Pembleton House EAP Project “MAKING MEALTIMES MAGIC”

To improve the mealtime experience for our patients. We achieved this by developing the relationship and communication between nursing and housekeeping staff, reviewing the way in which meals are ordered and the choice of food available, providing an excellent service to our patients within available resources. Our Mission

Good nutrition and hydration are an essential part of patient care and wellbeing and as an inpatient they are a significant part of their day. It is not just about promoting healthy eating and ensuring patients are getting adequate nutrition – it is also a social event which forms part of their recovery. Mealtimes should be calm and therapeutic where patients are supported to make choices and have food provided that meets their needs. Before: Why are mealtimes important?

Before: What our patients told us “Generally the food is delicious but I would like to see more variety on the menu – for example, granary bread, scrambled egg, bacon baps.” “The food is good, but I would like curry and rice as an option.” “The dining room can be overcrowded with too many staff in there.” “I would like to be offered the healthy options instead of the standard menu, for example fruit instead of cake, and for staff to be aware of this.” “Occasionally I have not been able to have the food I have chosen.”

Before: What our patients told us Real time feedback completed in August The average score for food on the ward was 8/10. Feedback showed that patients were generally happy with the food and mealtimes although comments were made about choices available and how it was presented and delivered.

Before: What our staff told us “Protected mealtimes are in place, however they still get interrupted at times.” “I take pride and I feel that I do a good job to make sure it is calm and relaxed for them.” “Sometimes we have food items out of stock.” “There is not a set time for breakfast which I feel is good as patients don’t feel hurried either to get up or eat quickly.” “Due to housekeepers being managed separately, I feel that this can create barriers and maybe we don’t work as effectively as a team.” “Sometimes I feel communication between the nursing and housekeeping team and also morning and evening housekeepers is not as good as it could be, which can lead to misunderstanding and not providing the excellent level of service our patients deserve.”

Moving on: Staff Conversation Our staff conversation was held over two sessions in September 2013, and involved nursing and housekeeping staff, estates and facilities managers and dietitian. The feedback was very positive and many ideas were generated which were both realistic and achievable.

Common Themes Moving on: Themes identified Dining room environment could be improved. Communication between nursing and housekeeping staff could be more effective. The way patients make choices about meals should change in order to support healthy choices and meet their needs. Housekeeping staff required more education around our patient group, nutritional needs and delivery/presentation skills.

Actions Moving on: Information about dietary needs and choices Housekeeping staff needed information about patients in order to meet their nutritional needs eg dietary requirements, likes/dislikes, food allergies. A Patient Status Board would help provide that information

After: Housekeepers’ Patient Status Board

After: Actions The activities hub needed was moved from one dining room area to its own dedicated area as the space was becoming cluttered and not functioning as a dining area. A lounge area was identified to become the new activity hub and the dining room reverted to its original purpose.

Before: A little used lounge

After: Our New Activity Room

Moving on: Dining areas transformed Dining room areas changed so no longer crowded and plain. Environment addressed – tablecloths, new curtains, pictures, menu boards. Only one member of staff allocated to each dining room unless patient need indicates otherwise.

Before: Plain dining area

After: Bright dining area!

After: Actions achieved Food champions identified – core group of nursing and housekeeping staff. Monthly food groups reinstated to involve housekeeping, nursing staff and managers to identify any issues and actions. Dietitian provided training package for housekeeping staff, to include nutrition and food presentation skills.

After: Actions Food choices available reviewed with food safety co- ordinator, housekeeping supervisor and food champions and variety increased. Weekly patient coffee morning run by nursing staff to give feedback on service and identify any issues. Continue weekly meetings between ward manager and housekeeping supervisor.

After: Actions Real time feedback completed October Menus revised by housekeeping supervisors to create individual daily menus for patients which also indicate healthy options, vegetarian options etc. Patients keep a copy of their menu.