NHS Borders clinical guidelines
Food Fluid and Nutritional Care Standards were published by Healthcare Improvement Scotland in 2014. Development of these standards followed review of Food Fluid and Nutritional Care Standards (2023) and consideration of related guidance e.g. Food in Hospital, National Catering and Specification for Food and Fluid Provision in Hospital (2008). In addition the scope of the standards was expanded to include community, thus the six standards were able to address nutritional care needs throughout the patient journey.
Food Fluid and Nutritional Care Policy
Warning
Objectives
NHS Borders recognises the importance of good nutrition in the delivery of quality care. The aim of this policy is to ensure NHS Borders’ works towards and attains compliance with the Food, Fluid and Nutritional Care Standards (2014), the Complex Nutritional Care Standards (2015) and the Food in Hospitals National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland (2016).
In meeting these standards NHS Borders will ensure the delivery of the highest standard of assessment and monitoring, and delivery of safe, effective and person-centred care in relation to meeting the food, fluid and nutritional needs of all patients, paediatric and adult, ensuring all patient groups are included in both hospital and community settings.
Staff should be aware of additional supporting documents which are relevant to this policy
NHS Borders Food, Fluid and Nutritional Care Strategy (2017) (under review), NHS Borders Best Practice Guidelines for Enteral Feeding (2024), Malnutrition Universal Screening Tool (MUST 2011), Paediatric Yorkhill Malnutrition Screening (PYMS) Tool, Protected Patient Meal Times SOP (2024), Healthcare Improvement Scotland (HIS) Food, Fluid and Nutritional Care Standards (2014) and HIS Complex Nutritional Care Standards (2015). Dietetic and specialist nutritional teams involved in the patients’ pathway must also be included when appropriate.
Eating well and enjoying food is fundamentally important for every individual’s health and wellbeing. In a hospital setting appealing food and good nutrition is more than this, here it is vitally important.
Food, fluid and nutrition are fundamental to health and wellbeing, and therefore to quality and safety in healthcare.
The British Association for Parenteral and Enteral Nutrition (BAPEN) report revealed that overall, malnutrition affected 24% of adults on admission to hospital in Scotland. Nutritional needs vary over a person’s lifetime and are influenced by such things as age, activity levels and disease. The ‘nutritionally vulnerable’ often have small appetites and poor food intakes. Older adults are more likely to be undernourished when admitted to hospital and remain so during their stay. Malnutrition can delay recovery and result in other complications in older populations and those who are ill.
Nutrition and hydration have a key role to play in healthcare. In order to be effective, nutritional care must adapt and change during the progress of a person’s life and illness. This requires monitoring and reassessment of the person’s nutritional status, implementation of a personal management plan of nutritional screening and appropriate referral to dietetic services in hospital and/ or community. An oral health risk assessment and timely referral to dietetic and oral health specialist care and services should also be undertaken in all settings.
1. NHS Borders will strive to deliver nutrition and hydration in ways that comply with HIS standards and will be used as a framework to achieve best practice in nutritional care regardless of the care setting.
- NHS Borders Food, Fluid and Nutritional Care Steering Group (FFNCSG) will oversee development, implementation and review of the food, fluid and nutritional care strategy and policy spanning all ages whether at home, in a community or hospital setting
- Responsibility for implementation of the strategy and policy will sit with the FFNCSG
- The FFNCSG and any sub-groups will be multi-disciplinary and involve members of the public.
- The FFNCSG will convene a sub-group to benchmark any new nutrition related national reports or standards which may have implications for food, fluid and nutrition provision across NHS Borders
2. To ensure patients get the nutritional care they need, they will be screened on admission or within the community when first assessed and weekly throughout their stay, or monthly within the community. If necessary, a personal nutritional care plan will be implemented through food and fluid charts, and in the community they will be added to the community nurse’s caseload.
- A Malnutrition Universal Screening Tool (MUST) will be completed for all adult BGH/Community hospital inpatients within 24 hours of admission and reviewed as indicated, but as a minimum weekly. This should be completed under the direction of a registered nurse
- If a patient is not well enough to be weighed, then a weight will be estimated and the patient will be weighed at the earliest opportunity. Alternative measures such as MUAC and ulna length may also be used to highlight nutritional status.
- An oral health risk assessment will be completed within 24 hours of admission for all patients.
- Each patient identified as being at risk of malnutrition will have an individual nutritional care plan documenting their risk and actions required.
- Similarly, patients will be screened and an individualised care plan put in place wherever NHS Borders services are provided, either in a patient’s home or other NHS setting (e.g. community day centre or outreach service). Screening will be part of initial assessment carried out by the patient’s relevant health care team. Repeat screening will be carried out in line with clinical need and NHS Borders MUST guidance.
- Clinical areas and community teams will have access to and use appropriate equipment to enable assessment of a patient’s nutritional status.
- All patients should be referred to the dietitian for assessment who have a MUST of ≥ 2 or a MUST of 1 with minimal dietary intake- in hospital this can be evidenced with a fully completed 3-day Food Record Chart. Other indications for dietetic referral regardless of MUST score see Appendix 1.
- Patients with eating and swallowing difficulties need to be identified in a timely manner and referred promptly to SLT for assessment of swallowing difficulties. An appropriate management plan should then be put in place.
- The PYMS tool should be completed within 24 hours of admission for all inpatient children between the ages of 1-16 to identify those at risk of malnutrition; the PYMS score will be repeated after a week for children scoring 0 and after 3 days for children scoring 1, children scoring 2 will be referred to paediatric dietetics. For infants, weight, length and head circumference should be measured and plotted on an appropriate growth chart
3. NHS Borders recognises the need for the best possible nutrition in order to manage disease and improve health outcomes and wellbeing
- A mealtime co-ordinator will be identified in ward areas for each mealtime: the mealtime co-ordinator role descriptor will be adhered to.
- A Protected Mealtimes policy will be adhered to allowing patients to eat with no unnecessary interruption, families and carers will be encouraged to be involved at mealtimes where appropriate.
- A menu review group will be in place at any time of significant menu change which will include the multi-disciplinary team and public involvement.
- Food quality audits will be carried out regularly by the catering department to ensure that food is served at the correct temperature and consistency, is attractively presented and of good quality.
- Patient feedback will be formally sought via questionnaires issued by the catering department twice per year and any necessary changes made by them following feedback.
- Menus will be available to offer choices suitable for a variety of cultures allowing patients to maintain their cultural wellbeing.
- Community based staff will promote dietary intake and be able to signpost to suitable support/ resources.
4. NHS Borders is committed to creating an environment in which people can enjoy their meals and consume food and drinks safely, as recommended in the food, fluid and nutritional care standards
- Food and fluid will be provided to patients in a way that is safe, aids recovery and is acceptable to them
- Where possible patients should be encouraged to sit up at a table during meals. If unable to get out of bed they should be positioned to allow them to be as independent as possible with feeding and drinking.
- Patients will be provided with appropriate cutlery and drinking vessels appropriate for their assessed requirements.
- Patients will have a choice of nutritious food and fluid options as well as a choice of portion size which take account of their religious, cultural and dietary preferences
- Patients will choose their food and fluid options at a time that is appropriate for them and as near to meal delivery time as possible
- Appropriate assistance will be given when making menu choices
- Patients will be given assistance with eating and drinking if required while food/fluid is at the correct temperature
- Patients will have access to out-of-hours food and fluid as required
- Menus will cater for varying nutritional needs and requirements of patients taking into account those who are nutritionally vulnerable. This includes the provision of modified diets and therapeutic diets
- Allergen information will be available for the 14 key allergies. Information regarding known allergies will be documented in the admission section of the inpatient record or within the patient held record
5. All staff will ensure that patients and carers are informed, involved and supported in all stages of their care and have access to information in relevant formats to support decision making
- Patients (and carers where appropriate) will have the opportunity to discuss, and are given information about, their food, fluid, nutritional care and mouth care
- Patient’s views are sought and inform decisions made about the food, fluid and nutritional care provided. They will be supported if required to make an informed choice
- Person-centred education and communication will be shared with the patient (and/ or their carer) along with evidence based written information to empower patients and encourage supported self-management where appropriate. This will include availability of mouth care resources and signposting to dental services
- Discharge planning will include signposting to other services such as weight management programs, lunch clubs, shopping services and meal makers where relevant
6. NHS Borders will ensure staff and volunteers receive regular, high quality training in nutritional care and patient support
- All staff will receive nutrition training and education commensurate with their duties and responsibilities and have access to ongoing continuous professional development
- All staff, carers and volunteers will have appropriate Hand Hygiene education
- Existing nurses and healthcare support workers (HCSWs) will have training co- ordinated by Training and Professional Development. This will include Caring for Smiles and Childsmile training where appropriate
- Nutrition will become a key clinical competence to be completed in the first 6 months of starting employment as a registered nurse
- Mealtime volunteers will undertake a training session prior to starting their role
- Every department will identify a link person/ ambassador who will have specific training related to their role
- Training data will be fed back to the FFNCSG on a quarterly basis
NHS Borders’s principal concern is the delivery of safe and effective food, fluid and nutritional care that ensures the best possible clinical outcomes for individual service users.
- A coordinated and whole-system approach to the delivery of food and fluid by different healthcare professionals that views individual needs and preferences.
- All new staff are familiarised with this policy on commencement of employment.
- All staff are able to access training to enable them to implement the policy, protocols and standard operating procedures as appropriate to their role. New staff receive training within six months of commencement of employment. All documentation fully supports the implementation of the HIS Food, Fluid and Nutritional Care standards.
- All individuals (children, young people and adults) at greatest risk of malnutrition (over nutrition and undernutrition) are assessed and cared for without prejudice thereby helping to improve the quality of overall clinical care.
This policy aims to ensure that the care provide by NHS Borders achieves optimal nutritional care and hydration in order to improve outcomes for individuals and, specifically to:
- Increase and improve the knowledge, skills and attitudes of NHS staff
- Improve inpatient experience of food, fluid and nutritional care
- Improve or maintain the nutritional wellbeing of individuals receiving NHS care
- Reduce inpatient stays and avoid complications associated with malnutrition
Service improvements in food, fluid and nutritional care are taken forward via the NHS Borders Food, Fluid and Nutrition group and are thereby underpinned by the FFN Group principles.
The food, fluid and nutritional care component of the NHS Borders Food, Fluid and Nutrition group applies the principles of best value and includes consideration of:
- Alignment with NHS Borders strategic objectives
- Extent to which services link to strategic objectives and deliver outcomes
- Quality of the services and how well users’ experiences are reflected.
- Ease and equality of access to services
- How spending on nutritional care is being utilised and how this could be improved to deliver efficiencies and best value
Continuous improvement is central to the provision of food, fluid and nutritional care for individuals. This methodology ensures that robust leadership is in position to make certain that systems and processes exist, to enable all staff to implement a continuous improvement approach to their work and so contribute to improving clinical outcomes and individual experiences. These fundamental features underpin NHS Border’s commitment to achieving and maintaining optimal standards of food, fluid and nutritional care for individuals as appropriate for age, culture or special needs, and across the Board’s hospitals and community settings. It is also the responsibility of NHS Border to engage with individuals and the public in reviewing, changing and developing nutrition related services and involving individuals in planning their nutritional care pathways.
NHS Borders Food, Fluid and Nutritional Care policy, standard operating procedures and protocols will be developed and reviewed in accordance with NHS Borders requirements.
NHS Borders will ensure systems of governance and audit, are in place to maintain nutritional standards and report these to the Strategic Food, Fluid and Nutrition Care Group.
- NHS Borders will audit compliance with Food in Hospitals: National Catering and Nutrition Specification for Food and Fluid Provision in Hospitals in Scotland (2014), using the Health Facilities Scotland monitoring tool.
- Performance, risk and quality improvement will be reported quarterly to the Strategic Food, Fluid and Nutrition Care Group.
The Strategic Food, Fluid and Nutrition Care group will report through the Public Health Directorate’s Clinical Governance and Audit Group to the NHS Borders Clinical Policy Governance and Care Governance Committee.
|
Name |
Job Title |
|
Elaine Dickson |
Associate Director of Nursing (Acute) |
|
Vanessa Hamilton |
Dietetic Service Lead |
|
Lynne Cairns |
Acute Lead Dietitian |
|
Emma Anderson |
Oral Health Coordinator |
|
Muriel Thomson |
Catering Manager |
|
Shirley Boylan |
Deputy Catering Manager |
|
Yolanda Lambert |
Senior Charge Nurse |
|
Jill Kirk |
Clinical Nurse Manager (Mental Health) |
|
Andrea Johnstone |
Clinical Nurse Manager – Community Hospitals |
|
Peter Lerpiniere |
Associate Director of Nursing Mental Health, Older People and Learning Disabilities |
|
Allana – Lee Gillies |
Paediatric Dietitian (AHP) |
|
Lindsay Dun |
Occupational Therapist |
|
Mandy Headspeath |
CCN/ Paediatric Rheumatology Nurse |
|
Lynn Weir |
District Nurse Team leader Teviot and Tweeddale |
|
Jan Turnbull |
Clinical Practice Lead |
|
Fiona Dickson |
Senior Charge Nurse (Ward Fifteen) |
|
Alison Downie |
Speech & Language Therapy Service Lead |
|
Christine Mann |
Highly Specialist Speech and Language Therapy |
|
Dr Jonathan Manning |
Consultant Gastroenterologist |
|
Jennifer Anderson |
Clinical Nurse Manager |
|
Grace Brydon |
Clinical Nurse Manager |
|
Kathy Steward |
Clinical Nurse Manager |
|
Sheila Murray |
Community Dietitian |
|
Rhona Morrison |
Quality Improvement Facilitator – Patient Safety |
|
Christine Proudfoot |
Alzheimer Scotland Dementia Nurse Consultant |
|
Zoe Spence |
Quality Improvement Facilitator – Patient Safety |
|
Name |
Job Title |
|
Nicky Berry |
Associate Director of Nursing (Acute)/ Head of Midwifery |
|
Helen Brand |
Oral Health Improvement Manager |
|
Gillian Bremner |
Lead Paediatric Dietitian |
|
Lynn Cairns |
Prescribing Support Dietitian |
|
Elaine Cockburn |
Professional Lead Education and Transforming Roles |
|
Shona Finch |
Clinical Midwifery/ Nurse Manager |
|
Stuart Grant |
Clinical Nurse Manager |
|
Caroline Herkes |
Catering Manager |
|
Fiona Houston |
Community Nurse Manager |
|
Emma Howie |
Lead Clinical Nurse Specialist Gastroenterology |
|
Rachel Jackson |
Occupational Therapy Team Lead |
|
Ruth Jones |
Clinical Improvement Facilitator/ Staff Nurse |
|
Diane Keddie |
Lead for Excellence in Care |
|
Peter Lerpiniere |
Associate Director of Nursing Mental Health, Older People and Learning Disabilities |
|
Christine Mann |
Speech and Language Therapy |
|
Dr Jonathan Manning |
Consultant Gastroenterologist |
|
Beverley Meins |
Community Nurse Manager |
|
Allyson McCollam |
Associate Director of Public Health/ Child Health Commissioner |
|
Lynne Morgan-Hastie |
Interim Professional Lead Physiotherapy |
|
Sheila Murray |
Community Dietitian |
|
Ann O’Connor |
Dietitian |
|
Anne Palmer |
Clinical Governance & Quality Facilitator |
|
Erica Reid |
Lead Nurse for Community |
|
Stephanie Sloan |
Catering Dietitian |
|
Kim Smith |
Operational Lead, Training & Professional Development |
|
Jamie Thomson |
Clinical Nurse Manager |
Gastrointestinal Conditions
- Liver disease – Alcoholic liver disease, Hepatitis
- Upper gastrointestinal conditions including newly diagnosed oesophageal cancer, oesophageal stent insertions, oesophageal strictures, achalasia, stomach cancer
- Lower Gastrointestinal conditions – malabsorption, newly diagnosed coeliac disease, inflammatory bowel diseases (active Crohn's and ulcerative colitis)
- Complicated bowel surgery that is poor to recover
- Pancreatic conditions e.g. severe pancreatitis or pancreatic cancer
- Diverticulitis
Artificial Feeding
- Requiring enteral feeding (NG, NJ, PEG, jejunostomy)
- Requiring parenteral nutrition (TPN)
- Eating disorders- if admitted for artificial feeding support
Electrolyte Abnormalities
- Persistent hyperkalaemia
- Renal disease requiring Low potassium, Low phosphate diets
Diabetes
- Newly diagnosed Type 1
- Newly Diagnosed Type 2 that are not suitable for DESMOND Group education
- Newly diagnosed Gestational
- Recurrent hypoglycaemic episodes and/or Diabetic ketoacidosis (DKA)- as discussed with DSN
- Type 2 requiring insulin/injectable treatment initiation
Other Indications
- Wound Healing for pressure ulcers or slow healing wounds
- Patients requiring bariatric equipment
Reminder: To be seen for undernutrition all patients should be a MUST of ≥ 2 or a MUST of 1 with minimal dietary intake as evidenced by a fully completed 3 day Food Record Chart.
|
Role |
Responsibility |
|
Director of Nursing, Midwifery and Acute Services and Medical Director |
The Executive Nurse Director has strategic responsibility for Food, Fluid and Nutritional Care, ensuring systems are in place to raise awareness; implement this policy across hospital settings; and enable appropriate support to be provided to staff in delivering practice, as outlined in this policy. The Medical Director has a role in ensuring medical staff awareness of this policy and the NHS Borders Food, Fluid and Nutritional Care Strategy. |
|
Food, Fluid and Nutritional Care Steering Group |
Is responsible for setting appropriate and relevant standards of competency to educate and train all staff and volunteers. Is responsible for overseeing food, fluid and nutritional care policy implementation, monitoring and reporting. Advises the Board on all aspects of delivering food, fluid and nutritional care for individuals including screening and assessment, care planning and provision of appropriate nutritional care. Ensures appropriate mechanisms are in place for the effective engagement of representation of the public, professional staff and clinical leads from across NHS Borders Undertakes the necessary work to ensure the promotion and delivery of safe, effective, person centred nutritional care Oversees the work of sub-groups which have delegated responsibility for developing policies and processes for each HIS standard The FFNCSG reports to the Executive Nurse Director who is Executive Lead for food, fluid and nutrition and is accountable to the Board Clinical Governance Committee, reporting is done via divisional board reporting. |
|
Associate Directors of Nursing, Associate Medical Directors, Heads of Service and General Managers |
Ensure that budgets are set and managed so that the nutritional requirements of all individuals can be met whatever feeding route is deemed clinically appropriate. Ensure adequate training and education programme is available for all staff involved in nutritional care assessment and delivery |
|
Clinical Nurse Managers and Community Nurse Managers |
Are responsible for ensuring that they feedback to all staff about training in nutritional care using the person-centred supervision tool |
|
Clinical Governance and Quality |
Provides support to the audit process to monitor compliance with the standards including the monitoring of complaints. Develop Person centred supervision tool for Senior Charge Nurses to use in clinical areas to coach staff on audit compliance with FF&N standards |
|
Senior Charge Nurses/ Team Leaders |
Ensure that staff are supported to be released for agreed training sessions. Trakcare ward audits are completed on a monthly basis and to use Person Centred Supervision Tool approach as a coaching mechanism to provide learning and ongoing training to teams and test effectiveness Spot check audits to be completed by the nurse in charge of the wards, to check that patient at a glance boards and drinking assistance sheets are completed and updated. Ensure if there is uncertainty that the adult has capacity to give or withhold consent, reference is made to the Adults with Incapacity (Scotland) Act 2000 and further advice sought; Ensure that equipment and resources are available for healthcare workers to provide adequate nutrition and hydration to all patients for example adaptive cutlery/crockery/cups/vessels Ensure that individuals with complex nutritional requirements have appropriate support from expert staff, for example Dieticians, SLT, Nutritional Support Team, Clinical Nurse Specialist Gastroenterology Ensure that all staff caring for patients in NHS Borders can carry out a nurse swallow screen and identify patients who require referral to SLT services Ensure that patients with eating and swallowing difficulties have a chart above their bed with SLT recommendations which have been discussed with the clinical team, patient and carers as appropriate Ensure compliance to food, fluid and nutritional care policies (i.e. protected mealtimes, food hygiene) Promote mealtime support from healthcare volunteers Nurse in charge of the ward is responsible for the ensuring staff providing food, fluid and nutrition to patient, are aware of patients risk assessed requirements Nurse in charge of the ward is responsible for ensuring that communication is provided to the Domestic staff members working on the ward that are serving hot beverages to patients in regards to what drinking vessel is required and what assistance is required. It is the nurse in charge of the ward responsibility to ensure that drinking assistance sheets are update each shift and that they coordinate with domestic staff and meal coordinators. Nurse in charge of the ward is responsible for coordinating nursing staff band 2 and above to provide assistance to patients with their hot beverages if required. |
|
Dietitians |
Ensure that on receipt of referral liaise with nursing, medical and other relevant professionals Assess and develop an individual nutritional care plan Monitor and review dietetic care plan Liaise with appropriate healthcare professionals regarding ongoing care and ensure relevant dietetic information is included in discharge letters for patients leaving hospital Advise on oral nutritional supplements, enteral and parenteral nutrition in conjunction with the NST when required |
|
Speech and Language Therapists |
Ensure patients have timely assessments of their dysphagia Ensure appropriate management plans are in place for patients which may include strategies and texture modification of food/fluid in line with National Descriptors Plans should be effectively communicated to allow the team to make the most appropriate decisions to ensure adequate nutrition can be provided in the most appropriate form When issues are identified regarding dysphagia which may compromise adequate nutritional management, these must be highlighted to the clinical team Provide appropriate SLT recommendations to people assessed by them and record progress in the relevant documents Regularly assess, review and provide advice/ treatment along the patients journey to ensure maximum recovery |
|
Occupational Therapists |
Provide advice in relation to correct positioning, appropriate aids, equipment, feeding techniques and adaptations |
|
Physiotherapists |
Provide advice no postural management to optimise safe eating, drinking and swallowing |
|
Pharmacists |
Supply nutritional products that are unable to be obtained via procurement. Advise on any adverse interactions between nutrients and drugs Dispense medicines in a suitable form for optimal up-take Advise on prescribing suitability and timing of administration of medicines for individuals on enteral and parenteral nutrition |
|
Catering Service |
Develop menus in conjunction with the Dietetic Team to ensure that all patients nutrition and hydration needs are met Ensure availability of meals and snacks 24 hours a day, according to National Catering Standards Ensure the needs of patients are met through meal provision taking account of clinical, cultural and religious needs or lifestyle Ensure a range of children’s meals are available which has had input from the catering and paediatric dietitians where necessary Is responsible for undertaking food quality audits as well as conducting bi-annual patient satisfaction surveys |
|
Healthcare Support Workers |
Support the mealtime co-ordinator and clinical staff to: - prepare patients for mealtimes by offering them personal care including mouth care, handwashing and if necessary, assistance to clean their hands. Support and assist patients to eat and drink at their bed or away from their bed if clinically appropriate maximising patients’ dignity at all times Ensure patients are provided with the equipment and utensils for eating and drinking that meet their individual needs Support patients after mealtimes with personal care where appropriate |
|
Individual Clinicians |
Assess patient’s nutritional status using the MUST/ PYMS tool within the agreed timescale on admission and draw up an appropriate care plan. Be able to undertake a nurse swallow screen and referral to SLT if required Monitor nutritional status on a regular basis and act on assessment outcomes Refer to appropriate healthcare professionals to support individual needs (Dietitians or SLT) Ensure patients are supported to receive appropriate nutrition and hydration Ensure patients identified as ‘Nil by Mouth’ have appropriate safety measures in place Ensure patients requiring modified food and fluid receive appropriate textured diet in line with SLT recommendations and national descriptors Ensure Mealtime Co-ordinator role is in place in all settings serving food and fluids Ensure the Protected Mealtimes Policy is adhered to at all times to minimise interruption to meals and to enhance the mealtime experience, taking account of support from carers/ volunteers Ensure patients receive assistance, aids or supervision to eat and drink as required |
|
|
Ensure food and fluid charts are completed correctly and acted upon Liaise with registered staff on the ward/department if there are concerns over a patient’s food and/ or fluid intake Liaise with appropriate teams when planning the discharge of patients requiring enteral feeds as advanced notice is required Ensure all patients are discharged appropriately, taking account of their ongoing ability to manage their food and fluid intake independently and where necessary, refer to relevant healthcare professionals in the community |
|
Mealtime Co-ordinators |
The Ward Meal Coordinator will ensure that all staff on the ward are aware of the practice of completing menu cards and that they are encouraged to adhere to this procedure. All patient menus are completed for the following day as the per the procedure outlined below: When the blank patient menu cards arrive from the kitchen in the morning, the Ward Meal Coordinator will assign at least one appropriate member of the ward team to assist in their completion The staff member will use the handover/safety brief to inform the needs of each patient, ensuring that the correct menu card is chosen and then completed accurately The staff member will check to see if there have been any changes to food/fluid recommendations Staff must choose the correct menu card for each patient:
Completion of Menu Cards - Standard Operating Procedure | Right Decisions (scot.nhs.uk) |
|
Mealtime Volunteers/ Carers |
Work under the direction of the Registered Nurse responsible for the care of the patients to assist named individuals or loved ones with a range of activities associated with mealtimes |
|
Medical Staff
Consultant in charge of the patient retains ultimate responsibility |
Liaise with the MDT to be aware of the nutritional needs of the individuals in their care Be aware of and actively support the protection of mealtimes Advise the MDT on medical issues that may hinder the delivery of optimal nutritional support Ensure that all medical staff receive specific nutrition training at induction and as part of annual updates Ensure ‘Capacity’ training is included in induction training for all new Doctors and in annual updates for Consultants |
|
Training & Professional Development |
Ensure all staff receive nutrition training and education commensurate with their role on employment Ensure all existing staff receive update nutrition training Mealtime volunteers will undertake a training session prior to commencing with their role Submit training data to the FFNCSG on a quarterly basis |
|
Oral Health Staff |
Facilitate training for Caring4Smiles and Childsmile Oral Health Improvement Programmes: - Caring for Smiles is Scotland's national oral health promotion, training and support programme for staff in all care settings. The guide is designed to support training and be a source of best practice and advice on oral health issues for nursing/care staff. It also gives guidance on oral risk assessment and referral process, should a patient require dental care from a dental professional/dental team. Childsmile’s aim is to reduce inequalities in oral health and ensure access to dental services for every child aged 0-15 in Scotland from birth: referrals can be made to Childsmile if a patient requires support with their oral health or accessing dental care. |
|
General Services staff |
General Services domestic staff are responsible for distributing hot drinks to patients on various wards, excluding Mental Health in-patient wards, Labour Ward, SCBU, ICU, and Recovery. They serve drinks at specific intervals: breakfast, mid-morning, lunch, mid-afternoon, and tea. Nurse in charge of the ward/areas is responsible for ensuring that general services staff provided with communication in regards to patients food, fluid and nutrition requirements and equipment requirements. Especially to Domestic staff members serving hot beverages to patients. It is the nurse in charge of the ward responsibility to ensure that drinking assistance sheets are update each shift and that they coordinate with domestic staff and meal coordinators. General Services Two-minute safety talk and induction training to include information about serving patients hot drinks |