Food pictures aid nutrition for learning disability patients

The picture menu cards were created in 2001 by learning disability nurses in Derbyshire as part of the Essence of Care nutritional benchmark.

Following success at the 2005 Nursing Times Awards – where the toolkit won the Essence of Care award – the nurses have collaborated with NHS Innovations East Midlands to adapt and update the tool for use in a variety of healthcare settings.

Over the next months, around 30 organisations across the East Midlands will trial the nutritional toolkit, including specialist schools, mental health settings and stroke rehabilitation units.

The pictorial toolkit was developed by staff at Ash Green assessment and treatment unit in Chesterfield – part of the specialist learning disability service at Derbyshire County PCT – after they became aware that patients with learning disabilities were struggling with written menus.

This resulted in patients having little choice over what they ate, as their meals were often chosen for them by staff.

‘We realised there was a barrier in that we were providing people with written information which they clearly couldn’t read or understand,’ said Nicola Myronko, deputy nurse manager at Ash Green.

‘We recognised that we needed to make things a lot more visual, and create something that people could actually look at to help them make choices, rather than us choosing everything on their behalf,’ she told delegates at NHS Expo in London’s Docklands last week.  

Since the introduction of the tool, patient involvement in food choices has increased dramatically, and one-to-one communication between staff and patients has also improved as staff support patients in making their choices.

The tool has also been used to help facilitate special diets for patients who also have conditions such as diabetes and hypertension. In addition, more patients are now achieving the government’s ‘5 a day’ fruit and vegetable recommendations, and there has been a significant reduction in food wastage at Ash Green.

With the help of NHS Innovations East Midlands and a design company, the team have redesigned the nutritional toolkit, which now consists of a pictorial catalogue set out with magnetic pictures, photographs and symbols which match the menus.

Healthcare settings across the East Midlands will trial the tool for up to six months, and the nurses at Ash Green also plan to adapt the tool for use in other areas of learning disability healthcare, such as personal hygiene.

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