Agenda item

The Chairman invited to the table:

• Selina Rodrigues – Head of Healthwatch Barnet.

Ms Rodrigues presented the Healthwatch Enter and View reports on mealtimes. She explained that volunteers had visited six Care Homes in total and undertaken visits in accordance with a structured set of questions. The visits had been announced to Managers and recommendations sent to Senior Managers within the Care Quality Commission (CQC), Barnet Clinical Commissioning Group and Barnet Council as well as being published on the Healthwatch Barnet website.

Ms Rodrigues said that analysis of the visits did not identify any key themes, but did highlight variation between how Care Homes facilitated mealtimes. She said some of the positive things included a relaxed and pleasant atmosphere, with residents being supported to eat and drink. Most of the Care Homes had processes in place to make the food digestible and appetising for residents, encouraging them to eat. Good levels of hydration were observed in most homes and incidences where residents did not appear to be eating or drinking enough were being monitored and reviewed. Staff demonstrated good knowledge of training by offering alternative options when residents said they felt too ill to eat a large meal.

She said staggering of the delivery of meals was demonstrated in some homes, ensuring the food remained at a good temperature. However, heating plates were available in some but not all Homes visited. She said some Homes had good pre-planning of meals and communicated to residents in advance what food options would be served. However, some did not demonstrate such good planning, leaving residents less engaged with mealtimes.

She said some locations were not seen to be actively encouraging residents to eat communally, but good practise suggested that a social environment encourages residents to eat and drink. Also, food was often bland and not suited to different cultural requirements with feedback provided that this could be improved in order to accommodate faith and cultural needs. Ms Rodrigues also noted that some Homes had provided contrasting colours on tables which was found to be good for dementia patients. However, others had provided bibs for the residents which was felt to be degrading and not good for the dignity of the patients.

The Committee asked if residents who choose to eat in their rooms were monitored. Ms Rodrigues confirmed that everyone was monitored, even when eating in their rooms, and that some had an electronic recorder or a team member observing them.

The Committee asked if good practices that were observed were shared with other Homes. Ms Rodrigues said that guidance was provided to aid relatives in supporting their relatives to eat and that Adult Social Care development and training is provided which aims to incorporate these aspects.

The Committee queried if it was normal to conduct announced visits and whether the results provided a true representation of normal practice in the Homes or rather gave a false representation of when staff were working to best practices for the purposes of the visit. Ms Rodrigues said that most of the visits were announced and that she felt volunteers most often saw things that represented real day to day practice. She said unannounced visits did occasionally occur and that repeat visits were conducted when improvement needs were identified. She said a quarterly meeting with statutory service partners was held and any concerns were taken directly to the Care Quality Commission (CQC), who followed up on serious issues. No specific referrals had been made to the CQC in relation to these Enter and View visits, but they had received a copy of all the reports. She said that Managers had responded to the comments provided and had now actioned improvements and changes.

RESOLVED that the Committee noted the report.