Adam Wilkie

About Adam Wilkie

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16 September 2021

How to Prep for a COVID Winter

After 18 months it’s hard to believe that this is still a topic of conversation that is continually first on the agenda. However, after such a devastating period for the care sector it’s really no wonder.

It seems with a tough winter ahead we’re not fully out of the woods yet and preparing now, hopefully using lessons learnt, we can protect residents and staff alike far more effectively.

The defense strategy rolled out by Cedar Revive to defend against the effects of COVID was far wider reaching than just infection control (although this is paramount at all times). We worked with our clients and supported many care homes with their own cost saving to ensure a high level of service could continue to be provided; and further than this we ensured and continue to ensure that overall health and wellbeing is top of the priority list by educating and guiding chefs and catering teams.

Some of the areas our strategy looks at are:

Infection control & cleaning procedures
Nutrition amongst residents
Recovering from Isolation (supporting mental wellbeing)
Cost Saving & procurement

We are very aware of the cost impact this pandemic has had on the entire sector, and therefore every procedure and protocol we rollout with our clients is to ensure efficiency and/or suitable care. It is very important to note that an unhealthy, vulnerable resident is more expensive to care for as they should have more time and resource dedicated to them; our strategy ensures they are as physically resilient and independent as possible, which is what they would want and deserve anyway.

We must state to begin with that nutrition cannot cure or protect anyone against Covid-19; we are in a position currently where nothing can apart from protection against exposure. However, nutrition can and does build physical resilience and support immune response. This helps give our bodies the best chance to fight disease and hopefully recover far quicker.

Lessons Learned

Throughout the past 18 months we have learned that isolation comes with many problems and, although is sometimes required, should not be the norm. To many residents in care have had premature ailments and downturns in health due to their mental state and the environment around them.

An example of this is Protected Meal Times…

Protected meal times are periods where eating and drinking are the focus. During these times, people are able to eat and drink in a clean, quiet and safe environment. Non-essential interruptions are limited, to allow staff to provide assistance and encouragement.

It may seem like the focus here is providing a nicer environment to dine, however it achieves much more.

In some recently completed a mealtime observations we found that due to the COVID rules, the core principles of the protected mealtime had been affected; the important care service was being affected negatively. We found residents, at times, eating in unsuitable areas with distracting or unsuitable traffic around them, including corridors and isolated in their own rooms…

We need to ensure that these principles remain in place and their importance highlighted. With the restrictions that COVID brings, we need to work the service around to maintain the respect and dignity of the resident’s mealtime whilst keeping them safe.

Supplementation

In a Cohort study that involved 9940 men and women, a team of researchers from Germany Cancer Research Centre assessed the link between Vitamin D deficiency and mortality from respiratory diseases[1]. The patients studied were between 50-75 years and all from Germany.

They found that 44% had insufficient vitamin D levels (25-hydroxyvitamin D blood levels of 30-50 nmol/L), and compared to those with a sufficient status the deficient had increased respiratory mortality. Overall 41% of respiratory disease mortality was statistically attributable to vitamin D insufficiency or deficiency…

So, it is no surprise that a recent retrospective study by the University of Chicago Medicine found an association between vitamin D deficiency and the likelihood of becoming infected with Covid-19.[2]

We therefore ensure the chefs within our client’s care facilities understand how to balance a diet with the correct vitamins and minerals to build a suitable base for health; menu planning here is KEY.

Procurement & Further Cost Saving

As far as cost-saving activities go, this is maybe the more obvious area to look.

Having a robust supply chain management system and careful menu planning is where we start. Some things to consider:

Assess your order volumes for your top 50 products over the past 3 months and ensure orders are logged early.
Assess required products and menus that may include ‘short-life’ products, and plan suitable alternatives in advance.
For products sourced from outside of the UK, ensure you are fully aware of any duty impact based on existing tariffs to allow for prudent financial planning.

If you feel your care home requires further support and advice we would be delighted to discuss this with you. Our experience could be a physical and financial lifeline during the upcoming difficult months.

[1]Brenner, H, Holleczek, B and Schottker, B. (2020) Vitamin D Insufficiency and Deficiency and Mortality from Respiratory diseases in a Cohort of Older Adults: Potential for limiting the Death Toll during and beyond the COVID-19 Pandemic? Nutrients: 12, 2488 https://www.mdpi.com/2072-6643/12/8/2488/htm

[2] Meltzer, D.O, Best, T.J, Zhang, H Vokes, T, Arora, V, Solway, J. Association of Vitamin D Status and Other Clinical Characteristics With COVID-19 Test Results. JAMA Network Open, 2020; 3 (9): e2019722 DOI: 10.1001/jamanetworkopen.2020.19722

15 July 2021

Protected Meal Times and the Covid Effect

COVID19 has forced care homes, and the entire 3^rd sector, to work very differently and has thrown up many challenges over the past 18 months…

Despite the principles of care we have developed and learned over years, we have put many of these to one side in order to protect staff, residents and the wider community. This protection has been vitally important, but in many cases it has been done with full focus on the pandemic and very little or no focus on the resulting effects on those in care.

We believe it is vital that important care principles are not forgotten. We also believe some imagination and problem solving around how services are provided could and does achieve both objectives.

Protected Mealtimes

It may seem like the focus here is providing a nicer environment to dine, however it achieves much more. ..

Nutrition is the key to improving, controlling, or mitigating from disease, and physical and mental ailments. Although Protected Mealtimes have not shown to improve nutritional intake directly, they are shown to allow/encourage residents and those in care to enjoy their food with more chance of meal completion, which does have a direct effect on nutritional intake.

Some of the principles set out by NHS Scotland to follow during meal times are:

Safe staffing levels
Minimise non-essential interruptions
Ensure food and drink is within easy reach
Provide assistance where required (open packets, cut up food, pour drinks)
Support people to eat and drink where required
Family, friends and volunteers may assist if this will encourage food and fluid intake and is safe to do so
Provide positive encouragement to increase food and fluid intake
Allow sufficient time for food and drink to be enjoyed

Our Mealtime Observations

As an organisation, Cedar Revive regularly completes mealtime observations at our client’s care homes and upon request from others looking for guidance. In some recently completed a mealtime observations we found that due to the COVID rules, the core principles of the protected mealtime had been affected; the important care service was being affected negatively. We found residents, at times, eating in unsuitable areas with distracting or unsuitable traffic around them, including corridors and isolated in their own rooms…

The key point to remember is residents enjoy and look forward to mealtimes. These times should be fun times. It has been very difficult during shutdowns when families and loved ones have not been able to meet and have social interaction, which is so important to everyone young and old. We as caterers have had a very important role when providing new dishes on the menu while maintaining nutritional guidelines. Catering trends have changed and just because your old and in a care home, these points are just as valid. So we at CedarRevive are very aware when planning menus. The introduction of themed days is also important and maintained in our menu planning.

If you require assistance or guidance with solutions to COVID rules in order to maintain a high level of service to residents, contact our team today and we’d be happy to chat.

[1]: careinspectorate.com – Principles of Protected Mealtimes

24 May 2021

Modified Texture Diet, What it is and the benefits?

A ‘modified texture diet’ is required by many of our customers for many different reasons.

Residents in care homes and young people in special schools have very different requirements for the type of dishes they want to eat, but that their condition allows them to. We therefore need to be imaginative and flexible with the choices available at mealtimes so that they have a good choice of tasty, well presented, nutritious meals.

What is a Modified Texture Diet?

Texture modification is when food is mashed or pureed to a certain level in order to make it safer to eat. When people have problems with swallowing, or controlling food within their mouth, they may require a modified texture diet to reduce the risk of choking or aspiration (food or fluid going into the airway).

This type of diet and food preparation is most commonly needed by those who have suffered strokes, have progressive neurological disorders( e.g. Parkinson’s disease), learning disabilities and the elderly. However this is not exclusive, and those who have suffered injury to the head and neck, for example, may also require such a diet.

It is vital no matter the person’s condition that they continue to receive nutrients in the most appealing way possible, which is one of Cedar Revive’s primary goals.

Texture Guidelines

The guidelines for the different levels of texture modification changed in the last few years to the IDDSI framework. This has made producing the meals a lot simpler by ensuring there are easy to use tests to check the food is in the correct consistency.

The framework has 8 levels from level 0 – thin liquid to level 7 – regular food. These can be seen in the following image.

There are many different considerations that need to be thought through to ensure that the texture modified meal is appetising and appealing, and ultimately the full portions are eaten to promote health and wellbeing.

Stay tuned to our social media channels over the coming weeks where we will be diving deeper into this subject and providing practical advice for care homes, schools and families at home.

To find out more or find out how Cedar Revive could support your organisation, arrange a chat with a member of our experienced team today – Contact Us.