Gold at the HSJ Partnership Awards 2024!

Gold at the HSJ Partnership Awards 2024!

WE WIN GOLD FOR PATIENT SAFETY COLLABORATION OF THE YEAR AT THE HSJ PARTNERSHIP AWARDS 2024

We’re delighted to announce that our partnership with the East Sussex Healthcare NHS Trust (ESHT) has been officially named as the “Gold” winner of the Patient Safety Collaboration of the Year at the HSJ Partnership Awards 2024.

The collaboration between OHK and specialist Speech & Language Therapists in ESHT and the Royal College of Speech & Language Therapy (RCSLT) launched a specialist, cost-effective e-learning programme that has been vastly improving the lives of those suffering with dysphagia since launch.

The HSJ Awards recognise an outstanding dedication to improving healthcare and effective collaboration with the NHS. OHK is owned and directed by Preston Walker and James Ball, both experts in the area of care catering, IDDSI and the texture modification of foods.

With 28 separate categories this year, the winners were announced during an impressive ceremony held at Evolution London, hosted by Miles Jupp. The event was attended by representatives from the NHS, and both the private and third sector as well as key players from non-clinical backgrounds, all coming together to celebrate the importance of positive partnerships and acknowledging how these underpin the future sustainability of the NHS.

The OHK and ESHT partnership was established in 2020 to create an interactive, immersive, and educational program tailored to address the diverse training needs of ESHT staff and enhance patient safety. Following the introduction of the eLearning-based there were no ‘never’ events or near misses and vast improvements in incident numbers being reported and acted upon. The collaboration and project was selected and put forward for the award based on its ambition, value and the positive outcomes that the project has had on both practitioners and patients.

James Ball, Director at OHK, comments: “Winning ‘gold’ in the Patient Safety Collaboration of the Year category validates our efforts in implementing the successful e-learning program. Everyone deserves the right to safe nutrition, and we are delighted to continue to work with NHS teams across the country to push this agenda forward. We’re committed to improving the lives of as many dysphagia patients as possible with our specialist training and support, and with our NHS colleagues, help to make dysphagia everyone’s business.”

HSJ editor Alastair McLellan commended the winners, emphasising the crucial role of external suppliers in healthcare improvement: “This year’s awards demonstrate there is almost no NHS clinical or support service which does not rely – sometimes almost completely – on the efforts of external suppliers.

“Almost any attempt to improve NHS productivity – the service’s greatest challenge – without working in concert with suppliers starts at a major disadvantage. Indeed, many of the best ideas for improving productivity do and will come from suppliers. Every one of the businesses on the Partnership Awards shortlist has shown the kind of thinking and determination it takes to deliver change in healthcare services. They should all be very proud of the efforts, our 28 winners especially so.”

OHK looks forward to building on this success and continuing their mission to improve healthcare outcomes in collaboration with NHS partners.

For more information about the HSJ Partnership Awards 2024 and the winners, visit https://partnership.hsj.co.uk/winners-2024

For more information on OHK, please see www.oakhouse-kitchen.com

Minced and Moist – Passing the IDDSI Testing Methods for MM5

Minced and Moist – Passing the IDDSI Testing Methods for MM5

Following on from our insight article on Passing the IDDSI Testing Methods for PU4 we now going to take a look at some of the points of interest relating to passing the IDDSI Testing Methods for MM5.

IDDSI Audit Sheet

As before, we are going to take the IDDSI Audit Sheet for MM5 as our benchmark for the determination of a MM5 food, as is specified by IDDSI. We make note of this as you may find that alternative, descriptive resources are available. Descriptive modes tend to bring more opportunity for subjectivity, and so we are sticking to the objective tests found on the IDDSI Audit Sheet.

The instructions on the IDDSI Audit Sheet for MM5, found at the top of the sheet, set out the critical testing methods that determine a correct food texture.

Appearance + Fork Pressure + Spoon Tilt Test

Combined success in all the tests must be achieved for the food to pass the audit, which is indicated by the + symbols. Where the tools required to carry out the critical tests are unavailable the alternative Finger Test can be used.

Creating a chewed bolus

The next point in the instruction sets out that food at MM5 is ‘intended to mimic a ‘chewed bolus’’. A bolus is the soft, moist, and cohesive ‘ball’ of food that, where an individual is healthy and can manage regular food, can be created from a wide range of food textures so that the food can be easily swallowed.

There is an expression ‘drink your food and chew your liquid’ that suggests food should be chewed until liquid enough to be swallowed. The more you chew, the finer the initial pieces of food become, and as more and more saliva is mixed the bolus becomes more semi-liquid, with some small pieces, that holds together cohesively. A bolus.

So, the purpose of creating food with the defined texture of MM5 is that the results can be easily transported through the mouth and swallowed as a bolus can. The testing methods identify, and define, how a bolus should respond in the mouth, with applied tongue pressure, to move and position the food to be swallowed.

Passing the IDDSI Testing Methods for MM5

Let’s take a look at the critical testing methods from the IDDSI Audit Sheet for MM5.

Critical: Appearance – Lumps less than or equal to 4mm (4x4x15mm) for adults and 2mm (2x2x8mm) for paediatrics; with no separate thin liquids

The preparation of food at IDDSI Level 5 – Minced and Moist is not required to follow a particular order that will bring success. Our ORAL approach allows basic and more advanced techniques to be structured as best suits the context where preparation is being undertaken.

It would certainly be the case that equipment, better suited for the tasks, will allow more freedom in which to order reform processes, resulting in more efficient production methods; saving time, and reducing wastage, for example.

Let’s take a plum, in this case, as an example.

Essentially the 2 factors that matter when preparing a plum for this MM5 IDDSI Testing Method:

  1. The ripeness of the plum
  2. The available equipment

If the plum is very ripe, it will be relatively easy to exclude the skin, stone, and stalk (if present) and break up the flesh to size requirements for MM5. There will likely be some excess juice that will need to be dealt with: thickened slightly so there are no separate thin liquids. However, this process could all be carried out with a fork and the use of your fingers, to great success, although a knife and chopping board would bring more control.

If the plum is unripe and very firm a tenderisation process will be needed. If equipment is limited, say we only have a fork available, then by tenderising the plum first, to a similar texture to that of a very ripe plum (poaching, steaming, etc..), then the fork can be used effectively to exclude and resize, as above. If, however, we have better equipment available, a knife and chopping board, then the firm plum can be resized first and then tenderised, which will speed up the process considerably.

Critical: Fork Pressure Test – Food can be easily mashed with a little pressure from a dinner fork (no thumb blanching); easily separates and comes through the prongs of a dinner fork

When testing the sample of food at MM5 its structure must be cohesive, however minimal tongue pressure should cause the bolus to be moved around easily (minimal chewing action).

Here we look at the structural composition, where the MM5 food is moist enough to be held together cohesively, however this should be delicate enough to be able to pass the tests.

Focus here on the thickness of any food or sauce that may take the role of providing cohesion, some dense components (thick starchy foods or nut butters are good examples where issues may lie).

It is also important that the lumps of food that are present in MM5 are not hard, details can be found in the IDDSI Framework section: Food Textures That Pose A Choking Risk, however objectively this can be clarified by ensuring the tenderness is that of SB6.

Critical: Spoon Tilt Test – Holds shape on teaspoon; food slides off spoon with little food left on teaspoon (i.e., not sticky)

Here, again, the cohesive agent of the MM5 food must be considered and if the test fails due to stickiness, then some form of texturisation should limit this issue and give rise to a reduction in stickiness sufficient to pass the test.

Core principles

As discussed previously, when you want to ensure food is passing the IDDSI Testing Methods for MM5 all tests should be performed on a sample at the time of service. The characteristics defined by the testing methods should persist for the duration of a meal, up to 30 minutes. If you find that the MM5 food sample fails in any of the areas discussed, the initial recipe can be modified to ensure excludetenderise, and texturise processes is sufficient to give compliance.

For more details on our health and social care sector training that is now widely used across NHS and private care providers in the UK you can follow this link: Online Dysphagia Diets for IDDSI Course.

What should I use when thickening food for IDDSI?

What should I use when thickening food for IDDSI?

We have had quite a few requests for answers to this question recently. In part, this is as a result of organisations adopting our ORAL training and dysphagia foodservice production system principles, which ensure that all the key aspects of producing food for dysphagia diets are considered, and in place, for consistent, assured results. In taking this approach it is inevitable that the question of thickening food for IDDSI is raised.

The IDDSI Framework defines food and drink textures, as levels, using objective, critical, testing methods, set out on the IDDSI Audit Sheets. The suitable textures must be stable over time periods of up to half an hour (giving time for consumption) without significant textural changes that would cause the failure of IDDSI tests and introduce risk.

Cooking for the IDDSI Framework

For the cook trying to ensure that the food they produce can pass the IDDSI Testing Methods, and that it remains suitable over the mealtime can bring great challenges. Time plays a huge part in this puzzle, as over time there are some critical changes that can occur:

Temperature change: Hot food and drinks will cool and cold food and drinks may warm up, affected by the temperature of the things around them. Generally speaking, as things cool down they become thicker and firmer; and as they warm up they become thinner and more tender.

Separation: The physics at play that allows a substance of mixed components to keep its structure is complex, and without everything being ‘just right’ the structure will start to break down. Forces holding things together will be acted on, resulting in changes to appearance, and importantly for maintaining IDDSI requirements, liquid can seep out, separating, and causing mixed textures to become apparent.

Chemical reactions: The complex nature of the composition of food, and some drinks, can mean that reactions between components after the item is made can result in unwanted texture changes. An obvious example of this can be seen with starchy foods that can thicken, become firm or form skins, due to starch molecules binding together.

Why does this matter when thickening food for IDDSI?

Let’s first look at why we might need to thicken food: There are 2 main requirements as to why we might be thickening food for IDDSI.

The first is the most obvious, and relates to LQ3 and PU4, when the food is too thin to pass the IDDSI Testing Method for thickness. For LQ3, the critical test is the Gravity Flow Test, now using the new IDDSI Funnel! If too much of the food passes through the funnel in the 10 second testing time than it will need to be thickened. For PU4, the critical test is the Fork Drip Test. The food will weed to be thickened if, when it is tested, it drips through the prongs of a metal dinner fork.

The second reason for thickening food for IDDSI relates to the separation of thin liquids over time. This can happen at all IDDSI Levels where the occurrences of mixed consistencies must be avoided, LQ3 to EC7. The influence of time here cannot be overstated, as you may find that at first appearance the food produced passes all the defining critical IDDSI Testing Methods, only for separation to occur and creating separate textures.

What methods can be used when thickening food for the IDDSI Framework?

We like to keep things simple at Oak House Kitchen, so that methods can be easily adopted, and lasting improvements can be made.

On the topic of thickening food for IDDSI we must explore what is meant by simplicity. Our experience has shown that the usual solution wanted involves trying to use ingredients and methods that are already available. This sounds simple: the simplicity being the accessibility.

Kitchen staples

This is a very valid option, for many reasons, and provided the approach is taken as a positive decision, and not just to sweep the complexity of this requirement (illustrated above) under the carpet, it can work. Flour and cornflour do indeed thicken, however they are unstable and sticky and require cooking (heating) to work. Accurate recipe testing and controlled cooking, storage and service conditions will need to be tight.

There are many other things available in a kitchen that will add body to something that is too thin, but in almost all cases flavour, colour and nutrition are affected (reflected in the ORAL Quality Audit); complex methods and controls are needed; and what works in one recipe won’t necessarily work in another.

Real simplicity

Working with chefs, organisations and manufacturers, committed to trying to improve their production standards and efficiency, we educate that the simple solution to be identified should be the simplicity of application that can affect the most items being made. To this end let’s look at the practical requirements of a dysphagia foodservice production system:

  1. Have a regular menu that can easily be reformed to any IDDSI Level
  2. Carry out reform processes so that IDDSI Testing Methods can be applied
  3. Find that the food produced is too thin or separates
  4. Mix in something that will correct this instantly so that it is suitable to serve

That’s simplicity, and that’s achievable. The ORAL: Dysphagia Foodservice Production System ensures the menu is available and managed for consistent results. Safety is improved and time and money is saved. This is clear now with the evidence we are seeing.

Point 4 on the list is also achievable with the various starch and gum based food grade thickeners on the market. The all have slightly different specifications and ingredients, but they all allow easy dosing and mixing when thickening food for IDDSI.

What’s next…

Many of the points raised here will be discussed in an upcoming IDDSI Myth Busting session with Peter Lam, Co-Chair of IDDSI, Dr Ben Hanson, expert in the science behind IDDSI and swallowing, and us, giving a culinary perspective. If you are interested in joining in with questions or just listening – SIGN UP HERE – it’s not to be missed!

For the IDDSI Audit sheets, mentioned in the article, visit the IDDSI resources page HERE and download for use.

Lunch Club – Getting Care Home Catering Right

Lunch Club – Getting Care Home Catering Right

Warning – this article does contain strong language.

I’ve been scratching my head a little recently.

I eagerly listened to the recent BBC 4 The Food Programme documentary on food in care homes (aired 2nd August 2021) and was left with quite a flat feeling, A missed opportunity perhaps? Something wasn’t quite right.

We will look at the areas of concern raised in the program, and there are some really important improvements that are needed, at a later date. The overall impression given was that the care sector has it all wrong. The people that take on roles of vital importance; supporting vulnerable people to eat, and eat well, don’t understand the impact they can have; they are unskilled as well as inadequately resourced; and systemic failures compound the issue. The future is bleak.

Even the ray of light emitted by the newly available health and social care catering course is suggested to be an opportunity missed. With virtually no training centres, low uptake and the question of whether employers will stump up the cash to train a clearly undervalued area of the service. The future will remain bleak.

It is great to have scrutiny and transparency, especially from outside perspectives and from experts in research and reporting.

So why do I feel flat? Head scratching…

I understand the pain, anxiety, and depressing narrative from the program only too well.

I had expected that cooking in a care home was going to be a transient role for me. I love cooking, I love food and drink, I love eating and drinking with other people, it must be in my make up.

Having spent some time as a restaurant chef, and with a head chef offer in the restaurant scene in Cambridge, I was having a sabbatical while I organised my thoughts, and resources, for the next step… A trendy food truck with an interesting, playful name; or a supper club cum cookery school – social events with humour and food. The shoots were green, but it was no business, yet.

So I took a role as head chef in a large care home in the city.

It was interesting to hear what people had to say and what their perceptions were…

“So you’re giving up cooking then and going to just serve slop?”

“You’re going to have to boil the shit of everything, you know?!”

“That’s not food, that’s just crap.”

Well let’s see, shall we? I walked positively into the kitchen, knowing I had the skills and the inclination to serve the people in the care home delicious food that would make them happy and healthy… I was buoyant, 76 residents across residential, dementia and nursing care, I had an opportunity to fit in and help these people’s lives.

Arrival…

I wouldn’t describe it as a kitchen. A kitchen is a place where you can create. It’s a bright and vibrant space to be in, both literally and metaphorically. Where thoughts and plans can be turned into delicious dishes, eagerly anticipated by those being served.

This was a dark place, both literally and metaphorically.

It was clean, but the walls had a grey, yellow tinge, and a light flickered in the tiny, disordered office situated between the back door and the pantry.

Everything was decaying: none of the shelves in the fridges were original; two of the eight hobs didn’t work; a useful combination oven and steamer stood, derelict, where it had once been the workhorse of the kitchen (there was no budget to repair it nor to maintain or service it, so it was left where it stood); the pots and pans were old and cheap, made of aluminium they had thin bases, guaranteed to catch and burn sauces and stews, tainting the flavour of everything. The silver metal dissolved during cooking to give light coloured food a grey tinge. Grey food from a grey place.

There was, though, a BIG mixer, plenty of trays, large bowls, whisks and spoons.

As Wolff’s Law states: “Form Follows Function”. This wasn’t a place to cook, this was a place to mix and reheat. The were virtually no raw ingredients, just packets and packets of expensive branded, or cheap basic processed food ‘solutions’ that save you time… to do what?

Well, it turned out that there was such a lack of management, energy, care, and pride in ‘that’ kitchen that a high state of entropy had been created; no thought or effort was needed because nothing of any quality could or would be made.

Want a pudding? Pull out the flan base, whip up some cream substitute and spoon on some tinned fruit salad. Done.

Fancy some soup? There was great choice available… Minestrone, cream of tomato, wild mushroom, farmhouse vegetable, cream of chicken? Just pull out the tub of soup powder you want and whisk into boiling water. Done.

Mash? Powdered.

Desserts? Powdered.

Main course options? Well, anything pre-made that was on the frozen order sheet, which meant: fish fingers, sausage rolls, Cornish pasties, faggots, sausages, fish portions, fish cakes…

(When things had settled down a bit, and I had broken down the established norms and attitudes (and some people had left, obviously); we had a motivated and energetic team; and the vast majority of options were made from raw ingredients, I did a little in-house study on salt content in our menu. The food we provided varied between 3g to 3.5g per day over a 2-week period. Cross analysis with the processed menu I have described showed that between 13g and 15g was being served! That’s not care, that’s not caring.)

The kitchen’s position…

I must have been quite disparaging to the chefs (and they were chefs – working in the care home to top up their ‘real’ jobs in high quality commercial restaurants and colleges in the city). I must have tutted, or looked shocked or something… because I was given some cursory advice from the old head chef, who no longer wanted the ‘hassle’ of ‘management’:

“Don’t worry if it doesn’t look like real cooking, it’s what they want. There’s no point in trying to do anything interesting, they only complain, it’s what they do, old people, complain.”

I remember it vividly, because of his matter-of-fact manner and assertion. Clearly warning me not to do anything silly, like change anything; and because at the time he was mixing raw beef mince into a powdered béchamel sauce bubbling on the stove, which was, as always, being served with powdered mash and frozen vegetables that had been put onto boil as soon as breakfast had been wrapped up.

Specialised diets…

In the brief interview I had for the head chef job, the (interim) manager had made it clear that individual needs were so important and that there were many residents with specialised dietary requirements. It was right up my street, not only providing delicious, good quality food for everyone, but also the opportunity to apply cookery skills to help people with profound dietary needs.

The reality was a long away from the story I had been given. For those with dysphagia, for example, once all the general cooking tasks were completed, various tubs were taken out from the hot-trollies and ladled into a blender. A short whizz of the machine and there you have it…. Brown sludge. No thought, just portioned, covered, labelled and into the trolley to be taken away. Out of sight, out of mind.

It was probably best for them not to think about it too deeply, or at least put it’s vulgarity down to the medical conditions causing the need for texture modified foods. Just a task. Got to do it. Sad for them. Sleep better at night.

The senior care manager overseeing the team supporting residents with dementia quite rightly paid us a visit. Taking me aside and with tears in her eyes, “Why, why! Why does the blended food always have to be brown? ALWAYS BROWN!”

The memories I have are vivid and the experience of the first days, weeks, months, and eventually years: trying, failing, successes, research, setbacks, improvements, consistency, quality, happiness, pleasure, health. All this underpins the philosophies and drive at Oak House Kitchen.

Resident feedback…

One final memory from that first glimpse, first step – they say that’s always the hardest.

In the interview the ‘chef walk around’ was discussed. “We like to find out feedback direct from the residents. It keeps our menus current and well-liked;  and you will be able to get to know everyone better, find out what people want. Remember we work in their home; they don’t live where we work.”

As I walked into the downstairs, residential dining room I got it all barrels.

“WHAT THE FUCK IS THIS SHIT THAT YOU SERVE US?! I WOULDN’T FEED IT TO A FUCKING DOG!”

That is an indelible memory. The chap was obviously right to say what he did, he was trying to take action. He must have been saying it before, maybe until he was blue in the face and until the inertia of the unresponsive chefs made it pointless.

He was taken to his room, and I was the one that got an apology.

Fight or flight?

I won’t lie, I didn’t want to go back into that for long. It wasn’t my doing yet I was getting all the blame. But it was my responsibility. I just made myself two promises: 1. Try and make every day slightly better; and 2. Avoid turning into them.

Those early experiences galvanised me and, over time, transformed the operation: creating a kitchen culture based on culinary skills and knowledge; a motivated and inquisitive team (one member worked one day a week in a Michelin starred restaurant and gleefully came in one day to tell me that some of our recipes were the same – it’s just cooking, eh?); we proved to the local college that care chefs should be eligible to do the Professional Cookery qualification; homemade bread, homemade stocks, real chocolate – all absolutely achievable with good management, systems, skills and motivation.

Most importantly people were happier, more content and had a better quality of life.

No extra budget, no fancy equipment, and £3.50 per resident a day.

So why the head scratching?

The Food Program documentary exposed the realities, just like I described. This is what is needed for change, right?

Well, the above were my first experiences of one care home with poor practices, bad management, and appalling delivery. It could well have been an isolated example. Sadly, that’s not the case, but we’ve been in hundreds of care home kitchens and worked with 1ooo’s of chefs  and there are many excellent examples out there.

I think that’s the crux of it: the examples, the Vox pops, chosen to expose inadequate and inhumane practices were real, sad, and tragic. The program left it there, with the shock, anger, and fear of likely horrors out there. A damning indictment.

That first promise I made, to make things a little better every day, still applies. No longer in ‘that’ kitchen, but in the sector, through Oak House Kitchen.

We, and many others, have not left it there…

There are many people working to ensure challenging questions are being addressed and tackled head on. Health and social care catering operations must strive to deliver the best possible experience for those in need so that they are well nourished and dignified, while maintaining independence and as much pleasure and social experiences as possible.

Within this aim there are many factors to consider: uncontrolled weight loss, dementia, learning disability, physical disability, mental disability, physical decline, acute and prolonged illness, palliative and end of life care, sensory decline, hormonal changes, effects of medication, loss of independence…

These are profound challenges, which can be, and are, overcome daily. Not everywhere, by a longshot, but effective practices are out there. They will, in the same way good clinical practice spreads, become more commonplace over time as small cohorts prove effectiveness. For example, our dysphagia training and systems are being evaluated in the hospital in Guernsey, for meal service provided to an acute stroke ward.

The sector, as a whole, does care. They are searching for solutions and improvements all the time, we see this on a daily basis, as well as when working with NHS trusts, councils and care providers large and small.

We will look to discuss many of the points raised in the program and offer some insights and solutions over the coming weeks. I will leave you with one final example that highlights some of the difficulties in finding solutions that residents and patients need when basing this on our personal beliefs and experiences.

To the Lunch Club

At Oak House Residential Home, we run a lunch club for local in the village. They are largely all in their 70s and live healthy and independent lives. We offer the same menu at the lunch club as we have on the residents’ menu on that day; it reduces the burden of preparation, and we are very happy with the quality of our menu.

The paying guests arrive and wait in the comfort of the lobby, while the dining room is reset after our residents’ lunch. There is palpable excitement. Many of the guests book their place for the following event before they sit down to eat. Chatter is jovial and light-hearted, with talk returning to food, drink, and travel. It is always a wonderful atmosphere. The meal service is wonderfully upbeat with complements and general good humour.

The same service, same food, same staff.

Now walk into the dining room an hour before, and the contrast is profound. It’s quiet, there is concentration, it is not light-hearted and carefree. That should be no surprise, the residents have profound differences in their needs. Most have some sensory impairments, hearing or eyesight, making conversation and the task of eating difficult. Frailty makes using cutlery a challenge and so independence is prolonged with adaptive crockery and plates. From time to time there is a requirement for food to be suitable for swallowing difficulties.

It doesn’t look the same…

Oak House Residential Home has a reputation for well nourished residents and effectively dealing with the complexities associated with care home catering, but, as the name describes, it is a residential home. Far more complex are the needs of those residents in dementia or nursing homes.

When The Food Program held up a kitchen garden as an exemplar operation of excellent care home catering standards it showed that its naivety and lack of intelligent investigative reporting. If we are going to judge care home food service and hospitality by holding it up against high end restaurants and hotels with kitchen gardens to see how they match up we are most certainly never going to get it right.

Needs, wants and desires – A care home with a kitchen garden is wonderful, and great work for achieving this. It is desirable but not needed to achieve what residents across the sector want and deserve: well cooked food that they like, served in a way they enjoy, can manage or require.

Remember Wolff’s Law, if form follows function then it won’t look the same… but it can still be high quality.

It was puzzling. I scratched my head…

Providing Skills and Competencies to Meet New Training Needs

Providing Skills and Competencies to Meet New Training Needs

Ensuring staff have the required skills and competencies is a high priority for businesses and there are many considerations to make when deciding which is the best route to take. Face-to-face or online; ‘in-house’ or external; free or paid for; robust or awareness; level? The needs of all businesses vary, here we look at some of the considerations around this complex area.

Online Training

E-Learning has always had its place in the training landscape of the health and social care sector. Mandatory training can be undertaken, and knowledge assessed before staff start their roles caring for very vulnerable people in our society. This brings confidence to organisations and the knowledge base given can be built on with good management and systems.

The outbreak of Covid-19 and the profound operational challenges this has posed health and social care organisations has accelerated the need for robust online training systems. There are many fantastic, hosted learning management systems (LMS) that provide catalogues of courses for mandatory and other important training needs.

Our Care Home

At our care home, Oak House Residential Home, we have updated our training provision and taken the step to have online training accounts for our staff. It has been a great decision! We can provide accessible modules in the core, mandatory areas, manage completion and evidence to regulators, all in one place.

We are not alone, these are great systems, and they are being adopted widely across the sector by large and small organisations. Problem solved.

Well not quite…

What happens when a training need is identified that lies outside the scope of the e-learning packages available?

Identifying New Training Needs

The identification of a training need means that it is a fundamental operational requirement and the outcome of investing in and implementing change (both effort and financial) must lead to a successful resolution.

This core question posed leads to a few other questions that need resolving before a decision can be made:

  • Can we identify a way we can provide adequate training ‘in-house’?
  • Do we have the knowledge base to provide adequate competencies in the area, or areas, required?
  • What is available on the market and who is providing the knowledge base?
  • Is there evidence that the investment will achieve our aims?
  • Does our decision-making show good governance and provide the assurances we need?

Dysphagia Skills and Competencies

Over the last 18 months Oak House Kitchen has developed sector leading training courses in the areas of dysphagia catering and management.

Eating, Drinking and Swallowing Competency framework Courses

Our dysphagia management courses have been developed in collaboration with Anita Smith, Laura Jones, and the team at East Sussex Healthcare NHS Trust (ESHT). The courses are aligned to the competencies set out in the Royal College of Speech and Language Therapist’s ‘Eating, Drinking and Swallowing Competency Framework’. Anita and Laura puled together a whole team approach to the project which included dietetics, occupational therapy, and dental care professionals.

The courses have been the focus of several pilots across the UK, that have not only refined the learner experience, but also provided excellent feedback from learners and led to endorsement by clinicians. As a result, we know have 1000’s of health and social care workers using the courses at NHS Trusts and care homes across England, Wales, Scotland and the Channel Islands.

Online Dysphagia Diets for IDDSI Course

Our dysphagia catering course, ‘Dysphagia Diets for IDDSI’ is a highly regarded course that simplifies the approach to catering for dysphagia that has shown improvements in choice, quality, efficiency and in meeting the requirements of clinical recommendations and IDDSI. Such has been the effectiveness of the course that it has been cited as a core component in The Close Care Home’s achievement of ‘Outstanding in all areas’ by the CQC.

The profound changes caused by the pandemic has meant that we have brought this course online. The course was recorded if full and each section of the 15-module course has its own feature video and is wrapped in interactive e-learning modules to enhance the learner’s experience.

We did not want the requirement of creating an online course to devalue the learner experience, we love the hands-on approach to catering training and know that this is a fundamental way that most chefs like to learn.

Feedback has shown that the online course is robust and effective and brings with it operational benefits that face-to-face training cannot provide:

  • Training is available to chefs before they start their role meaning that there are no competency gaps while a suitable course becomes available
  • Ongoing access to the resource to provide a reference and refresher in all areas of the course – an online manual so to speak.
  • Reduced training, labour, and travel costs

The ‘Online Dysphagia diets for IDDSI Course’ has been piloted by care providers and is now in use in NHS Trusts, County and City Councils, large and small care organisations and in facility management, including schools, prisons, and rehabilitation centres.

No Need to Compromise

We understand that training in this area is not a tick box exercise. The decision to implement training in this area needs more than a nod to the subject, skills and competencies are a must. It would be great to have additional modules added to LMS catalogues by the hosts, but the questions of quality and effectiveness remain.

With this in mind, we have made it easy for you to integrate our dysphagia management and catering courses onto your LMS. They are compatible with all learning management systems and can be embedded alongside your other courses so that users and managers still only need one system.

For those without an LMS provider all our courses are available on our Learning Suite and manager tracking is available to ensure both large and small organisations have oversight and the assurances they need.

Get in touch to see how we can help you…