Supporting and assisting people

Supporting people's nutritional needs is based on four principles:

  1. People receive the 'right' nutrition for their circumstances (that is appropriate for their diagnosis or status e.g., soft diet, clear fluids, low fat diet).
  2. People receive nutrition at the 'right 'time' (at times when they are likely to be hungry or that is appropriate for any treatment/procedure they might be undergoing).
  3. People receive nutrition via the 'right' route (by mouth or feeding tube or other route appropriate for their condition).
  4. People receive nutrition in the right place/manner (i.e., appetising presentation, correct temperature, within their reach etc).

When these four principles are achieved you will know that you are giving safe, dignified, quality nutritional care.

Protected mealtimes

Protected mealtimes are periods of time when people are able to eat their meal without unnecessary interruptions and when nursing staff and the ward team are able to provide safe nutritional care. The key principle of protected mealtimes is making sure people are ‘ready’ to eat.

HCAs have a vital role here, making sure people have had the opportunity to use the bathroom and wash their hands. People must be in the right position for eating (either sitting up in bed or a chair) and that they have the right equipment (like special cutlery, slip proof mats etc).

Activity should be focused on people and their meals. People should not be unnecessarily disturbed during mealtimes (for example having bloods taken; going off the ward area for tests; or being seen by the doctor or other allied health care professionals for ‘routine’ care). The environment should encourage eating - the place where people eat should resemble a dining area as much as feasibly possible. Appropriate assistance must be provided for those who need it. Finally, take note of what people have eaten – recording this in people’s records, particularly when they are on food/fluid measurement charts. This will ensure any changes are noticed early, reducing the risk of people developing malnutrition and dehydration.

The "Red Tray" campaign

The “Red Tray” campaign (or red tray system) is a simple way of alerting health care staff to the fact that a person requires help with eating. A red dot sticker on their menu sheet (or some other agreed system) signals to the catering department that the meal is to be served on a red tray. When the meals arrive on the ward, staff can easily identify people who require help by looking out for a red tray and providing assistance quickly, so that there is no compromising the dignity of the patient or the quality of the meal.

Follow the link to the Age UK website to see what this organisation is doing to tackle the issue of malnutrition in hospital and their 'Seven steps to end malnutrition in hospital'.

How to assist people to eat

Watch the slideshow on correct feeding technique to see Liz Evans, a specialist nutrition nurse, demonstrate the ‘right’ way to feed a patient who needs assistance to eat. At the end of the slideshow, you will see a link to play a video to watch a situation that occurs on a daily basis in hospitals and other care settings. How many bad practices can you spot?

Consider what you've seen in the slideshow and video and reflect on your care setting and what mealtimes are like for the people in your care.

Using the knowledge you've gained in this learning opportunity, select the link to Activity: My action plan (PDF 328KB). Use the template to address the issues you have identified and plan the steps you can take to address them. You may wish to print it out so you can discuss it with your colleagues and line manager. You can make a difference – but first you need to make a plan and take action! This document is in PDF format so that you can save it to your computer - see [how to access PDF files]. You may wish to upload it to your e-Portfolio as evidence of your learning and edit it at a later date.