Elderly not fed properly at care homes

Almost half of all care homes in Scotland do not meet national standards on eating, drinking and nutrition, leaving vulnerable, elderly residents at risk of weight loss and dehydration, according to a new report.

The report, published today by the Care Commission, also found that more than a quarter of care homes did not screen residents for malnutrition, and a third failed to screen their residents for dehydration.

The commission said it was concerned about the high number of complaints made over the issue, revealing that 76 of 91 complaints made to it in 2006 to 2007 were at least partly upheld, while improvement notices were served on 10 care homes last year to enforce better nutrition and hydration practice.

The commission demanded that the Scottish government support an integrated approach to improving nutrition throughout the care home sector.

Charities for the elderly backed the call, describing the findings as “alarming”.

The study analysed inspections of 303 care homes for older people in Scotland in 2006/07 and found that 49 per cent did not meet the National Care Standards in all of the five areas of eating, drinking and nutrition that they assessed. Despite the failings, the report said the findings were “generally positive”.

The researchers found that 85 per cent of care homes had a written food and nutrition policy and 94 per cent said they had access to an NHS dietician.

However, only 40 per cent had their menus nutritionally assessed by a dietician, and some menus had not been planned to meet the individual needs of clients. Others did not provide enough soft, easily chewed food, or food with enough energy to stop older people losing weight.

Almost a third (29 per cent) did not screen people for the risk of malnutrition, while 34 per cent did not screen people for dehydration when they were admitted to a care home.

Dehydration was the biggest issue in complaints, with claims that people were not encouraged to drink regularly, or that drinks were out of reach. As a result of the complaints, the organisation made 101 requirements and 38 recommendations.

The report called for improved awareness of the National Care Standards for eating well and said there should be more staff training in the areas of eating, drinking and nutrition. It also recommended that sufficient numbers of staff be employed to ensure residents are eating and drinking properly, and better menu planning for those with special needs.

Susan Brimelow, the commission’s director of healthcare regulation, said:“This report aims to make people aware of the standards of good practice we expect all care homes to follow. There is plenty of room to improve.”

Ms Brimelow suggested that the Scottish government implement and fund the “nutrition champions” initiative recently piloted in some care homes as a means of tackling the problems. Nick Waugh, policy and parliamentary officer for Age Concern and Help the Aged in Scotland, said malnutrition and dehydration had a devastating impact.

“We also urge the Scottish government to adopt the Care Commission’s proposal for a coordinated approach to nutrition and hydration across the NHS and social care agencies.”

Opposition parties expressed deep concern over the report. Ross Finnie, the Liberal Democrat spokesman, said: “Care homes have a responsibility to meet national nutrition guidelines. Those singled out in this report need to take immediate action to get this right.”