South East Branch Study DayMenu Planning

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RATIONALE FOR NEW NACC NUTRITIONAL STANDARD

The aims of the standard are:To simplify existing standards in line with

current best practiceTo define one standard across all social

care settingsTo provide choice menus that have the capacity to meet the nutritional needs of

both those at risk of malnutrition and those with special dietary needs

The reasons being:• The last decade has seen a massive growth in technology and it is now

commonplace for nutritional information and analysis software to be widely used by both lay and professional people

• New regulated nutritional standards in the public sector provide a recognised and easily-understood model for defining nutritional issues e.g. School Food Trust

• The Care Quality Commission (CQC), the monitoring body for England, will be monitoring across all care and social settings. Thus uniformity of food and beverage services standards in all these settings must be designed to meet the outcomes of Nutritional Standard 5

• All recommendations are based on current government or professional body advice. The evidence base for best nutritional practice for healthcare is found in the 1995 Guidelines for Hospital Catering (Department of Health (DH). These guidelines have been updated and revised to provide the nutritional decisions that underpin the new Standard

• The multi-agency 10 Key Characteristics of Good Nutritional Care, derived from Council of Europe Resolution 12/11/2003 Food & Nutritional Care and in which NACC is a stakeholder, strengthen the levels of good practice in food and beverage services to be expected in all care settings

• Hence existing NACC standards need to be modified to one clear Standard that meets these modern requirements and enables service users, their relatives, healthcare staff and auditors to witness consistent food services regardless of setting

• It is highly desirable that any nutritional care services for older people include input from an experienced professional, and the Standard is written in the belief that a Registered Dietitian (RD) or Nutritionist (RN) should be engaged at least annually to advise on a menu review (Or CCM?)

The 5 key points The 5 key points

are a mnemonic forare a mnemonic for

5 fingers of the NACC Caring Hand

2010 campaign:

‘‘No One Should Go No One Should Go HungryHungry’’

The Standard should be reviewed annually from

first publication date

Is this October 2010? Let’s discuss!

NNutritional analysis of menu and menu items

Nutrient content of all meals and snacks mustmust be provided.

As a minimum this should include energy (kcals) and protein content.

OOverall food and nutrient content of meal must meet minimum standardsA ‘meal’ such as is served at lunch, high tea / A ‘meal’ such as is served at lunch, high tea /

suppertime must at least consist of a main course and suppertime must at least consist of a main course and dessert course.dessert course.

Any such meal, whether a cooked meal or a lighter meal such as a sandwich, mustmust:

• include a good source of protein and a starchy carbohydrate, and a serving of vegetables or fruit. Where cooked vegetables are served, the total portion size must

be at least 80g

• provide a minimum of 300kcal of energy• provide a minimum of 15g of protein.• An energy dense dessert must be available as a choice

at each main meal and provide a minimum of 250kcal.

For those providing wider meal services:• Breakfast must provide a minimum of 380kcal

and 8g of protein• 5 portions of fruits and vegetables per day must

be available from the menu, some as snacks• Between meal snacks throughout the day must

provide a total of at least 400kcals and 4g of protein

• A minimum of 7 beverages per day (1.5l fluid) must be offered including the use of a minimum of at least 400ml full fat milk for drinks and on cereal where drinks are offered

For practical purposes the total meal, beverage and snacks

menu per day mustmust provide a nutritional content

of at least: 2150kcal (revised figure) 2150kcal (revised figure) & 55g of protein (nutrient)& 55g of protein (nutrient)

SSupport individual meal requirements

The menu should suit a variety of client needs including:

• Ethnic, cultural and religious requirements

• Medical /health conditions e.g. gluten free, modified texture etc.

• Local and regional customs and traditional practices e.g. fish on Fridays, roast dinners, culturally suitable menus

GGrouped dietary codings for specific nutritional needs

• “Healthier eating” choices should be available which are moderate in salt, saturated fat, sugar and total fat thus providing suitable items for people with diabetes, and those managing their weight, cholesterol levels and /or blood pressure

• “Energy dense” options should be available for those who require extra calories

• “Softer” code is useful for identifying which dishes are easier to eat for those with chewing problems

• Allergen content of meals must be available in accordance with UK Food Labelling Regulations and Amendments.

HHydration

• Fresh drinking water mustmust be accessible at all times and a choice of hot and cold drinks offered at meal times, bed time and at regular intervals in between

• Over the day, hot and cold drinks together should provide the client with at least 1.5 litres (6-8 cups/glasses) of fluid.

Menu planning

Planning pointersThis is your clients’ menu – not yours!

• Budget; proportional cost; waste• % uptakes• Logistics – length of menu cycle; meal timings and menu balance across day; catering skills;

deliveries; style of food service; hot food hot, cool food cool; assistance with eating

• Appropriate to client group• Appeals to clients - mixed and varied• Provides familiarity /comfort• With recognisable dish names• Combinations of colour, texture and flavours to suit recipients’ tastes • Includes clients’ suggestions• Daily / weekly / yearly patterning – specials, celebrations

• Texture (include a Softer choice)• Higher Energy (Energy Dense) to Healthier choices• Can identify good sources of vitamins C and D, calcium and fibre over the day/week• 5 A DAY over the day• Other diets?

• Acceptable dish repetition• Check first to last day of cycle repetition

Menu plan checker

Day

Soup

Main 1

Main

2

Vegetarian

Starch

1

Starch

2

Veg

1

Veg 2

Pudding

1

Sauce

Pudding

2 milk /cold

Mon B

Mon L

Mon S

Tue B

Tue L

Tue S

Wed B

Wed L

Wed S

Now let’s take a leaf out of this

presentation and try looking at your menus!!

Jo and I thank you for any feedback to take with us

to NACC Exec.anne.donelan@tilleryvalley.com