn t be out of place in a nice hotel. Combined with light music and a variety of other activities going on at the same time, residents are now much happier and engaged with each other. The dining room is now a hive of activity, full of chatter and laughter and residents are getting up earlier to make sure they don t miss out. This is a great example of staff consulting with service users and acting to support a refreshing, new approach to improving nutritional intake and relieving menu fatigue. How often do you change the food and drinks available for snacks or meals on your menus? Ask residents if they d like to try something different, offer taste tests linked to afternoon activities. With Christmas coming up, eating and drinking will become much more of an important part of life anyway so there will be lots of opportunities and choice of different things to start you off. Enjoy! 2
Christmas past How do you remember celebrating Christmas from your childhood or with your children? Each generation has greater expectations of the whole experience; from presents, to gift wrapping and food. Did you have a stocking at the end of your bed, by the fire...or maybe it was a pillow case... What was in it? Many of our residents were delighted to find that Santa had brought them a Satsuma, some nuts or a small chocolate bar and a homemade knitted dolly or wooden toy. Have you talked to your residents about what made their Christmases special and what would make them happy to find on Christmas morning? It doesn t take much to bring back happy memories and deliver what they want rather than what we think they would like. At Ach and Eas care home in Inverness, Donna (head cook) and Alma (manager) have been asking for residents views to develop a new menu and to plan ahead for favourite festive meals. Surprisingly, most people have asked for roast chicken, with only 3 people requesting turkey; others wanted either roast beef, nut roast or pork and Donna will make sure that that s exactly what they ll get to make it a very special day for everyone. 3
Prescribing of Nutritional Supplements I wrote out to you all a couple of months ago to let you know that dietitians and prescribers are modifying our approach to recommending oral nutritional supplements and will no longer be using them in care homes across Highland. Local community dietitians who see people with a MUST score of 2 or more will be able to liaise with cooks, residents/relatives and staff to give more indepth and detailed Food First/fortification advice at an individual level. They will be reinforcing this approach from now on, rather than recommending prescribed products, which are often wasted when residents don t want to take them. I know from auditing the use of these products over the past 2 years that many of you don t actually use them routinely anyway. We have always promoted a Food First philosophy to supporting residents whose MUST score indicates a risk of malnutrition. Care home cooks wherever I work, are always more than able and equipped to fortify meals and drinks and I have certainly emailed lots of information to you about this over the past 3 and a half years to support this practice. Let me know if you d like any of these resending though. All homes in Highland have a nutrition resource folder, which provides advice about managing malnutrition risk and articles in Nutrition News, as well as emails, have covered this topic too. People who come into care homes from hospital will often enjoy eating and drinking better within a couple of weeks once the cook and staff sit down with them to plan how to provide their food preferences, when and where they d like to eat and how they d like to be assisted to eat and drink. So even if they ve relied on ONS before admission I am confident that being cared for by you will result in improvements of residents appetites and enjoyment of eating and drinking. However, please contact me directly if you have any concerns or queries about any of this. Everything we do aims to improve the nutritional quality and mealtime experience of our service users and I want to work with you to make sure that your staff all feel able and equipped to fully implement a Food First approach. 4
Manager Ian Clayton tells us all about The Corbett Centre in Inverness The Corbett Centre opened as a new build facility in 1989, delivering a Day Care Resource for adults with a learning disability. At this time well over a hundred service users were in attendance, with disabilities ranging from mild to profound. Over time the remit of the Corbett Centre as a resource has somewhat changed. Along with the Day Care facility, The Centre is home to the Inverness West Urban and Rural Adult Health and Social Care Teams, the Community Learning Disability Nursing Team and Occupational Health Team. The Inverness Learning Disability Housing Support and Care at Home Service, also has a base in the building. The Corbett Day Care Service now supports approximately 35 service users from across the Inverness and Nairn area. A high number of service users, in addition to having a learning disability, have additional physical disabilities, communication difficulties and health needs. Service users will be a minimum of 16 years of age and to date we have had no upper age limit, as long as the service continues to meet the needs of the individual. Through person centred outcomes focused support planning and the use of therapeutic activities, both within the Centre and in the community, we refuse to see disability as a barrier. Working in partnership with, service users, their families, carers and other professionals, we always aim to maximise the potential of those in attendance. The Corbett Day Care Centre and Inverness Learning Disability Housing Support and Care at Home Service are both registered with the Care Inspectorate, with all staff being regulated by the Scottish Social Services Council. Ian Clayton Resource Manager Learning Disabilities 5
Meet Mary MacIver, from her home in Ach an Eas, Inverness I met Mary (89) and her daughter Flora last month, to hear about her life at Ach an Eas care home. Mary has lived there for 4 weeks, having spent the previous six and a half months in Raigmore hospital, following a stroke at Easter. Flora and her daughter Kirsty, spent time looking at Care inspectorate reports and visiting a variety of potential care homes before deciding that Ach an Eas would be perfect for her mum. Although Mary hadn t been able to visit the home before moving in, she was immediately struck by how clean it was, the warm, homely atmosphere and very welcoming staff. She and Flora have nothing but praise for them and she has enjoyed gradually getting to know about them and their families. She invited me up to see her large room, which looks onto the lovely garden, full of Autumn coloured trees just now. She was able to bring along her own matching bedroom furniture, her reclining chair and it is full of family photos (and dog!) and crafts. She enjoys going out and round the large garden in her wheelchair and has been learning all about the Victorian history of Ach an Eas, which dates back to 1864 as the house of an architect originally. Before her stroke, Mary was very keen on arts and crafts activities. She was also a very accomplished knitter but has struggled to do this just yet, as her fingers are still a bit slow. She has started to do more crochet for now, to improve her dexterity and is determined to get back to her favourite hobby as soon as she can. She is still doing the exercises she was shown in hospital, to continue to strengthen her muscles and is gradually becoming more mobile, using her walking frame for now. She also enjoys joining in with the weekly exercise class in the lounge and makes a point of always coming downstairs to the dining room for her meals with everyone. Mary is always up and ready for breakfast, down in the bright and cheerful dining room, by 8.30am. Like many residents, she enjoys a bowl of porridge and is very complimentary about the standard and quality of food in the home. It is especially important to her that food is locally sourced (good for local businesses) and homemade. There is nothing that she doesn t like but when pressed for a favourite meal, she said scampi and chips! which is already featured on the very varied menu. Staff offer drinks and home bakes etc between meals and through the night if she s awake, though she d be happy just drinking fresh, Highland water over any flavoured squash or juice. The effects of the stroke have left her feeling quite tired by the afternoon, so she often has a nap in her room rather than joining in with any activities in the downstairs lounge. Mary was brought up in Lochs, just south of Stornoway but moved to the Highlands with her husband more than 70 years ago. They had two daughters, who both went to school in the village school in Croy. Sadly, Mary was widowed when her younger daughter, Catherine, was just 3 years old and she went on to work in various roles as a clerkess. Tragically Catherine 6
Meet Mary MacIver (Continued) passed away 3 years ago, which is a great sadness to the family. Mary has a very strongly engrained personal faith, dating back to her Free church upbringing on Lewis. She was a regular worshipper at the local Church of Scotland in Croy and looks forward to the monthly service in the home. She has many visitors who come in to see her, including friends from the village. She is looking forward to going out for a visit to Flora s house sometime, to see her lovely dog Topsy. Unfortunately the dog is rather too over excitable to visit Ach an Eas... but Mary s son in law plans to bring in his Burmese cat to visit in her room soon. Mary feels that she has everything she needs and is very happy in her new home. Thank you very much for sharing so much with us Mary. Hopefully you ll go from strength to strength now you re becoming more active. Raigmore Hospital Inverness Nov 2017