The recent media outcry over Australian aged care residents being fed on $6.08 per resident per day has raised the issue of quality of meals in residential aged care. This is following publication of a paper by well respected Dietitian and Founder of The Lantern Project, Dr Cherie Hugo, who is passionate about increasing the quality of food for older Australians.
To stay within budget, the menu offering may include continental breakfast daily with a hot option once per week. Lunch is often the main meal of the day with one hot option and salad or sandwiches as an alternative. A lighter tea may include soup and sandwiches with a light hot option (eg sausage rolls). Basic fare for morning tea, afternoon tea and supper is also provided.
Even for facilities spending an average of $6 per resident per day on food, there can be significant waste. Until there is emphasis on a quality nutritional outcome for each resident rather than a one size fits all approach to the meal service, there will be waste. Until systems and processes are analysed to ensure the food reaches the resident in prime condition, there will be waste.
Dining Experience Specialists has seen many instances of food reaching residents in poor condition. This has led to an additional meal being provided, as the resident knows historically they will not like the meal, or on the day they do not want the menu item. Frequently we have observed up to 30% of residents requesting an alternative to the main meal hot option. This results in over supply, over production, tray and plate waste, additional food purchase for the alternative, additional labour and additional resources which are increasingly scarce.
There has been talk around enforcing a minimum $ per resident per day spend on food. I am not sure this will result in the best outcome for residents. There is already variance in what is included – or excluded – in the food cost. If providers add in other items such as supplements, bottled water, discretionary items etc, it may magically increase the food $$ but may not result in an improved outcome.
In addition, more food purchased may mean more food waste, if meals do not reach each resident in prime condition. If the value stream of supply, preparation, cooking, serving, delivery are less than optimal, the resident may be no better off.
While Dining Experience Specialists advocates sound cost management of a tight budget, cost cutting as a prime objective is bound to result in unintended consequences. Reducing hours from a task-focussed roster without reducing the tasks, reducing local supply, shifting from cook chill to cook fresh or vice versa, moving from outsource to insource or vice versa – what is often seen as a magic bullet does not necessarily deliver the results and often does not deliver the cost reduction hoped for.
Also not captured in the direct catering costs are other “hidden costs” – extra care staff time managing poor digestive systems and upset tummies, wound management, effects of dehydration, increased call bell use, tray service to the room, assistance with the meal, increasing supplements and special requests, etc.
Until strategy, vision, values and culture align, operational staff may struggle to implement an effective meal service that delivers a quality outcome for residents.
Does your service offering reflect your meal service value? Does community perception match your marketing? Do you offer champagne luxury resort style living on a beer budget?
Who are your key stakeholders? The residents? Or family, regulators, Board? Sometimes we have seen the intention of a central focus on the residents. In reality, compliance, safety, cost, OHS, legal, media and other constraints bump them off the top spot.
Utilising existing resources to their optimum is a good starting point. A sound strategic plan with collaborative, co-creation of the implementation action plan is essential. Without considering the end to end value stream and implementing siloed solutions, there is bound to be disappointment and stress felt by all.
Being consistently OK is quite adequate for many of our existing residents. While we plan for the future needs of an increasingly demanding consumer, lets not forget the people living in the now. Ensuring residents are comfortable and content on a daily basis often starts with food, a major component of their day. A shared vision with consistent leadership espousing this will naturally reinforce staff behaviour to view daily life through resident’s eyes.
What has been the reaction to the media stories at your facility? Is your public message shared by your staff in private? Will your residents, families, community, suppliers and staff speak positively of their touchpoint experiences with you, stand up and say “No, that does not happen here”?
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