ACTION PLAN FOR ARDEN COURT CQC Reference MRR1-6023570595

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Areas need improving Action required Timescale Update on Expected Outcome(s)

Responsible

Carer documentation on PCS Daily notes Arden Court uses PCS which helps our carers and nurses to record in the electronic system all care interventions. However, on the other side, the details of some nutrition offered was not very accurate. Staff was asked to record the details of a level 4/5/6 meals instead of just ‘pureed meal’ which raised another issue that CQC inspector did addressed in the CQC inspection. It is alleged that residents on level 6 diet was given solid food. Staff should have specified accurately that food was cut down in small pieces and mashed up with gravy before serving.

Urgent staff meeting on 15 November which addressed this issued. Immediate training was given by Home manager. Meeting note are sent to staff who are not on shift today. This will also be stressed in handovers.

Immediately on 15/11/2018

Staff is aware of the importance of record keeping. The documentation will be completed accurately.

Home Manager Office admin

Care staff training Staff need further training in record keeping to improve the quality of care notes to accurately describe care given. All Care staff are given further training with Nutrition and diets with both in house training and follows with an online training on Social Care TV.

ALL staff at Arden Court are enrolled with online Record Keeping and Nutrition & Diet

Staff have completed Record keeping and Nutrition & Diets training In house training completed 21/11/2018

All staff have better understanding about Nutrition and Diets, especially modified food, thickened fluids.

Home Manager Deputy Manager Office Admin HR

ACTION PLAN FOR ARDEN COURT CQC Reference MRR1-6023570595

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New starters will expect more details training about Nutrition and Diet.

Nutrition Champion New Nutrition Champion is appointed to improve the Safety of Nutrition and Diet given to residents.

The new Nutrition Champion is responsible for constantly checking on the PCS system for any inaccurate documentation. They will be informed of any changes in resident’s nutrition and diet, notify our kitchen and care staff. Make sure the right Food and fluids are offered to our residents. Update the resident’s doors with the correct level of food and fluid and ensure the information booklet is available in the resident’s bedroom. They will be the dedicated person to give training about food and fluids for all new starters.

Ongoing/ completed Ongoing/completed Ongoing/ completed Ongoing/ completed

All of the correct food and fluid to be given, all staff are aware of changes.

Home manager Nutrition Champion

Kitchen instruction The kitchen are ensuring extra checks are inplace to maintain food safety.

Introducing Colour coded IDDSI guidance for modified diets. The chef will check the diets against the check list and use the IDDSI colours to tick off the list. This is then doubly checked by the nutrition

Completed

By indicating clearly the colours of the special diet, care staff will find it easier to identify the right diets to offer to residents. Easier for manager spot checks.

Kitchen staff Home manager Nutrition Champion

ACTION PLAN FOR ARDEN COURT CQC Reference MRR1-6023570595

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champion - to ensure that the correct level of diet is given. The chef will also colour code the plates in the IDDSI colours to ensure that the staff are aware and can check the correct level of diet is given. For example a plate colour coded green would be level 4 in the IDDSI colour coding system.

The IDDSI colour for level 6 is blue. Therefore, staff can easily identify that the correct level is given.

Continuous safety on resident’s Nutrition and diet: Creating multiple layers of checks, audits, guidances to filter out any mistakes.

Clear instruction on resident’s door: Clear notice was put on resident’s door what food/fluid should be given for their special diets.

Completed on 14/11/2018

Home manager Senior carer Office Admin

ACTION PLAN FOR ARDEN COURT CQC Reference MRR1-6023570595

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A guidance booklet There is now a guidance booklet in every resident’s bedroom regarding their diet. To ensure that staff can check and education themselves to ensure that the correct diet is given. Guidance booklets are also available in the kitchen for kitchen staff when preparing food. Guidance is also available on the nutrition board.

Completed.

Home Manager Kitchen Staff Nutrition champion.

Instruction install on carer’s ipod: Guidance on level of thicken’s drink are displayed on the back of PCS ipods for reference.

Completed on 15/11/2018

Office admin

Dysphagia management Policy Dysphagia management policy is updated immediately and also sent to all staff’s email for attention.

Completed on 15/11/2018 and on going.

Home manager Office Admin Nutrition champion

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This policy will also be included in staffs induction package as one of the importance policies and procedures.

Exploring Dysphagia food menu with current food supplier

Current food supplier has a dysphagia menu choice. Explore and have a food tasting session

Staff attended Dysphagia course with food supplier on 15.04.19

Head Office

Nutrition board A reference point to ensure that all dysphagia and nutrition guidance is easily accessible to the staff.

The introduction of the nutrition board with up to date information of the current IDDSI guidance.

Completed

Home Manager Nutrition champion

Daily and weekly nutrition audits Audits are completed to ensure the correct food consistency is given to residents.

Daily audit will be done by nutrition champion or senior on duty. This would alert the nursing staff and management of any mistakes/ incorrect records for immediate action. In addition, Head Office will log in daily onto the PCS to check daily entries on the Food Chart.

Completed daily/ongoing

There are 2 daily audits completed: Food chart audit: The food charts are checked throughout the day by the nutrition champion, to ensure the correct food is given and documented correctly. Food level audit: The food level is checked by the IDDSI guidelines, to ensure that the correct consistency is given.

Dysphagia Champions Staff at Arden Court are going to be trained by the Speech and Language Therapists in Salford to become Dysphagia Champions

Arden Court has been chosen by the Salford SALT team to become dysphagia champions. Four members of Arden Court will become

Completed in May 2019

The members of staff will have to complete dysphagia online training before the course commences.Then the champions will undertake a weekly training

Dysphagia champions

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dysphagia champions.

session for 7 weeks. The champions will complete practical tasks, observations and reflections throughout the course to build on their knowledge and skills around dysphagia.

Wristbands to identify food/ fluid levels To promote and ensure safety regarding food and fluid intake the IDDSI coloured wrist bands are going to be introduced. This is optional for residents and their family members, although we received a positive response during the resident’s meeting and the resident’s were keen for this to be implemented.

TBC

Home Manager Dysphagia champions

Dysphagia workshops for the staff. Training sessions are going to take place to educate staff on dysphagia.

Once the dysphagia champions have completed the dysphagia course. Regular dysphagia workshops are going to run for the staff at Arden Court.

Completed/ongoing Staff will be able to test the food to ensure that this is the correct level and consistency, the staff will gain more understanding and knowledge around IDDSI.

Dysphagia champions