1. South East Branch Study Day Menu Planning

2. RATIONALE FOR NEW NACC NUTRITIONAL STANDARD The aims of the standard are: To simplify existing standards in line with current best practice To define one standard across all social care settings To provide choice menus that have the capacity to meet the nutritional needs of both those at risk of malnutrition and those with special dietary needs

3. The reasons being: The last decade has seen a massive growth in technology and it is now commonplace for nutritional information and analysis software to be widely used by both lay and professional people New regulated nutritional standards in the public sector provide a recognised and easily-understood model for defining nutritional issues e.g. School Food Trust The Care Quality Commission (CQC), the monitoring body for England, will be monitoring across all care and social settings. Thus uniformity of food and beverage services standards in all these settings must be designed to meet the outcomes of Nutritional Standard 5 All recommendations are based on current government or professional body advice. The evidence base for best nutritional practice for healthcare is found in the 1995 Guidelines for Hospital Catering (Department of Health (DH). These guidelines have been updated and revised to provide the nutritional decisions that underpin the new Standard The multi-agency 10 Key Characteristics of Good Nutritional Care, derived from Council of Europe Resolution 12/11/2003 Food & Nutritional Care and in which NACC is a stakeholder, strengthen the levels of good practice in food and beverage services to be expected in all care settings Hence existing NACC standards need to be modified to one clear Standard that meets these modern requirements and enables service users, their relatives, healthcare staff and auditors to witness consistent food services regardless of setting It is highly desirable that any nutritional care services for older people include input from an experienced professional, and the Standard is written in the belief that a Registered Dietitian (RD) or Nutritionist (RN) should be engaged at least annually to advise on a menu review (Or CCM?)

4. The 5 key points are a mnemonic for 5 fingers of the NACC Caring Hand 2010 campaign: ‘No One Should Go Hungry ’

5. The Standard should be reviewed annually from first publication date Is this October 2010? Let’s discuss!

6. N must Nutritional analysis of menu and menu items Nutrient content of all meals and snacks must be provided. As a minimum this should include energy (kcals) and protein content.

7. O Overall food and nutrient content of meal must meet minimum standards A ‘meal’ such as is served at lunch, high tea / suppertime must at least consist of a main course and dessert course. must Any such meal, whether a cooked meal or a lighter meal such as a sandwich, must: include a good source of protein and a starchy carbohydrate, and a serving of vegetables or fruit. Where cooked vegetables are served, the total portion size must be at least 80g provide a minimum of 300kcal of energy provide a minimum of 15g of protein. An energy dense dessert must be available as a choice at each main meal and provide a minimum of 250kcal.

8. For those providing wider meal services: Breakfast must provide a minimum of 380kcal and 8g of protein 5 portions of fruits and vegetables per day must be available from the menu, some as snacks Between meal snacks throughout the day must provide a total of at least 400kcals and 4g of protein A minimum of 7 beverages per day (1.5l fluid) must be offered including the use of a minimum of at least 400ml full fat milk for drinks and on cereal where drinks are offered

9. For practical purposes the total meal, beverage and snacks menu per day must must provide a nutritional content of at least: 2150kcal (revised figure) & 55g of protein (nutrient)

10. S Support individual meal requirements The menu should suit a variety of client needs including: Ethnic, cultural and religious requirements Medical /health conditions e.g. gluten free, modified texture etc. Local and regional customs and traditional practices e.g. fish on Fridays, roast dinners, culturally suitable menus

11. G Grouped dietary codings for specific nutritional needs “Healthier eating” choices should be available which are moderate in salt, saturated fat, sugar and total fat thus providing suitable items for people with diabetes, and those managing their weight, cholesterol levels and /or blood pressure “Energy dense” options should be available for those who require extra calories “Softer” code is useful for identifying which dishes are easier to eat for those with chewing problems Allergen content of meals must be available in accordance with UK Food Labelling Regulations and Amendments.

12. H Hydration mustFresh drinking water must be accessible at all times and a choice of hot and cold drinks offered at meal times, bed time and at regular intervals in between Over the day, hot and cold drinks together should provide the client with at least 1.5 litres (6-8 cups/glasses) of fluid.

13. Menu planning

15. Planning pointers This is your clients’ menu – not yours! Budget; proportional cost; waste % uptakes Logistics – length of menu cycle; meal timings and menu balance across day; catering skills; deliveries; style of food service; hot food hot, cool food cool; assistance with eating Appropriate to client group Appeals to clients - mixed and varied Provides familiarity /comfort With recognisable dish names Combinations of colour, texture and flavours to suit recipients’ tastes Includes clients’ suggestions Daily / weekly / yearly patterning – specials, celebrations Texture (include a Softer choice) Higher Energy (Energy Dense) to Healthier choices Can identify good sources of vitamins C and D, calcium and fibre over the day/week 5 A DAY over the day Other diets? Acceptable dish repetition Check first to last day of cycle repetition

16. Menu plan checker

17. Now let’s take a leaf out of this presentation and try looking at your menus!! Jo and I thank you for any feedback to take with us to NACC Exec. anne.donelan@tilleryvalley.com