4.4 Mealtime Management

Mealtime Management

4.4

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4.5 Mealtime Management Contents Preamble ............................................................................................................................. 3 4.4.1 Identify Clients ......................................................................................................... 3 4.4.2 Mealtime Management Needs................................................................................. 3 4.4.3 Client Involvement ................................................................................................... 3 4.4.4 Understanding Mealtime Management Needs ........................................................ 3 4.4.5 Managing Health Risks ........................................................................................... 4 4.4.6 Mealtime Management Plans .................................................................................. 4 4.4.7 Developing Menus................................................................................................... 4 4.4.8 Texture Modified Foods........................................................................................... 4 4.4.9 Identifying Correct Meals......................................................................................... 4 The IDDSI Framework ......................................................................................................... 5 Procedures .......................................................................................................................... 6 Summary ............................................................................................................................. 7 Worker Training ................................................................................................................ 7 Supporting Documents ........................................................................................................ 8 Policies ............................................................................................................................. 8 Forms ............................................................................................................................... 8 Information ....................................................................................................................... 8 NGO Training ................................................................................................................... 8 Legislation ........................................................................................................................ 8 NDIS Practice Standards and Quality Indicators ................................................................. 9 4.4 Mealtime Management ............................................................................................... 9 Human Services Quality Standards ................................................................................... 10 4 Safety, Wellbeing and Rights ...................................................................................... 10 6 Human Resources....................................................................................................... 10 Delegation of Authority....................................................................................................... 11 Version Details ................................................................................................................... 11

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Preamble Having access to mealtimes that are safe and enjoyable is critical as it minimises the risk of choking and serious health problems and also improves a person’s safety and quality of life.

BigDog Support Services Pty Ltd and Scottvale Health Club Group (BigDog) ensures that each client requiring mealtime management receives meals that are nutritious, and of a texture that is appropriate to their individual needs, and appropriately planned, and prepared in an environment and manner that meets their individual needs and preferences and delivered in a way that is appropriate to their individual needs and ensures that the meals are enjoyable.

4.4.1 Identify Clients Providers identify each client requiring mealtime management utilising the CareMaster App that has a photo of the client.

4.4.2 Mealtime Management Needs Each client requiring mealtime management has their individual mealtime management needs assessed by appropriately qualified health practitioners, including by practitioners: a) undertaking comprehensive assessments of their nutrition and swallowing; and b) assessing their seating and positioning requirements for eating and drinking; and c) providing mealtime management plans which outline their mealtime management needs, including for swallowing, eating and drinking; and d) reviewing assessments and plans annually or in accordance with the professional advice of the client’s practitioner, or more frequently if needs change or difficulty is observed

4.4.3 Client Involvement With their consent, each client requiring mealtime management is involved in the assessment and development of their mealtime management plans.

4.4.4 Understanding Mealtime Management Needs Each worker responsible for providing mealtime management to clients understands the mealtime management needs of those clients and the steps to take if safety incidents occur during meals, such as coughing or choking on food or fluids.

In the NGO Training Module, Mealtime Management course workers will learn why mealtime management is important for clients who experience difficulty swallowing. They will learn about the NDIS Mealtime Management Practice Standard and Quality Indicators. The course will give the worker a sound understanding of how this practice standard impacts their role and responsibilities providing mealtime support. Workers will learn how a mealtime management plan is developed and how they can implement a client’s mealtime management plan to support safe and enjoyable mealtimes.

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4.4.5 Managing Health Risks Each worker responsible for providing mealtime management to clients is trained in preparing and providing safe meals with clients that would reasonably be expected to be enjoyable and proactively managing emerging and chronic health risks related to mealtime difficulties, including how to seek help to manage such risks.

4.4.6 Mealtime Management Plans Mealtime management plans for clients are available where mealtime management is provided to them and are easily accessible to workers providing mealtime management to them. Plans will be available in the client’s folder in each house and also on CareMaster.

4.4.7 Developing Menus Effective planning is in place to develop menus with each client requiring mealtime management to support them to: a) be provided with nutritious meals that would reasonably be expected to be enjoyable, reflecting their preferences, their informed choice and any recommendations by an appropriately qualified health practitioner that are reflected in their mealtime management plan; and b) if they have chronic health risks (such as swallowing difficulties, diabetes, anaphylaxis, food allergies, obesity or being underweight) – proactively manage those risks.

4.4.8 Texture Modified Foods Procedures are in place for workers to prepare and provide texture-modified foods and fluids in accordance with mealtime management plans for clients and to check that meals for clients are of the correct texture, as identified in the plans. Copies of the International Dysphagia Diet Standardisation Initiative (IDDSI) are included in the client’s folder.

4.4.9 Identifying Correct Meals Meals that may be provided to clients requiring mealtime management are stored safely and in accordance with health standards, can be easily identified as meals to be provided to particular clients and can be differentiated from meals not to be provided to particular clients.

Be proactive by: Clearly labelling meals that are safe for the client.

Clearly label foods that are not safe for the client.

Use food-safe containers.

Keep hot foods hot (60°C or hotter) Keep cold foods cold (5°C or colder)

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The IDDSI Framework Providing a common terminology for describing food textures and drink thickness to improve safety for individuals with swallowing difficulties.

The IDDSI framework consists of a continuum of 8 levels (0 - 7), where drinks are measured from Levels 0 – 4, while foods are measured from Levels 3 – 7.

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Procedures Mealtime Management includes the following: Understanding the client’s needs for mealtime assistance.

Providing appropriate and safe food texture and nutrition Planning adequate supervision and support Using positioning and assistive technology at mealtimes Managing swallowing difficulties and oral health Recognise and respond to mealtime related incidents and emergencies.

Ensure each client receives meals that are: Nutritious Of a texture that is appropriate to their needs Appropriately planned.

Prepared in an environment and manner that meets their individual needs and preferences.

Delivered in a way that is appropriate to the client’s needs Enjoyable Support Workers must: Complete accredited first aid training and hold a current certificate.

Know if their client requires mealtime management support.

Check that clients requiring mealtime management have been appropriately assessed by a qualified health practitioner.

Understand the client’s needs and have easy access to their individual mealtime management plan.

Know how to manage safety incidents that occur during mealtime.

Be trained to prepare safe and enjoyable meals and proactively manage emerging health risks associated with mealtimes.

Follow mealtime management plans to proactively manage individual health risks and ensure nutritious, enjoyable and safe meals are provided.

Follow procedures for meal preparation and provision of texture-modified foods and fluids in accordance with the client’s mealtime management plan.

Know how to identify and safely store client meals, so they are not confused with meals not suitable for the client.

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Summary We eat food for multiple reasons including, maintain body functions, gain energy for activity, growth and repair of the body, keep our immune system healthy and for pleasure and social interaction. Support workers are required to focus on their obligations and duty of care.

Worker Training Mealtime Management In this course workers will learn why mealtime management is important for clients who experience difficulty swallowing. Workers will learn about the NDIS Mealtime Management Practice Standard and Quality Indicators. The course will give them a sound understanding of how this practice standard impacts their role and responsibilities in providing mealtime support. Workers will learn how a mealtime management plan is developed and how they can implement a client’s mealtime management plan to support safe and enjoyable mealtimes.

After this lesson workers will be able to: 1. Understand mealtime management.

2. Understand the NDIS Practice Standard for Mealtime Management.

3. Identify Dysphagia and associated risks.

4. Provide mealtime support to participants.

5. Proactively manage risks and mealtime difficulties.

Course duration: 52 minutes Nutrition and Healthy Eating In this course, workers will learn what nutrition is and why supporting people with disability to have a balanced diet is important. We’ll start by exploring the essential nutrients required and how to locate them within various food sources. Next, workers will delve into nutritional risks and the contributing factors that render people with disabilities more vulnerable to deficiencies.

Workers will understand the impact of nutritional deficiencies on health and well-being, and find out what they can do to support people to make healthy food choices and develop their independence in accessing and preparing food. Lastly, workers will learn about the role of Nutritionists and Dietitians, discerning when to enlist the assistance of other healthcare professionals to ensure optimal nutrition and safety during mealtimes.

After this lesson workers will be able to: 1. Explain what nutrition is and what healthy eating looks like.

2. Identify factors contributing to nutritional risk and understand common nutritional deficiencies and their health consequences.

3. Promote good nutrition, healthy eating, and mealtime safety for participants.

Course duration: 30 minutes

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Supporting Documents Policies 2.2 Risk Management 2.9 Emergency and Disaster Management 3.4.5 Duty of Care

Forms CareMaster Incident Report Child Safety Critical Incident Report Form Child Safety Major Incident Report Form Mealtime Management Checklist Mealtime Management Plan

Information Australian Guide to Healthy Eating Emergency Contact Numbers Human Services Quality Framework October 2021 Version 8 International Dysphagia Diet Standardisation Initiative (IDDSI) Framework NDIS Practice Alerts NDIS Practice Standards November 2021 Version 4 St Johns First Aid Fact Sheet – Choking Adult

NGO Training Child Safety Critical Incidents Child Safety Major Incidents Dysphagia (PA04) Mealtime Management (52 mins) Nutrition and Healthy Eating (30 mins) Oral Health (PA08)

Legislation Child Protection Reform and other Legislation Act 2022 (QLD) Disability Services Act 2006 (QLD) Disability Services and Inclusion Act 2023 (Cwth) National Disability Insurance Scheme Act 2013 (Cwth) NDIS (Provider Registration and Practice Standards) Amendment Rules 2021

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NDIS Practice Standards and Quality Indicators BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.

The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS participants.

The four core modules are: 1.0 Rights and Responsibilities; 2.0 Governance and Operational Management; 3.0 The Provision of Supports; and 4.0 The Support Provision Environment.

The supplementary modules cover: 5.0 Specialist Support 5.1 High intensity daily personal activities.

5.3 Implementing behaviour support plans.

4.4 Mealtime Management Each participant requiring mealtime management receives meals that are nutritious, and of a texture that is appropriate to their individual needs, and appropriately planned, and prepared in an environment and manner that meets their individual needs and preferences and delivered in a way that is appropriate to their individual needs and ensures that the meals are enjoyable.

4.4.1 Providers identify each participant requiring mealtime management.

4.4.2 Each participant requiring mealtime management has their individual mealtime management needs assessed by appropriately qualified health practitioners, including by practitioners: a) undertaking comprehensive assessments of their nutrition and swallowing b) assessing their seating and positioning requirements for eating and drinking c) providing mealtime management plans which outline their mealtime management needs, including for swallowing, eating and drinking d) reviewing assessments and plans annually or in accordance with the professional advice of the participant’s practitioner, or more frequently if needs change or difficulty is observed.

4.4.3 With their consent, each participant requiring mealtime management is involved in the assessment and development of their mealtime management plans.

4.4.4 Each worker responsible for providing mealtime management to participants understands the mealtime management needs of those participants and the steps to take if safety incidents occur during meals, such as coughing or choking on food or fluids.

4.4.5 Each worker responsible for providing mealtime management to participants is trained in preparing and providing safe meals with participants that would reasonably be expected to be enjoyable and proactively managing emerging and chronic health risks related to mealtime difficulties, including how to seek help to manage such risks.

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4.4.6 Mealtime management plans for participants are available where mealtime management is provided to them and are easily accessible to workers providing mealtime management to them.

4.4.7 Effective planning is in place to develop menus with each participant requiring mealtime management to support them to: a) be provided with nutritious meals that would reasonably be expected to be enjoyable, reflecting their preferences, their informed choice and any recommendations by an appropriately qualified health practitioner that are reflected in their mealtime management plan; and b) if they have chronic health risks (such as swallowing difficulties, diabetes, anaphylaxis, food allergies, obesity or being underweight) – proactively manage those risks.

4.4.8 Procedures are in place for workers to prepare and provide texture-modified foods and fluids in accordance with mealtime management plans for participants and to check that meals for participants are of the correct texture, as identified in the plans.

4.4.9 Meals that may be provided to participants requiring mealtime management are stored safely and in accordance with health standards, can be easily identified as meals to be provided to particular participants and can be differentiated from meals not to be provided to particular participants.

Human Services Quality Standards 4 Safety, Wellbeing and Rights The safety, wellbeing and human and legal rights of people using services are protected and promoted.

4.2 BigDog proactively prevents, identifies and responds to risks to the safety and wellbeing of people using services.

4.3 The organisation has processes for reporting and responding to potential or actual harm, abuse and/or neglect that may occur for people using services

6 Human Resources Effective human resource management systems, including recruitment, induction and supervisory processes, result in quality service provision.

6.1 BigDog has human resource management systems that are consistent with regulatory requirements, industrial relations legislation, work health and safety legislation and relevant agreements or awards.

6.3 BigDog provides people working in BigDog with induction, training and development opportunities relevant to their roles.

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Delegation of Authority Name

Position

Details

Courtney Carroll

Director

Authorise review and implementation

Ann Paull

Company Secretary

Manage Finances

Peter McGrath

Operations Manager

Ensure information dissemination

Monique Paull

HR Lawyer

Ensure compliance by workers

Version Details This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy.

If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0.

The following rules also apply in interpreting this policy: • Headings are for convenience only and do not affect interpretation.

• A singular word includes the plural and vice versa.

• A word that suggests one gender includes the other genders.

Date

V

January 2022

5.0 New Policy NDIS Practice Standards November 2021 Version 4

January 2023

6.0 Included Human Services Quality Standards and Child Protection Act and the term “Participant” is returned to “Client” to allow for policies to cover NDIS and Child Safety.

Term “Employee” changed to “Worker” for consistency.

January 2024

6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included.

June 2025

6.2 Scottvale Health Club included in policy Steven Paull has retired, responsible officers updated

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