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SO, WHAT EXACTLY IS THE IDDSI FRAMEWORK? Sophie Murray, the deputy national chair for the National Association of Care Catering (NACC), explains the IDDSI framework further: IDDSI is a recently implemented safety and guidance framework that helps to ensure that thickened fluids (fluids and food) are safely made for those with swallowing difficulties. It was created by a team of volunteer experts from a range of disciplines to put in place a consistent and safe global language for thickening fluids and food. Drink levels are shown in the bottom triangle from levels 0 – 4. Levels 0 – 3 testing methods are established by using a simple flow test and level 4 a fork and spoon test, all of which are described on the IDDSI site ( The flow test needs a slip tip syringe or specially-designed funnel, which can also be found on the IDDSI website. With safe methods to test fluids, care staff can quickly and easily ensure that residents receive the correct fluid thickness, in line with the speech and language therapist’s report. The syringe isn’t intended for use each time but for whenever there is uncertainty, such as when commencing the framework, using a new cup or using a new fluid. This flow test of liquid consistency is based on the funnels used in the food and chemicals industry, which has been adapted by IDDSI to use a commonly-available, inexpensive “funnel”. This can be formed by removing the plunger from a syringe, then setting a time limit of 10 seconds and volume of 10 ml to minimize time and wastage. The resulting test gives a scale from 0-10 which maps the full range of consistency from watery liquids to semi-solids (IDDSI Levels 0-3). The NACC was a member of the National IDDSI Reference Group. We supported by raising awareness of IDDSI implementation by April 2019 and encouraging anyone involved in care catering to work to the framework. Speech and language therapists throughout the UK indicate when each care home switches to IDDSI, based on when their assessment shifted from the old national texture descriptors to the IDDSI levels. It’s essential that all care providers and catering suppliers follow this framework – more information is available on the IDDSI website.

It’s important to be alert to the increased risks of dehydration for residents needing thickened fluids and food, especially as the weather gets warmer, and to ensure hydration is safe and promoted at every opportunity. Remain person centred and provide the hydration that will be enjoyed – even a glass of sparkling fizz can be thickened and still have the sensation of bubbles!

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Profile for The Carer

The Carer #44 Spring 2019  

Issue #44 of The Carer - The leading independent publication for nursing and residential care homes. Published Spring (April) 2019.

The Carer #44 Spring 2019  

Issue #44 of The Carer - The leading independent publication for nursing and residential care homes. Published Spring (April) 2019.

Profile for thecarer