Care Home Magazine March 2023

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Chief Editor

Jade Evans

jade.evans@cimltd.co.uk

Editor

Claudia Volpe

claudia.volpe@cimltd.co.uk

Editorial assistant

Brooke Tremain bt@cimltd.co.uk

Publication Manager

James Davies

jamesd@cimltd.co.uk

Tel: 01795 509 112

Account Manager

Hannah Moody

hannah@cimltd.co.uk

Tel: 01795 509 112

Credit Facilities Manager

Lauren Sharpe creditcontrol@cimltd.co.uk

Tel: 01795 509 103

Administration Manager

Natalie Murray admin@cimltd.co.uk

Tel: 01795 509 103

Design and Production

Grant Waters grant@cimltd.co.uk

James Taylor

james@cimltd.co.uk

Tel: 01795 509108

Sales Director

Tom Woollin tom@cimltd.co.uk

Chief Executive

John Denning

Editor’s Letter March 2023

Writing the first ever Editor’s Letter for Care Home Magazine fills me with the utmost pride. It certainly isn’t my first rodeo when it comes to these messages as I have proudly been editing a series of industry-leading magazines for over four years now. For me there’s nothing quite like it; writing has always ignited a funny kind of feeling in me, a fire in my belly, and I suppose that’s the passion. What’s more is when I know I am serving a purpose, as trade magazines do, it spurs me on to only want to do more and be better.

Care Home Magazine represents the residential care service industry, providing our audience with essential business information. With main focuses in this inaugural issue honing in on Cost Management – a topic currently on everyone’s lips - and Food and Nutrition, another essential area of interest where we promise not to disappoint. At Care Home Magazine, we pride ourselves on working pro-actively rather than reactively to an ever-changing, fast-paced industry by staying in constant communication with some of the most respectable personalities in the sector.

As a professional journal, Care Home Magazine keeps readers informed with all of the latest from the industry’s leading trade associations, providing business advice and new ideas to help propel our audience’s business to the next level.

If there is anything in particular you would like to see from our upcoming issues of Care Home Magazine, we encourage you to get in contact as we would love to hear from you.

Jade Evans, Chief Editor

Table of Contents

6 Industry Update

Providing insights into the latest happenings within the care sector, we share our Industry Update.

11 Cost Management

From keeping your care home’s laundry costs down to helping with budgeting and planning, we talk to industry experts to find out how to best manage expenses.

18 Cost Management – Guest Column

As part of our extensive Cost Management feature, the team at Brighton & Hove Energy Services Co-operative Limited share details on why managing energy costs effectively is key to the success of your care home.

20 Activity of the Month

Spark joy for your residents and add another reason for potential guests to choose your establishment. This month, Art Therapy is the activity in question; we reveal the benefits it can have and how to go about introducing it to your venue.

23 Food and Nutrition

We explore how you can ensure your residents have access to a nutritious and balanced diet and how this element can help you appeal to wider audiences.

32 Care Home of the Month

We are thrilled to share Banstead Manor as our first ever Care Home of the Month. Our regular piece will be delving in to the logistics at Banstead Manor, how it is successfully marketed and the elements which make it stand out from the crowd.

Industry update

Devon and Cornwall Care Record goes

live

The Devon and Cornwall Care Record has gone live on the Orion Health Amadeus platform, a leading provider of care records to the NHS in England, Scotland and Northern Ireland.

#ShareWhyYouCare: raising awareness

Recent headlines have highlighted a care sector under pressure, with 165,000 vacancies needing to be filled. In a bid to raise awareness of careers in care as well as celebrating the people already working within the sector, one care sector technology platform kicked off 2023 by calling on care staff to share the reasons they work in the industry.

Initiated by Care Hires, The #ShareWhyYouCare initiative called for the 1.5 million people who work in adult social care to share why they’ve chosen a career in care, and

help others appreciate the huge positives and great sense of reward.

Speaking of the initiative, Suleman Sacranie, Co-Founder of Care Hires, said: “We wanted to start 2023 with something positive to celebrate the staff who are rising to meet these challenges daily while raising awareness of the sector as a career path to those who may not have previously considered it. There are some incredible people working in care doing incredible things and we wanted to share their stories.”

For more information, please visit www.carehires.com

The new system went live at the start of August 2022 and is already enabling frontline staff to access key items of patient information from GP, hospital, health and social care IT systems as a single record.

Further phases of the rollout will add additional data, so professionals working across Devon, Cornwall and the Isles of Scilly have a more complete view of a patient’s medical history.

This will improve the quality and safety of care, by reducing the amount of time that staff have to spend calling around for information and cutting the number of times that patients have to repeat their story.

Dr John McCormick, a GP, and the clinical lead for the Devon and Cornwall Care Record, said: “We are developing the record progressively, in a controlled way, so we can be confident about the quality of the data that it contains, and how to use it.”

Coming to the Royal College of GP’s, London, on 7th March, Hallmark Foundation and Working Options in Education are hosting a free national care conference for school pupils aged between 14-19 years of age to encourage the next generation of health professionals into the care sector.

The fun and informative event seeks to attract young talent into the profession by increasing awareness and will share the importance of working in care settings, supporting the industry’s need to fill the 2.27 million roles

required to care for us all by 2035.

Anita Goyal MBE, trustee of the Hallmark Foundation, said: “Over 1.5 million people currently work in some of the most important and valuable jobs in our society. With our ageing population, there will be a growing demand for the next generation of the care workforce. Everyone can care!”

For more information, please visit www.workingoptions.org.uk

For more information, please visit www.devonandcornwall carerecord.nhs.uk

Care career conference reaches younger generation

Safety First

With over 30 years of experience within the fire industry, Head of Building Products Fire Safety in the UK and Ireland for Siemens, Rob Yates, reveals how technology can elevate protection in a care home.

All buildings have their own specific requirements in terms of fire safety and risk assessments are the primary method of ensuring that a fire alarm system meets those needs. Care homes are no different, although the nature of the elderly occupants and their mobility issues need to be a particular focus in selecting an appropriate method of protecting the occupants and the care home itself.

In the majority of buildings, evacuation plans are a core element of fire safety procedures and while this is also true of a care home, the fact that it may be impossible to evacuate some of the residents has a direct impact on the requirements outlined in the respective standards. In BS5839-1, for example, the following clauses need to be considered:

• If occupants need assistance from staff to escape and there are more than 10 sleeping persons the system should be addressable

• Residential care premises should be provided with automatic connection to Alarm Receiving Centres (ARC)

• Signals to Alarm Receiving Centres cannot be delayed from residential care homes

Addressing the specifics

Early detection is particularly important in a care home. Many operate with older conventional fire alarm systems. These need to be upgraded to addressable systems to enable the location of an incident to be identified quickly. In doing so, it is important to consider the options in terms of cost implications associated with this migration. Some systems will require replacement of not only the

devices but also reconfiguration of the wiring into a loop. Others do not, thereby offering considerable savings in installation costs.

The ability to identify the location of an incident quickly can be further enhanced through powered floor repeater panels, allowing the situation to be reviewed without needing to go to the location of the main fire panel. The ever-increasing use of cloud-based technology can take this a stage further, with apps available which allow monitoring on a mobile phone.

In many applications delays in sending a fire alarm signal to an ARC are often deliberate to allow time to investigate to see if it is a false alarm or of a scale that can be tackled safely with a fire extinguisher. However, as is clearly stated in the British Standard, this is not the case in a care home.

Cloud-based technology

Increasingly, as in many of our day-to-day activities, the internet and the cloud are becoming pivotal in fire detection solutions. Digitalisation has made significant advances in terms of ease of use of fire safety systems.

Online portals can provide an overview of a care home’s fire safety. Multi-site dashboards can also provide locations of multiple sites in one place, with a status bar indicating the respective status of each in real-time, with a simple colour-coded approach to identify sites where problems may be occurring.

‘Interoperability’ is a phrase that has been around now for some time in terms of building management systems and it is gathering momentum as digitalisation increases. This is the potential to connect multiple systems which can then compliment each other. An example would be a CCTV camera able to zoom in on a fire location or record the operation of a call point, while a lift can report return status or louvres can be automatically activated in the event of an alarm activation to aid smoke ventilation. Care homes offer their own specific challenges in terms of fire safety. By understanding those challenges and adopting an approach which reflects them, residents and the buildings can be effectively protected. siemens.com

Cost Management

As the cost of living continues to rise, it comes as no surprise that many are more price-conscious than ever. To lend a hand in guiding you through what is potentially a testing time, we outline our top five ways to help control cash flow in your care home.

1

Recognise the challenges

With various demands pulling at the purse strings, particularly the current cost of living crisis we are up against, it’s important to gain a clear view of what kind of things could be affected. The pandemic brought a plethora of new challenges, including staff sickness, which has led to a staffing crisis. With agency workers being paid up to 40 percent more than a permanently employed staff member, this can create difficulties but, by firmly outlining challenges and effective solutions and then sharing them with the wider team, it’s the most beneficial way to get ahead of the curve.

2

Eliminate food waste

As care homes look to tighten budgets, the thought of food waste is enough to make us quiver. Not only is the waste highly unsustainable, but it is also costing your business money. Ways in which you can help eradicate or lessen such waste is by thinking carefully about portion sizes – get to know which residents eat more and those who don’t. Keeping an accurate inventory so you don’t double up and miss use-by dates is a great place to start, alongside saving leftover ingredients to introduce unconventional but tasty additions to the menu.

4 3

Budget clearly

Regularly outlining monthly and yearly outgoings is imperative to any business. By keeping these notes in a clear and concise form, you will help further down the line when and if you do need to cut back in particular areas. Using software such as Excel or Budgyt makes things easy for the entirety of the team and can massively help with annual financial reports.

Introduce technology

Although there can be reluctance around learning how to operate and introduce technology, it can offer a timely, efficient and useful way to work. Moving away from traditional processes that you may be used to, and embracing the utilisation of a piece of technology can go hand in hand with the potential staffing problems you may face. It’s important to remember that in an ever-changing world, it’s essential to keep up with trends to ensure you’re always appealing to new residents.

5

Negotiate with providers

More than ever, now is the time to have those uncomfortable conversations. Negotiating the best deal for gas and electricity is critical to remaining a sustainable business. If you’ve been with the same provider for a number of years, it may seem that the easiest option is to stick with them. However, if you can get it cheaper elsewhere, be prepared to negotiate with the existing supplier and if they don’t budge, it may be time to jump ship. In this difficult climate it’s important to make hard decisions if they are going to have positive impacts long-term.

Staying afloat

From keeping your care home’s food waste minimal to helping with budgeting and planning, we hear from some of the industry’s experts to find out how to best manage expenses.

What does the cost of living crisis mean for your care home? After a turbulent few years and the pandemic bringing with it an array of unwelcomed challenges, the soaring energy costs and rising inflation is undoubtedly difficult to navigate through.

With Greetwell Purchasing Solutions’ Care Home Buyers Guide highlighting how there were financial pressures within the care sector before the pandemic arose, they detailed that in 2018 alone, more than 100 care homes in the UK were made insolvent. This shows that the sometimes wafer-thin margins on which some operate can mean trouble if you don’t pay attention to every aspect of your business.

The eBook which Greetwell put together on ‘How to Reduce and Manage Food Costs’ explained that when it comes to purchasing consumables - including food,

cleaning materials, uniforms and stationery - the process can unfortunately be fraught with long, time-sapping administration. Thankfully, there are several ways in which you can look to mitigate this within your organisation, which are highlighted throughout the eBook.

One of these methods included reducing your costs per resident, per day. Greetwell explained: “Looking at operations from a top-down viewpoint is often useful, but understanding the needs of your catering team, residents and the expectations of families is also needed.”

Saving costs is a benefit in itself, but it comes with further advantages when you are able to take the money that has been saved and apply it to a different area of the business in order to generate either greater profits or boosted footfall.

As catering operations continue to face rising food prices, Hayden Hibbert, Client Relationship Director at Food Procurement Experts, allmanhall, looks at key areas where caterers could become more efficient and thereby make significant cost savings.

According to Hayden, “Reworking the menu offering, reassessing how the supply chain is managed

and revisiting operational practices could all have a positive financial outcome for catering operations.”

Using smart and effective recipe and menu engineering can make a big difference when it comes to food costs. Without changing the offering, costs can be reduced by looking at your cost-to-serve. This is the cost for a supplier to make a delivery. It can be brought down by limiting the number of deliveries you have each week or by increasing the value of each delivery: “The other thing you can look at doing is reducing the need for your supplier to split cases, which again brings down your costto-serve.” Hayden added.

Another way of driving cost efficiency is by using modern equipment. When did you last consider your capital investment strategy in regards to equipment? Like spending on training, the benefits could quickly outweigh the outlay.

Food inflation is a reality. Hayden commented, “allmanhall aims to help its clients in theses testing times, be it by negotiating down proposed price increases, advising on product alternatives and range management, or mitigating risks.”

With the food inflation crisis continuing and the need to

maximise budgets even more crucial, Katrina Lane, Senior Relationship Manager at allmanhall offered advice to catering teams on ways to provide healthy nutritious meals within budget.

“A starting point is an accurate costing model that provides a comprehensive understanding of all the contributing costs across the catering operation. Full visibility of the fixed, and especially variable (controllable), costs is essential. Keeping track of this data, and nimbly controlling variable costs whilst also battling increasing food prices, can protect the foodservice operation from excessive spending on ingredients, labour, and energy costs.” Added Katrina.

Katrina revealed how savings will also be made by increasing the level of in-house preparation: “However, a cost benefit analysis is still recommended, as it is important to factor in additional

costs of doing this, such as energy, labour, and equipment depreciation.” Batch cooking is a good way of saving time and increasing production output for the same labour input.

At the back end of last year, Care England revealed their concerns about energy renewal costs faced by care providers since the War in Ukraine. Following feedback from their hugely successful energy webinars and their subsequent formal challenge into OFGEM around unduly onerous energy supplier practises, Care England aims to support care providers to secure the best value for money possible for gas and electricity.

Care England shared that as of mid-January, The Treasury has published a factsheet that outline the next steps of government energy support. The new business energy scheme will run from 1 April 2023 to 31 March 2024. The

Reassessing how the supply chain is managed and revisiting operational practices could all have a positive financial outcome.

current £18 billion scheme (Energy Bill Relief Scheme) announced in September comes to an end in March 2023. It supports businesses and public sector organisations such as schools and hospitals by providing a discount on wholesale gas and electricity prices.

The Treasury has also published a letter sent from the Chancellor to Ofgem, which outlined the latter’s

initiative to launch a deeper review of the energy market, to provide further support for customers (this can be viewed on the Care England website).

Budgeting is important to every care home, small or large, and setting this out clearly from the offset will only benefit you in the long run. Budgeting allows you to plan expenditure based on

Full visibility of the fixed, and especially variable (controllable), costs is essential.

expected revenue and allows you to set financial targets for the home whilst having set allocations. Having a clear indication of your financial goals at the beginning of your financial year will give you greater control over your money and spending, which is why it’s advised you work with an accountant to help implement your budget and track actual figures.

With gas and electric being one of the main areas of expenditure, it’s important these are prioritised when assessing yearly and monthly outgoings. Whilst we appreciate that it’s simpler to keep working wiht the same provider to ‘stick to what you know’, you could find that by shopping around you could save hundreds.

Navigating through these tricky times can be difficult when you have a business and reputation to uphold, but leaning on industry giants and experts is the way forward. Always ensure your source is reputable and if you need any further details on the information we have shared, please feel free to get in touch – we would love to hear from you!

The new business energy scheme will run from 1 April 2023 to 31 March 2024.

Being Strategic

Why managing energy costs effectively is key to the success of your care home, as told by Brighton & Hove Energy Services Co-operative Limited.

In recent years, the cost of energy has become one of the main concerns for business owners across the UK with some seeing their gas and electricity bills double or even triple. Few sectors have felt the pain of these increases more sharply than the care industry, which is dutybound to maintain high levels of warmth and comfort all year round.

Although there are some signs that energy costs may come down later this year, it is widely accepted that prices will stay relatively high for at least the rest of the decade.

Therefore, to maintain a healthy budget whilst continuing to offer a high-quality service, it is vital for care home providers to introduce a modern energy strategy that will reduce ongoing costs and deliver long-term energy security.

A sensible starting place for improving the energy performance of any business property is to look at the existing Energy Performance Certificate (EPC) or a Display Energy Certificate (DEC). This is something that is required of all care home providers that includes

details of the energy strengths and weaknesses of the property. An EPC or DEC will provide recommendations on the best ways to improve the energy performance of the building, complete with cost and savings estimates.

With heat accounting for up to 70% of a care home’s energy bills, it is essential to ensure the building is made as thermally efficient, retaining as much heat, as possible. This could mean topping up loft insulation to the recommended minimum of 300mm, adding cavity wall insulation where it is missing, and replacing older windows with high quality double or triple glazing.

For care homes that have a communal boiler, it may be worth looking at replacing this with a modern low-carbon alternative such as a heat pump. Heat pumps provide a low-cost and reliable source of heat for decades and they can even be powered by solar panels for added long-term savings.

It is important to evaluate a care home’s potential to generate its own solar power, because this could provide a source of free energy for

at least 25 years. If budgets allow, it can be cost-effective to combine solar panels with a solar battery that can store electricity for use in the evening and overnight.

Lighting can also be a big part of a care home’s energy bill, with residents expecting rooms and communal spaces to be well lit throughout the day. Replacing all lights with energy efficient LEDs can drive down lighting costs by up to 90%, while introducing motion sensor switches in hallways and outdoors spaces can cut down electricity waste.

Whatever your care home decides to do, it is important that some action is taken to try to reduce energy use over the longer term. Care homes, as high users of heat and power, are especially vulnerable to energy market volatility. Therefore, implementing a long-term energy strategy will deliver big benefits for your business, your stakeholders, and for your residents.

bhesco.co.uk

Creative care

In our first-ever Activity of the Month piece, we look into how the arts can enhance your residents’ stay with you.

Over the last decade, people have come to the realisation that arts and creativity play a significant role in one’s health and wellbeing.

Within care homes, staff have actively seen the benefits of creative activities on their residents – whether these are tailored to groups or to a particular individual – especially as memories and cognitive skills tend to deteriorate with age.

It is for this reason that we wanted to put emphasis on the importance of creating and planning bespoke activities for the elderly, and how it can help each

resident reconnect with reality and develop trustworthy relationship with both their peers and members of staff.

The implement of the arts within healthcare facilities has been long discussed, which means that nowadays we are blessed with a wide range of research that leads to better and more accurate methods of introducing these practices to a care home community. This enables staff to plan according to the latest data and responses these techniques have provoked, allowing them to have a better understanding if their own residents’ needs.

The first thing to consider when

evaluating whether to include a new activity or deciding to practice creativity within your care home is the fact that art comes in many forms. Whether your residents have a flair for drawing or a longlost interest in pottery making, or just quite simply need something to keep their mind busy, there are many creative activities you can put in place to help them recuperate or enhance some of their skills. What’s more, there are health benefits to including creativity within your care home – especially when it comes to mental health and wellbeing.

In the ‘Creative Homes: How the Arts can contribute to quality of life in residential care’ report

directed by the barring Foundation in collaboration with The National Care Forum (NFC) and the National Association of Activity Provides for Older People (NAPA), the authors state: “If we think about the whole range of expressive and performance arts, there can be few of us who have not had the experience of how they can make us think, laugh, cry, help us through sadder times, introduce a little excitement or fun and connect us to something that is important in our past or present.”

However, there is a massive difference between art therapy and art sessions delivered at elderly care establishments. With the first requiring specific qualifications, organising art classes and bespoke creative activities for your residents is a lot more approachable – and incredibly helpful!

Another element that you should keep in mind is that every patient can respond differently; not only because of their personal interests, but also depending on their health condition. Some could be affected by an illness that impacts their motor skills while others could be suffering from disorders that lead to cognitive impairment; this means that each of them could be attracted and able to respond to a certain activity, requiring a range of sessions that can adapt to any situation.

Several care homes in the UK

have now integrated art within their offering, organising events and spaces for residents to reconnect with their creativity. Opening up activities to friends and family is also something you could try out; often, this results in reigniting long-lost memories and it facilitates conversation, stimulating the lodgers’ skills. Whether your residents’ physical health is deteriorating or not, it is essential that you give them the means to express themselves in their own way, observing them to identify their needs and allowing them to carry on their activity at their own pace.

If you’re worried, as mentioned before, that some of your occupants won’t respond well

to group sessions, it is always possible to provide them with their own space to work in. Placing equipment and materials that can catch their interest and can be operated with at any given time during the session is the best way to get them to engage in some way.

As furtherly explained in the aforementioned report, “as long as we bear individual needs in mind, different forms of arts activity both individually and in groups, can contribute to health and well-being and help people stay connected to social groups and communities and to a meaningful past, present, future and end of life.”

Ultimately, you want to do anything to help your residents; involving art in your program will allow you to support them mentally and emotionally, focusing on their wellbeing while also stimulating their cognitive and motor skills. Not to mention the benefits this could have on your business, as implementing creative activities into your home can elevate marketing and help you stand out from the competition, appealing to a wider audience and giving you the upper hand.

Simple creative activities go a long way and positively affect the body as much as the mind, making the experience in your care home one that your lodgers will cherish and enjoy not only amongst their peers, but also with friends and family.

GET IN TOUCH

We’d love to hear from you on how your business is progressing in 2023. Specifically, any new ideas you’ve implemented, any ways you are making additional revenue, your sustainability initiatives and your plans for the rest of the year – we know that a lot of you are doing inspiring things every day in your businesses and we want to give you the opportunity to shout about it.

Please reach out to jamesd@cimltd.co.uk for the opportunity to be featured in Care Home Magazine.

Food & Nutrition

Essential 5

In line with the importance of nutrition within a care home, Nutritionist Resource member, Cressida Elias, outlines five important aspects to bear in mind when creating a weekly meal plan within your home.

1

Whole foods

Whole foods are the top priority. Pre-packaged foods are often full of sugar and salt both which can cause issues for elderly people because as we age, generally the kidneys start to weaken and struggle. Looking after your kidneys and liver, the 2 organs that are largely responsible for filtering out toxins becomes even more important in old age and could extend a person’s life. Whole foods in a meal doesn’t mean it needs to be complicated with hours of preparation. Simple cuts of meat, eggs, vegetables, low sugar fruit and some grain or pseudo grains can be cooked very simply in the oven, steamed, slow cooker etc. Spring water is also a whole food and should not be overlooked as an essential part of the meal plan.

Protein and good fats

Protein is needed each meal, but not always animal protein. Animal protein can be offered twice per day. Protein helps to rebuild tissue and animal fat helps the absorption of fat-soluble vitamins from foods and is good for the skin – other good fats include flaxseed oil, coconut oil and avocado oil. Avoid using seed oils like sunflower or rapeseed, which are often overused and overheated in kitchens or packaged foods. Seed oils get damaged when cooked and can cause more free radical damage in the body, so it is better to use them unheated in salads etc. Instead, when cooking protein, an oven, slow cooker or pressure cooker is preferable to frying although this is okay if the heat is kept fairly low.

2

Cooked vegetables

Although a little raw food is good every day, each meal should have a few cups of cooked veggies to aid in mineralising the body, adding fibre to help with feeding the good bacteria in the gut and transporting out waste efficiently. Veggies will leave a person more satisfied and satiated, and less likely to snack too much between meals. Cooking them until soft releases all the nutrients that are bound up in the fibrous tissue.

4 3

Snacks

Healthy snacks in between meals, if needed, are important to provide. Nutrient dense snacks rather than white flour products, like cake and biscuits, except on special days or occasions are advised. Snacks can include vegetable or salad sticks with hummus, tahini, roasted almond butter etc. Nut and seed butters are easier to digest and are recommended in preference to the nuts and seeds. Blue corn chips are an antioxidant-rich, healthy snack that can be dipped in any of the above as well.

5

Salad for digestion

Eating some bitter foods like radishes and rocket salad just before their meal will help residents produce more bile to aid digestion. Always have a bowl handy for residents to help themselves. www.nutritionist-resource.org.uk/nutritionists/cressida-elias

Goodness is great

With a healthy mind often constituting a healthy body, we explore how you can ensure your residents have access to a nutritious and balanced diet and how this element can ensure you appeal to wider audiences.

Food consumption is essential to human life, with our bodies needing energy and hydration to function properly. Amongst older people in particular, and individuals who require full-time assistance, access to nutritional food and drink options is fundamental to good care.

Malnutrition is common in care homes for older adults because as age increases, so does dependence and frailty, meaning there is a heightened risk of developing malnourishment issues.

Fleur Key, Nutritionist at Brakes Foodservice, explained how a healthy diet can look different from one person to the next as residents are all diverse and have various tastes and needs.

Fleur explained that The Eatwell Guide shows us what the general population should try and include in a healthy diet: wholegrains, at least five servings of fruit and vegetables daily, protein from beans, pulses, meat and sustainably sourced fish (including at least one serving of oily fish); limited dairy produce, a small amount of unsaturated oils, plenty of fluid and limited amounts of foods high in saturated fat, sugar and salt.

“Adapting the Eatwell Guide to individual preferences can lay the foundation of a healthy diet as it encourages us to eat more fruit, vegetables and wholegrains, which I believe are the foundation of a healthy diet.”

Fleur continued: “Another important aspect of a healthy diet is the quantity eaten: we often misjudge how much food we need, or eat particular foods as a way of coping with certain emotions.

This highlights the importance of promoting a healthy relationship with food, which can lead to eating the right amount for our genetics, biology, and our own individual activity levels.”

A nutritious diet meets the biological needs of each individual, whereby we take nutrients from the food and drink we consume and

use them to repair and grow cells in the body, which leads to optimum health outcomes such as a functioning immune system, diverse gut microbiota and a healthy body weight.

With dietary requirements broadening, it’s important as a care establishment that you can work to cater to specific needs such

as lifestyle choices (vegetarian and vegan), cultural requirements and medical conditions, including diabetes.

Fleur explained how caterers must find affordable ways to tweak recipes and suit most residents, whilst also offering variety and choice for all. There are many ingredients that may be suitable for most without modifications, such as foods that are inherently void of allergens like meat, fruit, vegetables, and many different seeds, which lend themselves to a menu that could be made suitable for most.

Fleur added: “It is also important to ensure that you have appropriate alternatives to meat, fish, dairy or gluten, such as gluten-free bread to use in place of standard bread in a sandwich; tofu, beans and lentils to use in place of meat or fish in a curry.

“Fortified milk alternatives, instead of milk, reduce the need to introduce a completely different meal to a standard menu and helps residents feel like they are all being offered the same dishes regardless of their individual requirements. The advice for people with diabetes is to follow a healthy, varied diet, which is the same advice given to the rest of the population, and reinforces the importance of offering a balanced diet to all residents, regardless of their dietary requirements.”

At Brakes, they offer a lot of support for care home caterers. Their free online nutrition course covers meal planning, education on what a healthy diet looks like, IDDSI and diabetes. Brakes also provide customer demonstrations via their team of chefs, educational leaflets on hydration and diabetes, a menu appraisal service whereby their nutritionist highlights where a menu is meeting the needs of residents and where it could improve, and a whole host of product support from their technical and nutrition teams who can advise on which products meet the requirements set by the customer.

Getting the balance right between nutritious and delicious in your dishes is what will allow you

to stand out to potential future residents when they enquire about your home. The important thing to remember is that you know your residents better than anyone when it comes to what they do and don’t like to eat. You’ll also know that if they don’t like it, even if it is the most healthy food in the world, they won’t eat it – it’s human nature, so you must continuously get feedback from residents on their thoughts about the food they’re eating.

“It is important, especially for older adults, that they enjoy their food as many could be relying on it to treat or avoid malnutrition, recover from illness or simply to have an enjoyable experience.” Fleur finished.

Regulation 14 of the Health and Social Care Act (meeting nutritional and hydrational needs) states: “the nutritional and hydrational needs of service users must be met.”

Prescribing Support Consultant Dietitian/Integrated Care System Lead Dietitian for the NHS and

Specialist Adviser on Nutrition for CQC Social Care, Alison Smith, explained how meeting these nutritional needs should rely solely on ordinary food and drinks. With many care homes nowadays offering a prescribed oral supplement in place of meals, Alison explained that prescribed oral nutritional supplements are not required to meet the needs of the vast majority of care home residents and low-cost homemade supplements (made by care home caterers) can provide the same nutrition in the same volume while being more palatable for occupants who suffer from malnutrition.

Alison highlighted an interesting fact as she explained how fortification of food and additional nutrient-dense snacks should not be provided for residents at low risk of malnutrition, as doing so increases their risk of developing obesity.

Care home chefs and catering companies are recognised as central members of the care home

Another important aspect of a healthy diet is the quantity eaten.

team when working to manage nutrition and malnutrition; Alison said: “Ensuring regular two way communication about each resident’s needs between care and catering staff is essential.”

Age UK’s Robert Ince recognises that good nutrition and hydration are essential for the maintenance of health and wellbeing, more precisely how the act of eating and drinking is important for developing and maintaining pleasure and social interactions.

Eating together is a core human activity and can help increase appetite and food intake, as well as helping individuals to make connections: “Mealtimes and food reflect our identity and are an important part of living with purpose, particularly for older people who live in care settings.” Added Robert.

As people age, they become more at risk of developing longterm conditions such as heart disease, COPD, and diabetes. We may also experience anxiety, depression, or the sadness of bereavement and loss. All of which may result in poor appetite and lead to gradual or rapid weight loss.

The ability to eat and drink can become more complex as we get older, which is why Robert recognises that more attention may need to be paid to environmental factors, including the availability of carers to help with eating and drinking, the choice and consistency of food, and eating in a comfortable setting.

Intake of liquids is just as important as eating sufficient meals as dehydration is a serious condition. Robert explained how older people are at risk when they rely on others for their drinking and care needs, whether this is in hospitals, care homes, or their own homes: “Some older people will unknowingly be dehydrated. Residents must have easy access to fluids throughout the day and night, as well as prompts, and help to drink when needed. Residents should aim for at least eight cups per day.”

It can be difficult to know how

to design nutritious meals when people have special needs and likes and dislikes. The British Dietetic Association (BDA) have plenty of good advice and helpful tips for eating well in later life: www.bda. uk.com/food-health/food-facts/ older-adult-food-facts.html

With official food standards for care homes never being put in place, it has meant alternative and trusted outlets have taken matters into their own hands.

Last year, independent care home directory Autumna unveiled a new food accreditation to help care homes showcase their all-important dining experience and attract selffunding enquiries.

CHOICE Dining, a consumer-

facing accreditation, offers ratings on Cuisine, Hygiene, Options, Individuality, Care and the Environment, allowing individuals to make more detailed searches and informed decisions about the things that matter to them most.

Autumna’s founder Debbie Harris said: “Our research shows the dining experience in the care sector is as important as the dining experience in a hotel. If someone is used to fine dining, they’ll want somewhere that caters for them, while the same applies for the individual with simpler tastes.

“The dining experience is a critical component of any care service and our CHOICE Dining rating helps differentiate care homes and offers

It is also important to ensure that you have suitable alternatives to meat, fish, dairy or gluten.

people even more assurance when deciding on the right type of care provision.”

To be awarded the CHOICE Dining badge, care homes must have a premium profile on Autumna and be committed to delivering an exceptional dining experience. For more details, and to see which providers have already achieved the accreditation, visit www.autumna. co.uk/choice-dining

Choice Dining is the first foodfocused accreditation for the care sector. It was designed from the ground up to give care-seekers the ability to easily consider and compare the dining experience within different care settings, in turn enhancing their offering and enabling them to appeal to a broader audience.

Emily Stuart is a dietitian at apetito UK, the Wiltshire-based company who provide exceptional meals to care homes. apetito’s meals are expertly crafted by their dietitians and chefs. Emily told us “Good nutrition and hydration play a critical role in the health and wellbeing of residents. We know one size never fits all when it comes to catering provisions within a care home. There are many reasons residents may need - or want - to exclude certain foods from their diet, whether this be down to personal choice and preference around vegetarianism, pescatarian, or plant-based/vegan meals, or personal or religious beliefs, and not forgetting medical conditions which require a bespoke diet.”

Catering to a diverse range of needs is essential for residential care managers, and Emily explained the importance food holds in our lives, and how this shouldn’t change for residents in care: “Care homes should strive to ensure the diverse needs of residents are met and are equally included on all occasions, whether that is offering a choice of meals for vegetarians on daily menus, offering a slice of glutenfree cake as part of a birthday celebration or serving a Pureed Fish & Chips meal to those with swallowing difficulties on a ‘Fish & Chip Friday’.”

apetito offer a number of solutions to combat malnutrition within care facilities: “With apetito, care homes are able to meet a wide and diverse range of nutritional needs that meet personalised pathways that supports residents’ care.

It provides more than 200 meal options for care homes to choose from including a wide range of main meals, and desserts giving huge flexibility. Menu planning and food ordering is all done online with each care home having a dedicated

‘myapetito’ ordering platform which is designed to be quick and user friendly” added Emily.

With food and drink being important for far more than their nutritional content, as food is associated with anticipation and enjoyment for most people, it is paramount to take the words of the experts on board. Offering nutritional and diverse options for residents and potential residents will benefit your care home further in the long-run.

Age UK’s tips surrounding Food & Nutrition in care homes:

• Everyone involved in food provision and service should be listening to the resident, as well as their family and friends. They should also be aware of the resident’s preferences and family traditions, bearing in mind that if a resident has dementia, their preferences could change and move back to previous likes.

• Care staff must undertake a nutritional assessment, identify what help is needed to support eating and drinking, and make sure this is recorded in their care plan and that everyone knows.

• Make sure there is a good choice of food available - little and often with small meals and snacks seem to be more manageable.

• Ridged set times for meals don’t work for everyone. Some people won’t be able to sit down for a whole meal or may be hungry at unusual times. Make sure a good choice of food outside of hours is available.

• For residents who find it hard to use cutlery, or prefer to sit/walk, a finger-food grazing menu should be available.

• Swallowing difficulties are common in older people and people with dementia. There is a risk of breathing in food particles that can lead to aspiration pneumonia. Specialist advice and support should be provided from a speech and language therapist (SLT).

Diet and a healthy heart

Is a Mediterranean diet the answer to a healthy heart for the elderly?

It is a sad fact that our risk of heart disease increases as we age. The good news is that there are actions we can undertake to reduce our cardiovascular risk. What we eat is one. The food provided by the catering team for those in care and residential homes, can have a positive effect on the health of their hearts.

Rachael Venditti RNutr from allmanhall, the leading and award-winning independent food procurement specialist who supports care home catering teams with practical nutritional advice, talks about catering for good heart health.

A Mediterranean diet has been proven time and time again to be beneficial for many aspects of health, including heart and cardiovascular health. Whilst sadly we do not benefit from the balmy Mediterranean weather, we can still take advantage of the dietary principles followed by many traditional Mediterranean cultures such as in Spain, Italy and Greece where rates of heart disease, stroke and type 2 diabetes are lower.

What we mean by a traditional Mediterranean diet is a diet with plenty of fresh fruit and vegetables, fish including both white and oily fish such as salmon, kippers and mackerel, wholegrains, unsalted nuts and seeds, lean meat and chicken, low-fat dairy products and unsaturated fats such as olive and vegetable oil. It also means a reduced intake of saturated fat such as butter, lard and ghee and other animal products such as cream and red meat.

There are some specific foods

which have been found to either increase or decrease cholesterol levels which, if high, demonstrate an increased risk of heart disease such as heart attack and stroke.

Foods that increase cardiovascular risk

• Saturated fat e.g. butter, full fat dairy products, visible fat on meat

• High fat, high sugar foods such as biscuits, cakes, chocolate, ice cream and sweet pastries

• Foods high in trans fats such as margarines and fast foods as well as those listed above in the high fat, high sugar foods list

Foods that reduce cardiovascular risk

• Monounsaturated fats such as olive oil, rapeseed oil and avocados

• Polyunsaturated fat found in sunflower, corn and rapeseed oils, nuts and seeds and oily fish such as salmon, sardines and mackerel

• Wholegrains such as those found in wholegrain bread, brown rice, quinoa, barley, high fibre breakfast cereals and oats

• Plant stanols and sterols which can be found in cholesterol lowering products such as Flora

Tips on catering for good heart health in care

homes:

• Incorporate plenty of fresh (or frozen) fruit, vegetables and wholegrains into your dishes wherever possible

• Cook fresh wherever possible and limit the use of processed items

• Cook with olive or vegetable oil rather than butter

• Incorporate heart healthy ingredients into sweet treats such as oat-based cakes or flapjacks for mid-afternoon tea

• Offer oily fish on the menu regularly once or twice per week such as baked salmon at lunch or sardines on toast for tea

• Reduce red meat on the menu and choose leaner cuts of meat

Proactiv and Benecol

NB: these must be eaten in a particular dosage each day to have the desired effect.

Care Home of the Month Banstead Manor Care Home, Surrey

Care Home Magazine caught up with Veronica Henman, the General Manager of one the latest additions to the Hallmark care home family, Banstead Manor, to find out exactly what makes it special in what is a competitive industry.

Banstead Manor markets itself as offering high standards of residential, nursing and dementia care; a ‘whole team approach’ as Veronica puts it, is what allows them to maintain this great standard. The home has adopted a team-led action plan, which is shared with everyone so they are aware of the direction of travel and are invested in how to further improve Banstead Manor’s care delivery.

Veronica highlighted the large amounts of resident involvement and believes this aspect also contributes massively to the

development of the home. She says: “We have an activities forum where residents can give feedback on the activities schedule, and food tastings where residents can tell us everything from which fish they prefer to their favourite wine, so we can tailor the menu to their wishes and take note of their preferences.”

Stand-out elements of the care home include a hair salon and a cinema room; Veronica explained that all of the facilities are a real asset to the home because they give ‘that’ community feel and enable residents to socialise with family and friends. The use of these facilities are also included in the cost of the care, so residents can enjoy a weekly trip to the hair salon, and a manicure/pedicure as well as regular chiropody treatment in the therapy room at no additional cost.

“Our residents and their relatives really appreciate that this is included and respect the fact that

we are transparent about our fees.” Veronica commented.

In July 2021, Banstead Manor were awarded with a Good overall rating from the Care Quality Commission, something which is highly sought after by potential residents. In order to reach the goal of an Outstanding status, Veronica explained how the team ensure they are on track by having a robust schedule of audits with a high bar for an acceptable score: “We also work collaboratively with the whole team, the residents and relatives. This means we now have a real opportunity to enhance our care delivery further. Looking beyond compliance as a team towards how we can innovate and develop the home with residents and their families, is at the forefront of our minds.”

The aesthetically pleasing purpose-built 77-bedroom care home boasts a wonderful ethos,

which is ‘first and foremost, everyone must care!’ Veronica highlighted the importance of Banstead Manor’s team members demonstrating care and passion from day one as she commented: “We can teach our team to perform tasks and we can develop their skill and knowledge base but we cannot teach someone to be caring.”

The care home staff pride themselves on an internal development first-approach to succession planning and work hard to make the best use of everyone’s

individual skills: “For example, one of our housekeepers who had a real passion for exercise was supported to develop and now runs a weekly ‘movement to music’ class for our residents. This has created a real sense of fulfilment for our team member, and the residents really enjoy the class as well.”

When posing such brilliant ideas, movements and additions in a care home, it is vital to make it a key area when creating marketing strategies to appeal to potential residents. At Banstead Manor, they have a good

Customer Relationship Manager whose role is to raise awareness of the home through advertising and building relationships with the local community: “We also have strong links with local charities and community organisations such as the Banstead Business Guild and Rotary Club.” Added Veronica.

Whilst marketing continues to be a key factor in heightened success across a number of industries, there is nothing better than authentic and honest feedback. Banstead Manor welcome all feedback so they can learn from it and improve their care delivery. As of now, the home are proud to have a 9.7 out of 10 review score on carehome. co.uk from residents and their families. Positive feedback is always welcome and sharing this with the team is great for a sense of boosted morale so they know they are appreciated for all their hard work.

The most consistent feedback received from both relatives and residents at Banstead Manor is that everyone is ‘so kind’; “for me this is the basis of everything we do” finished Veronica.

For more, visit www.hallmarkcarehomes.co.uk

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