Aged Care Commission serves up food, nutrition and dining insights and issues

Last updated on 10 May 2024

Meal choice is a rising issue in aged care with residents often wanting more variety. [Shutterstock]

Food, nutrition and dining will have a far more prominent place in the strengthened Aged Care Quality Standards and to better understand how this might look, the Lantern Alliance’s Food, Nutrition and Dining and Aged Care Reform webinar tackled some of the top issues aged care providers face in the hospitality settings. 

Jessica Zilujko, an accredited practising dietitian and the Director of Food, Nutrition and Dining Unit Advisory Support Unit, spoke of some of the Aged Care Quality and Safety Commission’s work during the webinar’s first half.

She highlighted the Commission’s role in protecting and enhancing the safety, health, well-being and quality of life of people receiving aged care services. This involves using intelligence to identify emerging issues or to intervene early to prevent non-compliance or potential risk of harm. 

This approach has resulted in major changes to the Aged Care Quality Standards, where Ms Zilujko mentioned the existing Standards have only one requirement out of 42 directly related to food, nutrition and dining.

“The Royal Commission into Aged Care Quality and Safety and recommendations that came out of it… one of those was that the Aged Care Quality Standards were reviewed and food and nutrition were identified as a priority area to be addressed. This resulted in the Aged Care Quality Standards being strengthened to include a Standard dedicated to food and nutrition,” she said.

“Standard 6: Food and Nutrition describes the aspects of food, nutrition and the overall dining experience that impact on older people’s quality of life. It has four outcomes that highlight the importance of partnering with older people to provide enjoyable food, drink and dining experiences that are in line with contemporary and evidence-based practice that meets the needs goals and preferences of older people living in residential aged care.”

The Aged Care Quality Standards are not the only change around food, nutrition and dining in aged care, though. Ms Zilujko’s own Advisory Group is new while a Food and Nutrition Expert Advisory Group identified four key areas of improvement in this space: choice, swallowing, oral health and dining.

A suite of resources has been developed for each priority area to support providers, staff and people receiving care, including the food, nutrition and dining hotline and additional dementia-specific training.

Meanwhile, site visits have been ramped up with up to 1,440 targeted assessment contacts to be completed between July 1 2023 and June 30 2025. The hotline and site visits are the two main tools being used to unearth the good and bad.

“When we look at complaints between April 2023 and March this year the most common topics the Commission received complaints about were adequate nutrition and hydration, allied health assessment and services, the quality and variety of food and the choice of food,” Ms Zulijko said.

The majority of calls in the hotline fields are diet-related questions, with many callers seeking advice or raising concerns around choice, quality and quantity of food, meal timing, engagement strategies and training or education for staff. 

“When we focus on providers and staff most of the inquiries the Unit are supporting this cohort with are predominantly on food advice, training and food safety; they account for approximately half of the inquiries we received from this group,” she added.

“We’ve supported providers and staff on interpretation and clarification of provider responsibilities and best practice for food, nutrition and dining, including topics such as texture-modified, fluids, ways of supporting people with dementia to eat and dine well, cultural requirements for choice, mealtime support and assistance […].”

Additional issues have been spotted in site visits, including noisy dining environments, poor adherence to modified food and fluid frameworks and poor practices for malnutrition screening management. 

Ms Zulijko said it’s not all bad, with examples of good practice and successful outcomes for residents. 

“We’ve seen food, nutrition and dining champions who can support consumers at meal times and are dedicated to that function, as well as some services ensuring that all staff across all their services are educated and upskilled in food, nutrition and dining issues and how to address them,” she said.

“We have also seen great engagement with specialist services or consultants such as dementia specialists and regular engagement with consultants for very specific concerns and issues that affect older people.”

“I mentioned training and education was an issue we identified but there have been cases where there’s a real dedication and prioritisation of food, nutrition and dining education for all staff.”

As for the Commission’s next steps, Ms Zulijko said they will focus on the four priority areas of dining, choice, swallowing and allied health, plus how providers can better support people living with dementia and those from culturally and linguistically diverse backgrounds. 

A limited number of providers can also benefit from a new program where an independent, dietician-led review of meal services occurs. Expressions of Interest need to be submitted by May 10.

Draft guidance resources to help providers and stakeholders understand the new Quality Standards are also being finalised with the consultation process closing on May 19.

Aged Care Quality and Safety Commission
aged care hospitality
Jessica Zilujko
lantern alliance
Nutrition and Dining Unit Advisory Support Unit