Put in place strategies to make sure the dining experience meets the needs and preferences of older people and supports social engagement, function and quality of life.

Integrate these strategies with your:

• broader strategies for daily living (Outcome 7.1). This is to include older people in dining activities that:
  • promote older people’s quality of life
  • enable them to share food and drinks with their visitors if they want  
  • help older people maintain social connections and contribute to their community. For example, by having older people take part in meaningful and engaging activities, such as themed dining events for special occasions, and cultural and religious holidays that older people have chosen to celebrate or take part in.
• workforce strategy (Outcome 2.8). You need to determine and arrange for the number and mix of workers that makes sure you support older people to eat and drink safely (Outcome 2.9). At a minimum, you need to consider skills and qualifications workers need to make sure they safely prepare and serve food (Outcome 6.3).
• strategies to support older people who need physical assistance to consume their meals safely. This may be because of visual, dexterity (skill in performing tasks) or sensory impairments, as well as swallowing difficulties (Outcomes 5.4 and 5.5)
• strategies to supervise older people with eating, drinking or swallowing difficulties as identified by a speech pathologist. This must follow recommendations made in their assessment (Outcomes 5.4 and 5.5)
• strategies to manage people’s assessed needs in relation to mealtimes. For example:
  • workers are aware of signs and symptoms of eating, drinking and swallowing difficulties and escalate concerns as soon as possible (Outcomes 5.4 and 5.5). Document this information in their care and services plans (Outcome 3.1). These plans should also include information on individualised strategies as assessed and prescribed by a Speech Pathologist.
  • monitor and assess the skills of workers on an ongoing basis to make sure they are providing appropriate texture modified foods and thickened fluids, as assessed and prescribed by speech pathologist (Outcomes 6.3 and 5.5). This includes being able to identify appropriate consistencies in line with older people’s assessed needs (Outcomes 6.2).
  • you have processes to investigate, document, respond to and manage incidents to do with eating, drinking and swallowing (Outcome 2.5).
• broader strategies to create and maintain a service environment that is clean, safe, welcoming, comfortable and accessible (Outcome 4.1b). Make sure the dining environment supports reablement, social engagement, cultural safety and promotes a sense of belonging and enjoyment. Also, partner with older people to find ways to improve the dining environment so it’s enjoyable and tailored to their individual needs and preferences at mealtimes (Outcome 6.1). For example, you can do this by:
  • supporting older people to eat where they want. Older people should be encouraged to eat in the communal space but supported to eat where they wish. For example, to sit at the table of their choice whether indoors or outdoors, or in their room.
  • ensure dining room is free of clutter and furniture doesn’t block pathways    
  • installing handrails between older people’s rooms and the dining room (where practical) to make sure they can move safely as prescribed by an occupational therapist.
  • asking older people what their favourite condiments are and offering these on their tables during mealtimes.

Put in place strategies in partnership with older people that are in line with their needs and preferences (Outcomes 6.1 and 2.1). Consider:

• the needs of older people living with cognitive impairment, including dementia (Outcomes 3.2 and 5.6). For example, they may need modified cutlery or colour contrast of utensils and plates as assessed and prescribed by an Occupational Therapist. Identify when to escalate concerns to an appropriate allied health professional such as an occupational therapist. They can assess their needs and inform how workers can provide support to the older person during eating times.
• the older person’s cultural and social needs and preferences in their dining experiences (Outcome 1.1).

Make sure older people have choice and preferences for their ideal dining environment. You need to acknowledge the older person’s right to exercise choice and dignity of risk when considering their requests (Outcome 1.3).

Make sure the workers who provide dining experiences have the time, support, resources and skills to do this in line with older people’s needs and preferences.

Make sure you consider older people’s individual needs when you plan for workers’ rosters (Outcome 2.8). This is to make sure there are enough qualified workers available when providing dining experiences (Outcome 3.1). This needs to consider each older person’s individual needs in line with their care and services plan. Based on this, make sure you have enough qualified workers to:

• support older people to eat at the times they want to and at their own pace
• promote older people’s reablement. Workers can do this by rebuilding older people’s skills and confidence to eat or drink by themselves (Outcome 3.2).
• support people living with cognitive impairment, including dementia (Outcomes 3.2 and 5.6). Some older people may have individualised mealtime support strategies recommended by an allied health professional that you should follow. For example:
  • modified cutlery and colour contrast of utensils and plates
  • verbal prompts to slow down the pace of eating
  • equipment to ensure safe positioning.
• identify:
  • when the older person may be having difficulty eating, drinking or swallowing
  • the correct consistencies of texture modified diets and thickened fluids (Outcomes 6.2 and 5.5).
• monitor older people’s food and drink intake. This will help you identify older people who require a further nutritional assessment.
• support older people who eat in their rooms to experience a positive dining experience
• support older people to eat and drink when there is an infectious disease risk or outbreak (Outcome 4.2). For example, make sure additional staff are available to support older people to eat and drink during mealtimes.

Provide workers with guidance and training on how to provide positive dining experiences to older people. This needs to be in line with:

• the organisation’s policies and procedures. These should reflect contemporary, evidence-based practice.
• workers’ roles and responsibilities.

Make sure workers understand how to:

• support older people to eat and drink. This includes identifying older people who need extra assistance to safely eat and drink.
• provide a dining experience that supports reablement, social engagement and a sense of belonging and enjoyment
• provide opportunities for older people to share food and drinks with their visitors.

The guidance for Outcomes 2.8 and 2.9 has more information on workforce planning and worker training.

The guidance for Outcome 3.2 has more information on delivering aged care services.

Monitor how well you provide a positive dining experience in line with older people’s needs and preferences.

To check if you’re providing a positive dining experience in line with older people needs and preferences, you can review:

• older people’s aged care service documents (Outcome 3.1). For example, making sure care provided in the progress notes aligns with the older person’s needs outlined in their care and services plan.
• complaints on the dining experience (Outcomes 2.6a and 2.6b)
• feedback (Outcomes 2.6a and 2.6b) on how to improve the dining experience. This is to optimise older people’s quality of life.
• workers’ ideas to support each older person’s dining experience. This can help you find opportunities to improve the dining experience and make it more enjoyable. For example, by supporting or encouraging older people to pick fresh flowers from the garden to place on tables.
• incident information (Outcome 2.5).

Look for situations where older people haven’t had:

• support to safely eat and drink
• a positive dining experience.

Also, talk with older people, their supporters and others they may want to involve, such as families and carers, about their dining experiences (Outcome 2.1). Partner with older people to get their feedback and include this in continuous improvement plans for dining experiences (Outcomes 2.1, 2.6b and 6.1). You may need to think about other ways to get feedback from older people with communication barriers, such as using visual supports.

Assess if workers are following your quality system (Outcome 2.9). You can do this through quality assurance and system reviews.

If you find any issues or ways you can improve through your reviews and assessments, you need to address them. If things go wrong, you need to:

• practise open disclosure (Outcome 2.3). This means being open about what has gone wrong. Share what went wrong with older people, their supporters and others they may want to involve, such as family and carers.
• have strategies to mitigate the risk of things going wrong again.

The guidance for Outcome 2.3 has more information on monitoring the quality system.