The Leeds Teaching Hospitals NHS Trust

The Leeds Teaching Hospitals
NHS Trust
Making a Difference for
Older Patients
Authors
Diane Spalding, Facilities Dietetic Adviser
Andrew Wilson, Senior Facilities Manager (Patient Catering)
Anthony Warren, Facilities Manager (Patient Catering)
Background
Leeds Hospitals have adapted their Core Menu to accommodate the needs of patients on the Older People’s wards. This
has included reviewing the items offered on the Trust ‘Bistro-style’ lunchtime menu and the introduction of cake served with
Afternoon Tea.
Process
 Sub-group of the Older People’s Forum
 Actions identified to review Menu suitability
 Feedback from patients, their relatives /
carers and ward staff
 Changes agreed between Patient Catering
Facilities staff, Nursing staff and Dietitians
Outcomes
The ‘Bistro-style’ Menu Lunchtime Menu adapted to include:
 Nourishing Soups
 Complete Mini Meals
 Easy to Eat / Finger Food selection
 Locally sourced creamy ice cream
Locally sourced fresh cakes to serve with Afternoon Tea
Picture Menus produced
Snack Menu items reviewed
Picture Snack Menu developed
Mealtime Volunteer trial started on Older People’s wards
Conclusion
A joint initiative between Patient Catering, Facilities, Nursing staff, Dietitians and Dietetic
Assistants has resulted in extremely positive feedback and an on-going work programme has been agreed.
The Leeds Teaching Hospitals
NHS Trust
Which Texture?
Authors
Diane Spalding, Facilities Dietetic Adviser
Colour Coding for Dysphagia Diets
Andrew Wilson, Senior Facilities Manager (Patient Catering)
Anthony Warren, Facilities Manager (Patient Catering)
Background
Leeds Hospitals have introduced colour coding to aid communication at ward level
to help ensure that the patient receives the correct texture.
Process
 Ensure that all products meet the appropriate texture checklist
 Develop colour coded Menus for each texture required (B, C, D, E)
 Label all products for each Menu with the
appropriate coloured label and Descriptor
 Produce a colour coded chart to display at
ward level
Outcomes
 Working relationships established for future
initiatives
 Consistent language used for dysphagia diets
 Consistent colour coding used across this
large Trust
Texture B






Does not hold its shape on a plate or
when scooped
Cannot be eaten with a fork because
it slowly drops through the prongs
The prongs of a fork do not make a
clear pattern on the surface
It cannot be piped, layered or
moulded
It can be poured & 'spreads out' if
spilled
Texture C






Holds its shape on a plate or when
scooped
Can be eaten with a fork because it
does not drop through the prongs
The prongs of a fork make a clear
pattern on the surface
It can be piped, layered or moulded
Cannot be poured
Does not 'spread out' if spilled
Texture D





Food is soft, tender and moist and
needs very little chewing
It must be in a pre-mashed state
before being offered to the patient
It usually requires a very thick,
smooth sauce, gravy or custard
No mixed textures
No hard pieces, lumps, crust, skin,
pips, seeds and no loose fluid
Texture E





Food is soft, tender and moist but
needs some chewing
It can be mashed with a fork at the
point of service / consumption
It usually requires a thick, smooth
sauce, gravy or custard
No mixed textures
No hard pieces, lumps, crust , skin,
pips, seeds and no loose fluid
A disposable teaspoon stands upright
Thin Puree
Thick Puree
Pre-Mashed
Fork Mashable
Conclusion The use of colour coding has helped to ensure that the patient receives the appropriate
texture of diet as prescribed, and has aided staff education of the National Descriptors.