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Rise in care home hydration and nutrition levels reported after CCG support scheme

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Hydration and nutrition has improved among care home residents following a programme of tailored support provided by a clinical commissioning group, according to an evaluation.

In addition, it found care home staff were “overwhelmingly positive” about the scheme set up by Surrey Downs Clinical Commissioning Group.

“Even those who were doing something similar before felt that they had made significant improvements”

Healthwatch report

The Quality in Care Homes team (QICH) has been offering tailored support to individual care homes in Surrey Downs since January 2017 and has so far worked with a third of the homes in the area.

The team’s support includes on-site training from experts, regular forums with topics suggested by homes, and specific support on key areas, such as advising on residents’ hydration and nutrition.

A new report, published by Healthwatch Surrey, has highlighted that the intervention seems to have improved hydration and nutrition among older and frail care home residents in the region.

For example, the team has encouraged homes to offer residents fortified milkshakes and smoothies, provide additional access to water through “hydration stations” and in some to reconfigure kitchens.

“Care homes said they have incorporated… suggestions such as ways to fortify food, giving residents different snacks to increase calorie intake, and the introduction of easily accessible snacks, jellies and milkshakes,” said the report.

“We now have better awareness of issues relating to dehydration resulting in improved accessibility to refreshments”

Carol Kirby

Healthwatch Surrey interviewed the QICH team members and then talked to a sample of the care home residents, their families, and staff in 10 care homes.

In its report, the independent health watchdog praised the team for its sensitive approach to offering tailored support, training and advice to management and staff.

It said: “Care homes reported that the QICH team come into the homes and get to know the issues, which is important to the care home teams.

“The QICH team are seen as experts who are trusted to give good advice alongside emotional support and understanding,” the report stated.

As a result, the report said that “almost all staff felt they had a better understanding of nutrition and issues around calories, food fortification and weight management”.

“This has made an important contribution to resident wellbeing,” it stated, adding: “Even those who were doing something similar before felt that they had made significant improvements.”

The report added: “Importantly, the QICH team enable the sharing of ideas and best practice, leading to an increase in confidence in care homes and quality improvements.”

One manager quoted in the report said: “We had a lady with dementia who usually refused to eat, and she loves the milkshakes. We’re not so worried about her now and only have to weigh her once a month.”

Meanwhile, Carol Kirby, manager at Cossins House care home in Cobham, said: “We now have better awareness of issues relating to dehydration resulting in improved accessibility to refreshments for care home residents – we always ensure glasses of water are within easy reach.”

“High fluid foods also count towards intake – think about watermelon, oranges and tomatoes”

Jennifer Halliday

Jennifer Halliday, the CCG’s urgent care and integration project support manager, highlighted that keeping cool, hydrated and well fed during the current hot weather was “vital” for older people.

However, Ms Halliday also acknowledged that, while getting older people to drink six to eight glasses of fluids a day was “the ideal”, it could “be hard to achieve”.

“In care homes we created ‘hydration stations’, so residents were better able to serve themselves water, squash and other drinks at any point throughout the day, without having to wait for food service or ask a member of staff,” she said.

“Warm weather can also reduce people’s appetite, so we shared recipes for light and tasty finger food, jelly shots, fortified milkshakes and healthy fruit smoothies and encouraged residents to get involved in making these, as part of fun cookery activities,” she said.

“High fluid foods also count towards intake – think about watermelon, oranges and tomatoes,” she added.

Sample recipe provided by the QICH team

Sparkling Citrus Fizz – A good fortified refresher for low appetites in hot weather: Dairy free, no blender required

  • 100ml lemonade
  • 100ml orange juice
  • 2 tablespoons icing sugar
  • 1 tablespoon of honey or golden syrup

Whisk together all of the ingredients and serve. Try pineapple juice for a sharper taste.

Approx. 200kcal

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