Food & Drink Strategy

Transcription

1 Food & Drink Strategy

2 Food and Drink Strategy Equality Statement Lincolnshire Partnership NHS Foundation Trust (LPFT) to its best ability will develop and implement business plans, project initiation documents, service change, service delivery and provision and policies and other corporate documents that meet the needs of the local community. They will take account of the provisions outlined in the Equality Act 2010, to eliminate discrimination, harassment and victimisation, promote equality of opportunity and build on good relations between diverse communities. The aim is to ensure no individuals receive less favourable treatment on the grounds of age, disability (learning disabilities), sex (gender), race, gender reassignment, sexual orientation, religion and belief, marriage and civil partnership and pregnancy and maternity. LPFT will have due regard to the different needs of those listed on the protected characteristics and those not listed to ensure dignity and respect, leading to a fair and equitable service for all.

3 Introduction Welcome to the Trusts Food and Drink Strategy which outlines the Trusts ambitions over the next three years to provide high quality and nutritious food to our patients and staff. As part of the response to the Francis report and other key documents the Department of Health published The Hospital Food Standards Panel s report on standards for food and drink in NHS Hospitals (Department of Health 2014). The multidisciplinary Panel, led by Diane Jeffery, Chairman of Age UK was asked by Ministers to tackle the problem of variation of quality of food and drink in hospitals by examining existing food standards and advising on how they should be applied and monitored. The Panel, supported by three Expert Reference Groups, was also asked to recommend future improvement actions, and make recommendations to the Government to improve the quality of food and drink in NHS hospitals. Diet significantly affects people s health, both in terms of over nutrition as well as under nutrition. Patients who are malnourished not only have a longer length of stay in hospital but are also more likely to develop complications or infections. Many patients come to hospital already malnourished, and many more become even more malnourished during their stay. The hospital setting therefore has an important part to play in improving patients nutritional status or to prevent them from becoming even more malnourished. It is therefore important that patients at risk of malnutrition and those already malnourished are identified early to ensure an individualised plan can be devised to support good nutritional status both during their hospital stay and following discharge. Conversely, in England, many people are overweight or obese, which includes 62% of adults and 28% of children between the ages of 2 and 15. Illnesses brought on by overconsumption such as type 2 diabetes, heart disease and certain cancers have a

4 Conversely, in England, many people are overweight or obese, which includes 62% of adults and 28% of children between the ages of 2 and 15. Illnesses brought on by overconsumption such as type 2 diabetes, heart disease and certain cancers have a higher risk of incidence in those people that are overweight. Health problems associated with being overweight or obese cost the NHS more than 5b each year. Obesity and overweight also affect NHS staff, so it is important that staff too are supported and encouraged to make healthier food choices. NHS Trusts have a wider social responsibility and the Trust acknowledges this responsibility with its work around sustainability and effective use of resources. The Hospital Food Standards Panel s report concludes that, as major purchasers of food and catering services, Trusts have the opportunity to put healthy eating and sustainability at the heart of their work. The Secretary of State has indicated that the Government takes nutrition and hospital food very seriously and the standards, as recommended by the Panel, will become legally binding standards as part of the NHS Standard Contract. The report identified five food standards required of hospitals which are captured within this strategy. The strategy focusses on three key areas: 1. Patient nutrition and hydration. 2. Promoting healthier eating to service users and staff. 3. Sustainable procurement of food. The delivery of the strategy will be measured in part by the annual Patient Led Assessment of the Care Environment (PLACE), the patient survey, family and friends test and feedback from the CQC.

5 This Food and Drink strategy has been developed in a way that clearly demonstrates the Trust wishes to adopt the ambitions of the Hospital Food Standards committee. The Strategy has been reviewed by representatives from medical staff, dieticians, risk management and facilities. This strategy should be read in conjunction with the following: Catering Policy. Staff Health and Wellbeing Strategy. Trust Food Safety Management System. People Strategy.

6 Strategic Vision (Purpose) & Scope The overall vision of the strategy is for the Trust to deliver wholly appropriate nutrition and hydration to its Service Users that aids both their recovery and future health. It is also committed to promoting the message of healthy eating to its staff and to incorporate the Panel s recommendations and guidance so as to demonstrate provision of the best possible service that is consistent and effective in its delivery. The strategy recognises that people must be considered and cared for as individuals with reasonable adjustments made accordingly. This requires responsive care and support that is designed to meet their specific needs coordinated across the various Trust settings. As the use of tube feeding is extremely rare, Enteral (liquid food delivered directly to the stomach) and Parenteral (nutrients delivered directly to the blood stream) feeding will not be covered by this strategy. However, specific guidelines have been developed by the Physical Healthcare Group for use as required.

7 Aims and Objectives Key Area 1: Patient Nutrition and Hydration The Trust will look to provide appropriate and effective nutrition and hydration to its service users that are accessible and helps with the maintenance of physical well-being and function, improves health and aids recovery. To achieve this it will follow the Panel s recommendations, which include the 10 Key Characteristics of Good Nutritional Care (Nutrition Alliance). Note the implementation of the 10 key characteristics of good nutrition and hydration care is a requirement to meet the Hospital Food Standards SC19 in the NHS Contract for hospitals. Below are the updated (2015 NHS England website) 10 key characteristics: 1. Screen all patients and service-users to identify malnourishment or risk of malnourishment and ensure actions are progressed and monitored. 2. Together with each patient or service user, create a personal care/support plan enabling them to have choice and control over their own nutritional care and fluid needs. 3. Care providers should include specific guidance on food and beverage services and other nutritional & hydration care in their service delivery and accountability arrangements. 4. People using care services are involved in the planning and monitoring arrangements for food service and drinks provision. 5. Food and drinks should be provided alone or with assistance in an environment conducive to patients being able to consume their food (Protected Mealtimes).

8 6. All health care professionals and volunteers receive regular training to ensure they have the skills, qualifications and competencies needed to meet the nutritional and fluid requirements of people using their services. 7. Facilities and services providing nutrition and hydration are designed to be flexible and centered on the needs of the people using them, 24 hours a day, every day. 8. All care providers are to have nutrition and hydration policy centered on the needs of users, and is performance managed in line with local governance, national standards and regulatory frameworks. 9. Food, drinks and other nutritional care are delivered safely. 10. Care providers should take a multi-disciplinary approach to nutrition and hydration care, valuing the contribution of all staff, people using the service, carers and volunteers working in partnership. In addition, the guidance included in the Nutrition and Hydration Digest (The British Dietetic Association) will act as the benchmark for the Patient Catering Service. The Trust supports the use for all service users upon admission of the Malnutrition Universal Screening Tool (MUST) (British Association of Parenteral and Enteral Nutrition) will be used in connection with the first of the 10 key characteristics listed above.

9 Extracts from Nutrition and Hydration Digest are provided below: Requirements to include the following on menu cycle/meal offers use of high & low fibre cereals, white & wholemeal bread, soft & higher energy starchy carbohydrates & vegetables, ability to provide the 5-aday fruit & vegetable requirement and a soft or puree fruit at each main meal. There is a requirement on the menu cycle to have a higher energy, healthier, softer and hot vegetarian option available at each meal, foods rich in iron and fish available twice per week and cooked breakfast available for those on dietetic referral. Arrangements should be in place to meet special diet requirements, religious/cultural requests and other identified needs. There should also be an out of hour s menu in place, snacks provided and sufficient beverages available to meet dietary and special needs. It is recommended that 400mls of milk for beverages is allocated per patient each day and that semi-skimmed and full fat milk are offered. Milk based desserts should available at each main meal and butter, unsaturated spread, standard preserves, condiments and sauces available as appropriate. There should be appropriate ingredient, allergen and per portion nutritional information available at point of service.

10 It is recognised that the Trust cares for different client groups from young people, active and inactive adults to frail elderly people with dementia and therefore the service must have sufficient flexibility to meet these very differing needs. To ensure staffs have appropriate skills and competencies to enable assessment of a service users nutritional needs training will be provided as appropriate for staff. Where appropriate the Trust will appoint Nutritional Link Workers into in-patient areas to support this. The dieticians provide training to clinical staff in best practice for nutrition assessment and management including the use of the Malnutrition Universal Screening Tool (MUST). There will be a process in place to ensure that all service users are screened on admission and their care plan will reflect their nutritional needs and how these are to be met during their stay. There will be a nutrition policy which includes specific guidance on nutritional care including the food allergy labelling directives. There will be a Facilities Catering Handbook which covers food service. Work has been carried out to support nutrition and hydration to service users with cognitive impairment. This includes providing coloured crockery and drinking vessels, plating sandwiches and provision of finger foods on the standard menu.

11 4.2. Key Area 2. Promoting healthier eating to service users and staff The Trust is committed to support the government initiative in promoting healthier eating to the service users, staff and visitors. Extracts from Nutrition Principles (ref Eatwell guide) Food choices generally follow basic healthy eating advice Plenty of starchy foods, plenty of fruit and vegetables, some meat, fish, eggs, beans and other sources of protein. Some reduced fat milk and dairy products. Foods high in salt, saturated fat and sugar should be consumed in small amounts or less often. Foods high in salt and saturated fat but low in fish, fruit, vegetables and fibre increase the risk of high blood pressure, cardiovascular disease and some cancers. Nutrient guides per meal (based on 20% breakfast, 30% lunch, 30% supper and 20% snacks, of daily allowances) Kcals, 450 b/fast,& 675 lunch & supper / fat (g) 17.5 b/fast & lunch & supper / saturated fat (g) 5.5 b/fast & 8.25 lunch & supper / added sugar (g) 13.2 b/fast & 19.8 lunch & supper.

12 The Eatwell guide and the Eatwell plate will be promoted. This will guide service users and staff on the choice of foods, drinks and snacks that they should be eating daily. Our aim for our staff is to ensure that each employee is supported to maintain and improve their health and wellbeing and that every employee will be expected to take reasonable steps to improve their health and wellbeing. We know that improved staff health and wellbeing will lead to improved patient care, reduced costs and improved service delivery to our service users. This ethos supports the Trusts Staff Health and Well Being Strategy.

13 4.3. Key Area 3. Sustainable procurement of food The Trust will procure catering products and services in line with Government Buying Standards (GBS) from the Department of Environment, Food and Rural Affairs where economically viable and also incorporate sustainable working practices into the services provided. This will involve working in partnership with key suppliers and other stakeholders to instil a continuous improvement culture into the service. These standards cover three areas of sustainable procurement: Foods produced to higher sustainability standards covering issues such as food produced to higher environmental standards, fish from sustainable sources, seasonal fresh food, animal welfare and ethical trading considerations. Foods procured and served to higher nutritional standards to reduce salt, saturated fat and sugar and increase consumption of fibre, fish and fruit and vegetables. Procurement of catering operations to higher sustainability standards including equipment, waste and energy management.

14 Extracts from GBS All foods served must be produced to UK legislative or equivalent standards, including animal welfare. Authenticity and traceability of fresh, chilled & frozen produce is in accordance with UK legislative or equivalent standards. Country of origin of meat and dairy products indicated on menus or accompanying literature. All eggs, including fresh in-shell, liquid and powdered eggs are sourced from systems that do not use conventional cages. If from a caged system, enriched cages must be used. At least 10% of total monetary value of primary commodity and drink procured shall be inspected and certified to: Integrated Production (IP)/Integrated Farm Management (IFM) systems at farm level or formally recognised organic standards. All palm oil products used are to be sustainably produced. All fish are demonstrably sustainable meeting FAO Code of Conduct for Responsible Fisheries (including Marine Stewardship Council & Marine Conservation Society)

15 Implementation/Duties Many strands of work on nutrition and hydration are being completed across the Trust and it is anticipated that by implementing this strategy they will be brought together to ensure there is cohesion and cooperation across all areas and all aspects of the care pathway. This will be orchestrated by the Nutritional Steering Group and incorporate additional specialist groups as required. Following a current position appraisal it is also envisioned that specific departments would be allocated actions as appropriate and be accountable to the group for progress and development as identified. Current Related Meetings Physical Health and Medical Devices Group Group Education Talks (Service Users) and Client Forums Nutrition Groups (Service led) Catering Contract Meeting Quality Group (Senior Nurses) Matrons Group Staff Engagement Group Senior Management Team (SMT) meetings (Location Based) Housekeeper meetings (Location Based)

16 Monitoring & Review It is anticipated that the Nutritional Steering Group will work to continuously improve principles and provide evidence of implementation and development from the various actions. However, it is recognised that verification of on-going maintenance of standards will be needed and it is expected that the Trust will look to undertake an audit program to monitor the various aspects and standards adopted and provide evidence for external audit purposes. This should include clinical and nonclinical processes. The data will be collected via the annual Patient Led Assessment of the Care Environment (PLACE), the patient survey, family and friends test and feedback from the CQC. Reference and Associated Documents The Hospital Food Standards Panel s report on standards for food and drink in NHS hospitals. An independent group established by the Department of Health and led by Dianne Jeffrey, chairman of Age UK (Department of Health & Age UK August 2014) ent_data/file/365960/ _hospital_food_panel_report_c omplete_final_amended_for_website_oct_14_with_links.pdf 10 Key Characteristics of Good Nutritional Care (Nutritional Alliance) Nutrition & Hydration Digest (The British Dietetic Association) - ndigest.pdf

17 Malnutrition Universal Screening Tool (MUST) (British Association of Parenteral and Enteral Nutrition) - Healthier and More Sustainable Catering - Nutrition Principles (Public Health England) (For staff & visitor catering) - Government Buying Standards for Food and Catering Services (Department of Environment, Food & Rural Affairs) - Catering Policy Provision of Food to Patients, Staff & Visitors Improving the Physical Health of People with Serious Mental Illness A Practical Tool Kit. (NHS England May 2016) Staff Health and Well Being Strategy Trust Food Safety Management System

18 Header here: Sub Header here Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do Lorem eiusmod ipsum tempor dolor incididunt sit amet, ut consectetur labore et dolore adipiscing magna elit, aliqua. sed do Ut enim eiusmod ad minim tempor veniam, incididunt quis nostrud ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud. xxx xxx xxx Sub Header here Sed ut perspiciatis xxx unde omnis iste xxx natus error sit voluptatem xxx accusantium doloremque laudantium, totam rem aperiam, eaque ipsa quae ab illo inventore veritatis et quasi architecto beatae vitae dicta sunt explicabo. xxx Nemo enim ipsam xxx voluptatem quia voluptas xxx sit aspernatur aut odit aut fugit, sed quia consequuntur magni dolores eos qui ratione voluptatem sequi nesciunt. xxx xxx xxx Sub Header here Neque porro quisquam est, qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit, sed quia non numquam eius modi tempora incidunt ut labore et dolore magnam aliquam quaerat voluptatem. Ut enim ad minima veniam, quis nostrum exercitationem ullam corporis suscipit laboriosam, nisi ut aliquid ex ea commodi consequatur? Trust Headquarters Sub St George s Header here Quis Long autem Leys vel Road eum iure reprehenderit qui in ea voluptate velit esse quam Lincoln nihil molestiae consequatur, vel illum qui dolorem eum fugiat quo LN1 voluptas 1FS nulla pariatur Sub Single Header Point of here Access Neque Tel: 0303 porro 123 quisquam 4000 est, qui dolorem ipsum quia dolor sit amet, consectetur, adipisci velit, sed quia non numquam eius modi tempora incidunt ut labore et dolore magnam aliquam quaerat voluptatem. Ut enim ad minima veniam, quis nostrum exercitationem ullam corporis suscipit facebook.com/lpftnhs laboriosam, nisi ut aliquid ex ea commodi consequatur? Twitter.com/LPFTNHS