- Published: 06/10/2022
- Contains public sector information licensed under the Open Government Licence v3.0.
Over the next few months, we will be exploring the CQC key lines of enquiry by each question and sharing resources we think you might find useful.
Sources of evidence: what CQC inspectors look at against each KLOE
By effective, the CQC mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.
Questions
E3.1 How are people involved in decisions about what they eat and drink and how are their cultural and religious preferences met?
E3.2 How are people supported to have a balanced diet that promotes healthy eating and the correct nutrition?
E3.3 Are meals appropriately spaced and flexible to meet people’s needs, and do people enjoy mealtimes and not feel rushed?
E3.4 How are risks to people with complex needs identified and managed in relation to their eating and drinking
Potential sources of evidence
People & their carers, friends and relatives:
Feedback about:
- Food and mealtimes; quality of meals and dining experiences.
- Food choice and involvement in menu planning.
- Support with any eating / swallowing difficulties.
- Access to food and drink outside mealtimes / regular drink times.
- The attitude and approach of staff and volunteers to meeting individual needs.
CRM (Customer Relationship Management)
- Share your experience forms.
- Information of concern enquiries.
Organisations
Feedback about whether/how:
- Catering, nutrition and hydration practice.
- Practice in relation to particular risks and issues; people with complex needs.
Feedback from community dieticians.
Staff & Volunteers
- Awareness of particular needs and risks in relation to eating and drinking, e.g.
people living with dementia (in particular of specialist staff such as chefs). - Recognition of and response to individual preferences and religious/cultural
requirements.
Observation
- Mealtimes; choice, presentation, quantity, special diets.
- Support / arrangements for people to make their own meals and drinks; promotion of
independence. - Access to food and drink outside mealtimes.
- Staff communication about eating and drinking risks and issues at handover.
Records and policies
- Food and fluid charts.
- Nutrition, hydration and swallowing assessments.
- Weight records.
- Menus.
- Internal feedback surveys.
- Complaints and compliments.
- Staff training records and plans.
- Equality and diversity policy.
Ratings characteristics
- Outstanding
There is a strong emphasis on the importance of eating and drinking well. The service provides good quality food with a variety of different options to choose from each day. People are fully involved and help to plan their meals with staff, taking nutritional advice into account. Staff are aware of people’s individual preferences and patterns of eating and drinking and there is flexibility when needed or requested.
Creative ways have been introduced to encourage food to be as attractive as possible when people are on specific diets, for example soft diets.
Innovative methods and positive staff relationships are used to encourage those who are reluctant or have difficulty in eating and drinking.
The service embraces different cultural, religious and ethical issues around people’s choice of food to make sure their wishes are respected. There is a creative approach to food from different cultures, for example making it available on particular days for festive celebrations.
There is positive feedback from dietetic professionals that the service asks for their advice and applies it properly.
- Good
People can exercise genuine choice and have access to sufficient food and drink throughout the day. Meal times are set to suit people’s individual needs, are not rushed and are supported by enough members of staff to provide personal support.
The dining environment is pleasant and food is well-presented. Staff are aware of safe temperatures for food to be served.
The service takes cultural, ethical and religious needs into account when planning meals and drinks, and encourages people to make healthy food choices with a range of health options available.
People feel actively involved in this aspect of the service and are enabled to give regular feedback.
The service protects people, especially those with complex needs, from the risk of poor nutrition, dehydration, swallowing problems and other medical conditions that affect their health. Regular monitoring and review is carried out with people using the service and relevant professionals to ensure people’s needs continue to be met.
- Requires improvement
Some people may not always get enough to eat or drink. They are not always encouraged to eat a healthy balanced diet because options are limited, and not all of the food provided is appropriate to meet people’s nutritional needs.
The service does not always involve people in planning their meals, nor does it act on feedback received from people who use the service.
The service does not always understand people’s cultural, ethical and religious needs.
The dining environment is not always pleasant or food is not always well presented.
The service does not sufficiently monitor or manage the risks associated with poor hydration and nutrition, or ensure access to dietary and nutritional specialists when needed.
- Inadequate
The service does not ensure that people have enough to eat and drink throughout the day. Drinks and snacks are restricted.
Mealtimes are often rushed, with insufficient staff with the right skills to support people appropriately. Meals are often served too hot or cold for people to eat and enjoy. There is little attention to the dining environment.
The service does not involve people in decisions about what they eat and drink. Specialist dietary needs and those relating to culture, ethics and religion are not catered for.
There is no support available for people from dietary and nutritional specialists. Consequently, the service puts people at risk because of poor monitoring and management of food and fluid intake.
Does your service need some support with making sure you have the policies, processes, and evidence to respond to the CQC to achieve your desired rating?
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