OPINION: Revolutionising nutrition and hydration in care sector

It’s an overused term that nutrition and hydration are critical to an individual’s health and development. As human beings, it’s the bedrock to ensure our survival, promote stronger immune systems, and reduce the onset of non-communicable diseases. However, despite the obvious factors highlighting its importance, there is still a long way to go to ensure that people can access the necessary nutrients and vitamins to live a healthy, happy and well-balanced life, particularly from a health and social care standpoint.

Malnutrition currently affects more than three million people in the UK. Around one in three people admitted to acute care will demonstrate signs of malnourishment, while 35% will be seriously affected.

Both dehydration and malnutrition have significant consequences on a person’s health and are integral to all care pathways. These problems are still poorly recognised in healthcare settings despite numerous reports showcasing an inadequate level of focus in these particular areas. Much of this will be down to care providers not fully understanding the benefits that come from greater nutritional expertise within a care environment. The operation of food production in a care home, after all, is incredibly complex and very different to your common household kitchens.

This was something I learnt very quickly following my appointment with Nellsar five-and-a-half years ago, and I am extremely keen to bring these challenges to light. From the get go, my responsibilities were to take charge of the food assessment process of our residents, while underlining the key elements to improve their nutritional well-being. From there, everything spiralled and I was quickly pulling together comprehensive plans that were proving to be of incredible value to the business as a whole.

Unfortunately, despite these plans demonstrating an array of benefits to resident well-being, our Kitchen Teams didn’t quite have the capacity to carry them through, which forced the business to broaden its horizon from a nutritional expertise standpoint, prompting them to offer me a promotion! We have also employed a team of Nutrition Champions across our homes to help support the whole process of implementing change, education and support. My promotion was a huge opportunity for me given my nutritional background as it has always been a passion of mine to be part of the movement that strives to improve nutrition, not only within social care but beyond. I think a striking moment for me was when I discovered how people in hospitals who are recovering from surgery and illnesses, for example, aren’t necessarily fed very well, in the context of appropriate vitamins and minerals, despite being crucial elements of our health and well-being, which never made sense to me.

Similarly, in care homes, I’ve seen numerous examples of care providers focusing a lot of attention on medication administration, which, of course, is important – and expensive, too – while overlooking the value of tackling health problems directly through good nutrition and a well-balanced diet. W|hen Nellsar approached me with the same enthusiasm for identifying these problems at the source, I inevitably jumped at the opportunity. One of the first things I noticed on the job was how transitional the skills were following my studies as a qualified nutritional therapist many years ago. On top of this, once I saw the current recruitment shortage strangling the sector, I thought to myself why other nutritionists who were once in my position weren’t capitalising on the chance to broaden their nutritional understanding, particularly from a clinical and catering perspective; it could kickstart their careers.

In truth, it’s quite a technical job and one involving familiarising yourself with comprehensive guidelines while simultaneously learning about dysphagia and texture-modified diets. However, it’s also a fast-paced role with endless learning opportunities alongside like-minded individuals who are determined to make a lasting and transformative impact on the sector.

Another valuable lesson I quickly learned was that our practices are clinically proven to work. At Nellsar, we build therapeutic menus specially tailored for residents with a wide range of dietary needs. On top of this, we’ve introduced bespoke training courses for all catering members of the businesses’ 13 care homes that ensure there’s a unilateral approach to how we make and distribute food. It's not just about raising nutritional standards, but also coaching the wider care teams  to understand why we’re encouraging better nutrition and hydration. Similarly, we champion residents to ask questions and get involved with trials. This enables us to explore new ways to improve not only nourishment but the dining experience, as for years the sector’s stance on nutrition has been drastically outdated.

A survey commissioned by eProcurement technology firm, Zupa, polled hundreds of care home professionals across the country, finding that two-thirds of care home staff admitted the quality of resident care and the ability to cater properly for dietary and nutritional needs were some of the key areas being side-lined as a result of outdated practices.

Clearly, caring for the elderly day-to-day is already demanding and time-consuming enough for such an overstretched sector. The over-reliance on outdated processes, such as one-food diets, weight loss supplements, avoiding cultural foods, eliminating food groups and ‘clean eating’, adds to the growing fury amongst health professionals, and things simply have to change. Inevitably, the lack of staffing throughout the sector is still a major concern. However, it’s clear that in many cases, the adoption of new innovative methods to instigate positive change may just be right under care providers’ noses.

So, to anyone reading this with a nutritional background and struggling to apply their skills and insight to something practical, I urge you to consider social care as a potential avenue. Likewise, for any care homes who perhaps don’t quite understand the endless benefits that come from championing positive nutrition, I invite you to come to one of our Nellsar homes and see the impact it’s having for yourselves. 

Leni Wood is head of nutrition and wellness at Nellsar, a family-run group of 13 care homes throughout Kent, Surrey, and Essex that prides itself on being approachable, accountable, and empathic in its relationships with the families it supports.

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