PUREé Playbook

A Chef’s Playbook Third Edition

Table of Contents Overview ............................................................ 3 Objectives .......................................................... 4 Guiding Principles ........................................... 6 Essential Tools .................................................. 10 Equipment .......................................................... 12 Back of House .................................................. 16 Menu Categories ............................................ 18 Entreés or Main Course ............................... 18 Step-by-Step Plating ..................................... 20 Proteins ............................................................... 28 Cold Platters ..................................................... 32 Fruits ..................................................................... 34 Desserts .............................................................. 36 Garnish ................................................................ 38 Spreading Guidelines ................................... 40 Sample Recipes ............................................... 48

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Overview Textured modified foods is an art and a process of redefining a natural food product into a new form – a form that represents the corresponding regular diet from a presentation standpoint – as well as providing a flavorful experience.

PUREé will bring a new dimension to our residents in your community.

“Equal emphasis” is the guiding principle of PUREé and the operating standards that will create a consistent delivery on quality, nutrition, flavor and artistic presentation for seniors in our communities. Textured menu items should receive the same attention to details as it relates to plating, quality, flavor and choices as offered to residents dining in other dining venues in your community. Textures should be properly executed and utilize the same quality of ingredients with excellent visual appeal. They should exude a pleasant aroma while maintaining the appropriate smooth texture for a safe dining experience.

By following the PUREé standard operating procedure provided in this manual, you can create an attractive, safe, and quality experience which will enrich the lives of seniors in your community.

PUREé Standard Operating Manual has been developed to meet two levels or outcomes in our business.

Level #1 is designed for communities with less than or equal to 15 purees* Level #2 is designed for communities with equal to or greater than 16 purees Minimum Standards Required for Level #1: Protein Formed or Shaped, Starch Piped or Formed, Vegetable Piped or Formed, Dessert Molded, Piped or Parfait and Fruits Molded Minimum Standards Required for Level #2: Starch Piped or Formed, Vegetable Piped or Formed and Dessert Molded, Piped or Parfait *Level #1 is available for communities with more than 15 purees with additional labor.Book • 3 PUREé Guide

PUREé Objectives 1. Clear operating procedures and expectations on executing both level 1 & 2 of PUREé 2. Outline the essential equipment, back-of-house and front-of-house tools to be successful 3. Provide clear expectations and standards as it pertains to shaping techniques by menu category 4. Step-by-step pictures to illustrate plating standards by menu category 5. Webtrition recipes outlined at the end of the guide 6. Sweet and savory garnish for appropriate menu items 7. Provide a safe texture and nutritious menu items.

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Guiding Principles • PUREé foods are prepared according to a standardized recipe and the standards of techniques listed in this guide.

• Residents on pureé diets are served the same foods as residents on regular diets or a similar alternative in accordance with regulatory requirements and diet manual’s texture guidelines.

• PUREé foods shall be fresh from today’s menu – NEVER use leftovers.

• PUREé foods are served in normal dishware, not on a divided or lipped plate, in fruit dishes, mugs or soup bowls, unless required as an adaptive feeding device for residents to use for independent feeding.

• PUREé foods are garnished, utilizing standardized garnishes listed in this PUREé guide.

• Hot broths and/or sauces, thickened to the appropriate consistency, shall ALWAYS be served over entrees, starches and vegetables.

• PUREé food items shall always be tasted before each meal to assure quality and consistency of foods.

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Tips • Complete an inventory of both front & back of house smallwares to determine if you have the correct service ware and tools to perform all techniques listed in this guide • Inspect your food processor to determine if the blade is sharp, the bowl is in safe condition and the motor is operating correctly • Work with your nursing team, dietitian and speech therapists in the planning phases of the PUREé rollout before implementing • Create a PUREé tasting in your community and be sure to include nursing, dietitian and speech therapist • Update your menu collection to include correct menu items as well as diet extension. This assures that correct recipes are being utilized and the appropriate pureed item is correctly spread (example: Chicken Stir Fry is NOT the best pureed dish to have as an extension) • Search PUREe recipes by filtering Recipe Source ML-Puree PUREe 8

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Essential Tools Having a complete focus on PUREé from both front of house and back of house is extremely important for a successful launch as well as maintaining our brand standards.

Listed below are the essential tools needed to properly execute our PUREé standards. These items must be purchased prior to starting PUREé.

Note: Refer to the PUREé tools guide located on the My Compass Morrison Living Smallwares link.

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Equipment The proper equipment is essential in order to produce high quality, pureed foods that meet the required texture. Be sure to inspect your food processor, sharpness of blade and condition of the bowl and lid.

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Food Processor with sharp blade – Minimum requirement: Robot Coupe R2 or Blixer 3 or larger depending on volume

Blender – Vitamix CIA Pro series or Waring HGBSS

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Equipment • Plates should be in good condition with the appropriate matching lid • Square or rectangular plates and lids are optional • Small ramekins used to hold additional sauces • Assure that hot & cold holding equipment is readily available and functioning properly • Rocks glasses to serve as great vessel for piped desserts • Layer piped desserts and pureed fruits in parfait glassware

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Plates

Plate Lids

Ramekins

Rocks glass

Parfait glass PUREé Guide Book • 15

Back of House Equipment 1: Pastry bag with various tips for piping of starches and vegetables 2: Spaetzle press for starches, rice and pasta to create a noodle or rice like presentation 3: Ring mold for protein plating options 4: Flex molds for protein plating options 5: 1 oz. scoop for vegetable plating (both oval and round) 6: Terrine mold for protein plating options 7: Squeeze bottles for sweet and savory garnish 8: Layer piped desserts and pureed fruits in parfait glassware

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2.

3.

4.

5.

6.

7.

8.

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Menu Categories Note: Expectations will be clearly defined in each section indicating minimum requirement for level 1 and level 2.

Entrées or Main Course Executed as a complete entrée plate which includes assigned starch or grain, vegetable and appropriate garnish as per the texture modified diet spreads approved by your dietitian.

In this section of the operating standards guide you will understand the four core plating techniques for PUREé guidelines. Refer to the spreading guidelines to determine the appropriate recipes for the diet extensions. In addition, if your community chooses to provide piping for sausage type entrees as well as slurried breads, please first review with the community speech therapist.

Core Plating Techniques 1. Traditional Plating 2. Casserole Style 3. Pasta Bowls & Plates

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Step-by-Step Plating Traditional Plating

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2.

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4.

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Step-by-Step Plating Casserole Plating

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4.

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Step-by-Step Plating Pasta Bowls & Plates

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3.

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Tips • Create your PUREé plating guide to establish clear expectations on the plating standard for each meal period and meal item (utilize PUREé plating guide template) • Create a photo catalog for each day which includes breakfast, lunch and dinner menu items (utilize PUREé photo standards template) • Designate the proper time each day to prep PUREé items.

This should not be an afterthought or a scramble to plate meals or figure out plating style for menu items (utilize PUREé prep sheet template) • Customize a PUREé cook’s checklist to assure that this position is successful and daily assignments are completed (utilize PUREé cook’s checklist) • The dietitian and chef should work closely to ensure that the menu items and recipes chosen for the puree diet are best suited for production, puree technique and menu similarity to the regular diet.

• Be sure to have Webtrition Menu at a Glance for reference.

• Make readily available the audit texture tool to verify the puree consistency.

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Proteins Proteins require the following techniques: Ring mold, Terrine or mold from a shaping technique. Piping is acceptable for sausage entrees with open tip only. No single scooping of proteins, all proteins must be formed/shaped using the below techniques while adhering to Webtrition recipes.

Molding & Shaping Techniques 1. Ring mold: 4oz ring, place pureed protein in ring then lift 2. Terrine: Cook in terrine, then slice and place on plate 3. Flex or molds: Cook in silicone style approved molds, invert and place on plate 4. Scooped & piped: Meatball or sausage execution (limited applications)

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Ring

Flex Mold

Terrine

Scooped/Piped

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Essential Tools All recipes for side dishes consisting of starches and vegetables are available in Webtrition and only these recipes should be utilized for PUREé. If there is a need to add recipes to the PUREé database, please make a request to your Corporate Executive Chef.

Plating/Shaping Techniques Vegetables: Piped or scooped Starches: Piped, ring mold or Spaetzle pressed

Tip When piping out vegetables or scooping on plate, be sure to scoop a 4oz. portion on test plate to create a side by side comparison to assure correct portioning.

1. Spaetzle Press: Use a spaetzle press for pasta like appearance 2. Scoop: Only use for brussel sprouts, cauliflower and broccoli (4 – 1oz. scoops) 3. Ring Lift: Option for starches 4. Piped: Option for both starches and vegetables (except brussel sprouts, cauliflower & broccoli) 5. Pulling: Technique of pulling pureed vegetable with back of spoon to provide a colorful plate coverage (be sure to measure vegetable portion on plate prior to pulling) 30

Sample Side Dishes Pipe

Scoop

Ring

Pasta

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Cold Platters A cold platter option when typically pureed or slurried sandwiches are offered in our communities is a great way to break up the routine and provide an enhanced presentation for our seniors. The objective of serving cold platters is simple, equal emphasis as it pertains to the flavors and ingredients being served.

Plating Techniques Ring Mold: Proteins (examples: chicken salad, tuna salad, ham or turkey) Piping: Composed Salads (examples: potato, macaroni, pasta, & beet salad) Molded: Fruits (examples: cantaloupe, watermelon, pears or apricots)

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2.

3.

4.

Platter Examples

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Fruits The goal is to provide a molded fruit option that brings the great flavor and shape of the fruit offered on menu. Refer to our Webtrition recipes for proper preparation and standard technique. It is important that once the fruit is placed in the desired mold that it be placed in the freezer to set up prior to unmolding for plating purposes.

Molding & Plating Techniques Piped: Fruits piped into serving vessel Fruit Mold: Pureed fruits placed in shaped molds that resemble the shape of the original fruits Flex Mold: Pureed fruits placed in a silicone mold, set in freezer then presented sliced on plate Cut Fruit: Pureed fruits are placed in shallow pan, set in freezer then cut into ½” x ½” dice then served in bowl to represent diced fruit (canned or fresh fruit) Service Vessels: Ramekin, Dessert Bowl or Plate Tips • Utilize silicone molds for consistent portioning • Slightly freeze in molds then pop out for improved presentation • Purchase fruit shaped molds, i.e. melon, pear, peaches, pineapple • Be sure to drain canned fruits before blending • All fresh fruits should be ripe prior to blending 34

Sample Fruits

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Desserts Desserts are created using Morrison Living Recipes that are either slightly modified from the original recipe or add an additional step to change texture that works great for residents on a puree diet. In most cases, desserts can be pureed to maintain a flavor profile and presented in a way that elevates the presentation to enhance the overall dining experience.

Molding & Shaping Techniques Piped: Cake and brownie style desserts can be piped onto a plate and garnished to enhance the flavor and presentation Parfait: Puddings, mousse and cakes can be layered into a parfait cup/vessel with layers of whipped cream and garnished appropriately to add flavor to overall dish Molded: Cake and brownie style desserts are pureed and placed in flex mold, set in freezer, then inverted on plate and garnished Smoothie: Pie desserts such as apple, cherry, pumpkin or blueberry are pureed with ice cream and/or yogurt to a smoothie-like consistency then served in a glass with appropriate garnish to improve flavor profile

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Sample Desserts Piped

Parfait

Molded

Smoothie

Tips • Keep a good variety of dessert sauces available • Inventory your service vessels to assure flexibility and variety • Maintain an inventory of various sized pastry bags and tips • Use silicone flex molds for pureed cake: Slightly freeze, pop out prior to service, and serve with appropriate sauces • Utilize clear rocks glass or squat cup for parfaits • Add pastry cream, fresh whipped cream or puddings as layers • Consider referring to and utilizing the Smallwares Guide under Dignified Dining for other options Service Vessels: Plate, Dessert Bowl, Parfait Cup, Rocks Glass, or Clear Glass Mug PUREé Guide Book • 37

Garnish All garnishes should complement the dish regardless of sweet or savory and should be completely functional in both appearance, consistency, as well as flavor. Garnishes for purées should have a smooth consistency with an strong flavor profile while providing a great color contrast to the dish being served.

Recommended Garnishes Sweet Garnish Options Blueberry Coulis #123042 Caramel Sauce #123041 Chocolate Sauce #123040 Raspberry Sauce #123039

Savory Garnish Options Roasted Tomato #122377 Dill Crème Fraiche #122364 Onion Jam #122361

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Savory Garnish

Caramelized Onion Roasted Tomato

Basil Crème Fraiche

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Menu Spreading Guidelines 1. PUREé puree recipes should be the primary puree recipe chosen, when applicable.

2. When spreading to a pureed diet, the following guidelines and concepts will be used: a. search a PUREé recipe that is similar to the regular menu item.

For example: baked chicken as regular recipe, use PUREé chicken #122362 3. In absence of a similar PUREé recipe, spread the regular menu item to the puree diet using the following category guidelines: starch, vegetable, fruit, mixed dishes, garnishes, and desserts.

4. Pureed portion amounts will follow portion size standards.

5. Menu spreads will indicate the following, but not limited to: a. Recipe b. Portion c. Utensil d. Instructions used for each individual portion.

6. When slurry foods are required, the slurried baked products recipe in this guide book and corresponding technique should be followed. A slurry is a soft, moist mixture often used for people with swallowing problems. The moisture of the liquid makes it easier for someone with swallowing problems to swallow soft bread products.

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Starch • Starch PUREé recipes available are: - PUREé rice, egg noodles (see spreadsheet for recipe #s) • When a PUREé recipe is not available, spread the regular recipe to the puree diet and notate, “PUREE” in the comments field.

• Egg noodles are the preferred product for any pureed pasta foods.

• For all rice lunch and dinner dishes, the PUREé Rice recipe #134600 is preferred.

• Mashed potatoes are their own recipe and should be used for potato recipes – example: DO NOT puree any potato that has been baked, fried, roasted or have skin on potatoes, etc...

• Portion sizes are the same as the regular recipe.

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Vegetable • Vegetable PUREé recipes available are: - Asparagus, carrots, green beans, peas, spinach, broccoli, yellow split pea, Brussel sprouts, rutabaga, etc...

• If a PUREé recipe is not available, spread the regular recipe to the puree diet and in the notes section indicate “PUREE.” - NOTE: Pureed mixed vegetables are not acceptable.

Do one of the following: • Choose one of the vegetables from the mix. For example:

- if carrot is part of the mixed veg, use a PUREé carrot

recipe, #122365, for the pureed diet OR puree them separately and plate a smaller portion of each vegetable

- NEVER puree raw vegetables, for example: leaf lettuce

- Portion sizes are the same as the regular recipe

• NOTE: regarding residents on a renal diet – do not use mashed potatoes to thicken vegetables, use the Simply Puree recipes found in Webtrition instead.

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Fruit • The following Fruit PUREé recipes are available: - Fresh Fruit: Watermelon, cantaloupe, honeydew, pineapple - Canned: Mandarin orange, peach, and pear.

- NOTE: Xanthum gum is used as the thickening agent in PUREé fruits.

• If the regular menu item is not allowed on the pureed diet, substitute an appropriate menu item”. Choose a similar pureed canned fruit recipe that is as close to the regular recipe as possible.

- Only certain fresh fruits may be pureed, (no seeded fruits) such as those available through PUREe program.

Bananas are the exception.

• Portion sizes are generally the same as the regular recipe, or 4oz • NOTE: Make sure the Community Specific Diet Addendums are updated to reflect the use of fresh fruits for purees.

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Proteins & Casseroles (Mixed Dishes) • The following PUREé protein recipes are available: - Beef, chicken, ham, pork, salmon, white fish, turkey, PUREé protein template.

- NOTE: Cannelini beans and egg whites are used as the thickening agent for protein PUREé recipes.

• If a PUREé recipe is not available, spread the regular menu item to the puree diet and notate, “puree using #134828” and then add the PUREé puree thickener recipe #134828 to the menu spread under thickener-texture modified. For example: if Beef Burgundy is the regular recipe, then spread the Beef Burgundy recipe to the pureed diet, then in the notes section indicate “puree using #134828”, and add PUREé puree thickener recipe under condiments.

• Certain protein portions are 1oz greater than original core recipe to allow for comparable protein content to the original recipe. For example; if a chicken breast portion on a regular recipe is 3oz, we serve a 4oz portion for purees.

• ALLERGEN NOTE: Residents with an egg allergy should not receive PUREe Entrée recipes due to the addition of egg whites.

• NOTE: regarding residents on a renal diet or phosphorous restrictions, PUREé recipes should be avoided due to the beans used for thickening.

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Garnishes • The following PUREé protein recipes are available: - Beef, chicken, ham, pork, salmon, white fish, and turkey, PUREé protein template (see spreadsheet for recipe #s) - NOTE: Cannelini beans and egg whites are used as the thickening agent for protein PUREé recipes.

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Desserts

• If a slurry or smoothie method is required for desserts, please utilize appropriate Webtrition recipes.

- Common slurry recipes are: cakes, cookies, donuts, and muffins.

- Common smoothie recipes are: pies, layered desserts, and parfait.

• Common portion sizes are 4oz.

• Obtain approval for the use of slurry recipes by SLP and access slurry recipes in Webtrition” When a slurry, smoothie, or similar puree recipe is not available, spread the regular recipe and indicate in the notes section, “PUREE”.

PUREé Level 4 IDDSI Description APPEARANCE: No Lumps FORK TEST: Food sits in a mound on fork and does not drip or flow through fork.

SPOON TILT TEST: Holds shape on spoon and slides off spoon.

Puree needs to be able to be put in the mouth and swallowed whole.

No chewing and no bolus formation skills should be needed.

PUREE CONSISTENCY:

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Slurried Baked Products • Prep time is five minutes.

• Total time is 45 minutes (based on product).

Item to Slurry

Slurry Mixture

To Slurry

• Breakfast bread (biscuit)

• Prepare the Thick & Easy

• Method 1: Dip the item

• Cake (without icing or nuts)

using the directions on

completely into the

• Muffin (without nuts,

the package

slurry liquid and plate

fruits, grains, or any item that cannot be softened by liquid) • Rolls (no whole grain items)

• Prepare to nectar

for presentation. Allow to

consistency for liquid

absorb for a minimum of

• The liquid used should

30 minutes. This depends

be one of flavor (orange

on the fat content of the

juice, apple juice, or

product being slurried. The

simple syrup)

higher the fat, the longer

• Simple syrup is sweetened water

Note: Only baked goods without nuts, fruit, hard items or whole grains can be slurried.

the soaking will take.

• Method 2: (not recommended) you can pour the liquid over the item and allow to soak.

Garnish

Plating

Holding

• All slurried items are

• Place the slurried item on

• Keep all slurried products

best presented with a

the plate which it will be

moist. Mist spray the

complimenting sauce

served once dipped in the

product as needed.

such as vanilla custard or

liquid for softening.

a strained fruit puree.

• Breakfast items should be served with softened

• Place plates onto sheet pans and use cup to raise the plastic wrap so that it does not touch the food.

butter and fruit jelly.

Note: Allow for time so that the product is softened by the slurry liquid (allow at least 30 minutes).

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Protein Recipes Chicken PUREé #122362 Chicken Standard #1794.16 Beef PUREé #122358 Beef Standard #4897.6 Fish PUREé #122384 Fish Standard #810.18 Pork PUREé #122375 Pork Standard #5314.9 Turkey #122362.2 White Fish #122384.1 PUREe Puree Thickener #134828

Starch Recipes PUREé Rice #134600 PUREé Pasta #134597

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Sample Recipes Potato Salad Standard #61715.1 Tuna Salad Standard #5810.9 Beet Salad #81.5 Egg Salad #1932.28

Plating Technique Ring Mold – Proteins

(example: chicken salad, tuna salad, ham or turkey) Piping – Composed Salads (example: Potato, Macaroni, Pasta, Beet Salad) Molded – Fruits (Cantaloupe, watermelon, pears or apricots) Vegetables Piped or Scooped Starches Piped, Ring Mold, or Spaetzle Pressed

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Fruit Recipes Cantaloupe PURE #122360 Cantaloupe Standard #10345.2 Honeydew PURE #122368 Honeydew Standard #10345.2 Watermelon PURE #122383 Watermelon Standard #88.1 Canned Peaches PURE #122371 Canned Peaches Standard #10335.8 Canned Pears PURE #122372 Canned Pears Standard #1308.4

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Notes

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