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This Policy defines the principles and practices to be followed when planning menus of food and drink for the service user’s meals, and to promote healthy eating whenever applicable.


This Policy should be read in conjunction with the following policies, as appropriate to circumstances:


Policy No 3400 Nutritional Support Policy

Policy No 3401 Food Preparation at the Service User’s Home



A: SERVICE USERS’ INDIVIDUAL MENUS - PRACTICAL & NUTRITIONAL CONSIDERATIONS:

1. The service user requires a balanced diet that contains the right proportion of the 5 basic food groups and vital nutrients that are essential to maintain health and well-being. Care staff will receive appropriate training in food technology, nutrition and hydration (see sections B & C below), which will include an awareness of malnutrition and dehydration, its causes and remedies.


2. Menus will include the presentation of meals, and the following must be taken into consideration when planning menus:


2.1 The service user’s preferred times of eating.


2.2 The service user’s preferred locations to eat; e.g. sitting at a table, or on a tray on his / her lap.


2.3 The service user’s ability to eat, and what discreet assistance may be needed; for example:


  • portion sizes, and whether foods need to be finely cut up, or pureed etc.

  • the need for modified or adapted cutlery, cups and other utensils.

B: FOOD & DRINK MENUS - BASIC NUTRITIONAL PRINCIPLES - FOOD GROUPS:

All foodstuffs are divided into the following 5 food groups:


1. Starchy foods, such as bread, potatoes, pasta and rice:


These provide a good source of energy, and wholemeal or wholegrain varieties contain more vitamins, minerals and fibre than the refined (white) varieties.


2. Meat, fish, eggs and pulses:


These provide a good source of protein.


3. Milk and dairy products:


These provide a good source of protein and fat. If fat is contra-indicated in diets, skimmed or semi-skimmed varieties should be used.


4. Fruit and vegetables:


These provide an essential part of any diet and 5 portions is a recommended daily intake. Eating fruits and vegetables of a different colour will provide a wider variety of nutrients.


5. Food and drinks high in fat / sugar:


These should be used sparingly to ensure maintenance of a healthy diet.



C: FOOD & DRINK MENUS - BASIC NUTRITIONAL PRINCIPLES - NUTRITION GROUPS:

Foodstuffs contain some or all of the following types of nutrient which will form the essential basis of any diet:


1. Carbohydrates:


Carbohydrates provide the body with energy, and are of 2 types:


  • Complex carbohydrates - found in starchy foods, such as bread, potatoes, pasta and rice


  • Simple carbohydrates - found in cakes, cereals, biscuits and puddings which are classified in Food. Group B.5 above, and should be used sparingly. Complex carbohydrates provide better nutritional value than simple carbohydrates.


2. Fat:


Fats are of 2 types:


  • Unsaturated fats - found in fish, nuts, seeds and vegetable oils. A small daily intake of unsaturated fat can help to lower cholesterol and maintain health.


  • Saturated fats - found in butter, full cream products, cheese, pastry products and biscuits. Excessive amounts of saturated fats in a diet can raise cholesterol levels in the blood, and can contribute to high blood pressure, heart disease and strokes.


3. Protein:


Good sources of protein are meat, fish, eggs, cereals, beans, nuts and pulses. Protein provides a good source of energy, and is needed to promote growth and cell repair.


4. Fibre:


Fibre is of 2 types, both of which contribute to a healthy digestive system:


  • Soluble fibre - found in all fruit and vegetables. A daily intake of soluble fibre can help to lower cholesterol and control blood sugar levels.


  • Insoluble fibre - found in cereals, grains, wholemeal bakery products, pasta and fruit that contains seeds. A daily intake of insoluble fibre can help to prevent constipation and bowel problems.



5. Vitamins and Minerals:


There are 2 types of vitamin:


  • Fat-soluble vitamins - (Vitamins A, D, E & K) - these are stored in the liver, and do not need to be replenished every day.


  • Water-soluble vitamins - (Vitamins B-complex & C) - these are highly soluble vitamins, and need to be replenished within the body every day.


A well-balanced diet containing meat, fish, fresh fruit and vegetables, dairy products and grains (pasta, rice and bread) will provide all the necessary vitamins and minerals.




D: FOOD & DRINK MENUS - SPECIAL CONSIDERATIONS:

The following factors must be considered when planning healthy meals for the service user. These factors will have been identified at the Baseline Assessment of Needs and Care Planning stages:


1. Service user dislikes and preferences with respect to foods, and their preferred portion sizes.


2. Foods prohibited by religion, faith or culture.


3. Any special medical dietary needs that may relate to obesity, malnutrition, dehydration or other clinical needs.


4. The timing of meals; i.e. the times at which the service user usually likes to eat. This will include the need to eat at certain times for clinical reasons as indicated in the Care Plan.


5. Ensuring that each meal contains the right balance of food and nutrient groups, and cover a range of colours and textures to make the food look appetising.


6. Avoid using dishes containing the same ingredients, or have been prepared using the same cooking styles, on a day-to-day basis.


7. Ensure that the planned meals are not beyond the cooking skills of other care workers, and that the meals can be cooked and served within the allocated time, and presented to the service user at the correct temperature.



FORMS REFERENCES:


Form No: 3-002 Baseline Assessment of Needs for Daily Living - Service User

Form No: 3-013 Care Plan - Service User

Form No: 3-400 Nutrition Risk Assessment

Form No: 3-401 Service User’s Diet, Ethnicity & Religion - master matrix

Form No: 3-402 Risk Assessment - Service User - Hydration

Form No: 3-403 Specific Care Plan - Service User - Hydration

Form No: 3-404 Diabetes Risk Assessment

Form No: 3-405 Diabetes Care Plan

Form No: 3-406 Food Intolerance Summary Chart - Lactose

Form No: 3-407 Food Intolerance Summary Chart - Wheat & Gluten

Form No: 3-408 Food Intolerance Summary Chart - Yeast

Form No: 3-409 Food Intolerance Summary Chart - Histamine

Form No: 3-412 Risk Assessment - Service User with Dysphagia

Form No: 3-413 Care Plan - Service User with Dysphagia

Form No: 3-414 Food Intolerance Summary Chart - Nuts

Form No: 3-415 Food Intolerance Summary Chart - Egg

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