1. Adult Safeguarding & Nutritional Care MQNF, 23rd September 2015
Wendy
Professional Lead for Dietetics, SSOTP
Liz Osburn
Training Officer, Adult Safeguarding, Staffordshire County Council

2. The History to this Piece of Work
cases of neglect
526 (27%) did not meet the threshold for investigation- Poor Care identified
Nutritional issues identified were:
Lack of food and drink
Unexplained weight loss
Inappropriate feeding methods
Force feeding

3. What do I do with my concern
What do I do with my concern? Let’s look at the safeguarding referral process and changes introduced with the Care Act 2014, before we move on to appropriate working with the dietician

4. Raise a Safeguarding Concern when:
An adult who:
Has needs for care and support
Is experiencing, or at a risk of, abuse or neglect: and
As a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect

6. Safeguarding –not as a substitute for
Provider responsibilities
Commissioner responsibilities
CQC and compliance with fundamental standards
Duties of Police and other statutory investigators

7. Section 42 Enquiries
Local Authorities MUST make enquiries or cause others to do so if they reasonably believe an adult with care and support needs is being abused/or is at significant risk of abuse
Person-centred and less prescriptive

8. Contact Numbers
Staffordshire
Stoke –

9. “What did you eat and drink in the last 24 hrs?”

11. Why do we eat and drink? Taste Enjoyment /social interaction
Nutrition and hydration:
Fuel for our bodies (energy Kcal)
Vitamins and minerals
Essential macro-nutrients (protein, carbohydrates, fats)
Fibre
Health

12. ‘Food Glorious Food, Colourful and Tasty’
Overview of malnutrition
Staffordshire scrutiny review and CQC outcome 5
Staffordshire Nutrition Support Guidelines and helpful Resources

13. Malnutrition
“A state of nutrition in which deficiency, excess or imbalance of energy, protein and other nutrients causes measurable adverse effects on tissue/body form (body shape, size and composition) and function and clinical outcome”
Elia, 2000

14. What happens when we don’t eat and drink what we need?
Physical changes to the body and deterioration in mental state

15. General Effects of malnutrition
Make Every
Mouthful Matter
General Effects of malnutrition
Tiredness and fatigue
Muscle weakness – falls, immobility
Low mood unwilling to engage
Reduced immune system - increased illness and infections
Confusion, reduced memory
Feeling cold, difficulty getting warm
Longer wound healing
Development of pressure ulcers

16. How much of a problem is it?
Make Every
Mouthful Matter
How much of a problem is it?
Malnutrition is estimated to affect about 3 million people in the UK.
BAPEN, 2014

17. How much of a problem is it in our care homes?
Make Every
Mouthful Matter
How much of a problem is it in our care homes?
30-42% of people admitted to care homes are at risk of malnutrition (BAPEN, 2014).
51% of patients admitted to hospital from care homes are malnourished, (BAPEN, 2014).
Public expenditure on disease-related malnutrition in the UK in 2007 was estimated at more than £13 billion.

18. Staffordshire Scrutiny Inquiry 2011
Make Every
Mouthful Matter
Staffordshire Scrutiny Inquiry 2011
Raise awareness and increase the profile of malnutrition
Explore a multi-agency approach to prevention and management of community malnutrition.
10 recommendations for Care Homes: -
ONS, MUST, education and Training

19. CQC – Outcome 5 Nutrition and Hydration
Make Every
Mouthful Matter
CQC – Outcome 5 Nutrition and Hydration
1 in 6 six care homes did not meet this standard (CQC Nutrition and Dignity for Older People, 2012)

20. What is SSOTP doing to help?
Make Every
Mouthful Matter
What is SSOTP doing to help?
Staffordshire Nutrition Support Guidelines (SSOTP, August 2014).
Clear guidance on:
MUST
Food First Approach to good nutritional care

23. Education and Training
Make Every
Mouthful Matter
Education and Training
21st July – Malnutrition and Dysphagia Workshop in partnership with SCC.
Training sessions on MUST and appropriate use of ONS in partnership with SCC and Abbott Nutrition.
Nutrition Champions: - Opportunity for 10 care homes to nominate 2 Nutrition Champions :-
Achieve QCF level 3 - Promote Nutrition and Hydration in Social Care Setting (Skills for Health Innovation Fund in Partnership with SCC and SSOTP).
undertake a project aiming to improve nutrition long-term for the people they care for.

24. Make Every
Mouthful Matter
Summary
Preventing and identifying malnutrition is key to good outcomes for older people
Alert the Safeguarding Team When you have any concerns:
Staffordshire Stoke –
As partners lets work together to drive down the financial, health and emotional costs of malnutrition.
Support the people you care for to enjoy their food and drink!
- Dietetics and Speech and Language Therapy
undertake a project aiming to improve nutrition long-term for the people they care for.