Reusing half-eaten food, reheating food in a cold bain-marie and maggot-infested rubbish are among the poor food practices in aged care facilities revealed at the royal commission in Cairns this week.
The commission heard from a panel of aged care chefs with combined experience of over 30 years in aged care food service.
Lindy Twyford, Timothy Deverell and Nicholas Hall covered issues ranging from training to food budgets and storage practices.
Deverell said all of his industry qualifications and experience could not prepare him for the dietary requirements and nutritional needs of an aged care kitchen.
“Up to 70 per cent are on texture-modified diets. Nowhere during any of my training did I receive anything on texture-modified diet,” he said.
“You get no training on texture modifications, fluid, thickened fluids … nothing prepares you for that side of it. And you don’t get told what would happen if a resident gets fed the wrong texture modification or liquid,” he said.
Twyford said that her facility has been proactive in ensuring training for kitchen staff, telling the commission that “they always look at improving the training for staff to enable them to do their work”.
But Hall, who works as a chef manager at an aged care facility, believes more needs to be done.
“If you can call it training. It’s usually a half-hour session that the staff will do at home on a computer. There’re no trainers provided. There’re no examples. There’s no actual teaching. It’s just read and tick and flick,” he said.
Deverell, who has held executive chef management positions in aged care, told the commission that menu planning often gets taken out the hands of the chef.
Deverell also told the commission of some unsafe food practices he has witnessed first-hand.
“Reusing food that’s already been served to the resident and come back to the kitchen,” he said.
“Reheating textured modified food in a cold bain-marie. Texture-modified food is high risk.
“I’ve had one place where the fridge temperature for the whole day was 14 degrees. I reported it to the manager and they said under the food safety plan they only have to take the temperature once a day, and they did it at midnight. At midnight, it was four degrees, but the food was in the danger zone for the whole day. So, yes, I could go on, there’s endless examples.”
The panel cited a lack of food diversity as another issue, telling the commission that meals can be repeated up to “three or four times a week”.
Throughout the panel’s testimony Hall and Deverell’s experiences often differed from that of Twyford, highlighting the difference in approach by providers.
When asked if nutritionists or dieticians had input in the design or make-up of menus, Hall and Deverell gave resounding nos.
“Nutritionists are there just solely so … the home or the third-party facility can say, ‘We have a dietitian or a nutritionist, have a look.’ But when I was at the aged care provider, I think I saw her once a month for one hour,” Hall said.
Twyford told the commission that she had a good relationship with dieticians and that they have direct input into the details of the food served at her facility.
“She asks for two pages sent to her about everything that’s in those recipes: the portion sizes, the ingredients, how it’s cooked. We also have dietitians come in regularly to the facility. If there’s a resident that needs reviewing, they will review it, then the dietitian will come and speak with myself or the catering staff so they’re all on board and know the changes in the diets for that resident,” she said.
“She will advise and see how we cook it, what we add to the cooking ingredients and everything.”
However, all agreed on the importance of food in the life and happiness of aged care residents.
“It’s everything. It’s what they look forward to at the end of the day,” said Hall.
“Nutrition is vitally important to both physical and emotional wellbeing because malnourishment will lead to wounds or bedsores. And to them – it’s a social site in the dining room,” said Twyford.
The cost of happiness
The day also saw celebrity chef Maggie Beer give testimony in her capacity as head of the Maggie Beer Foundation that seeks to improve food quality in aged care.
She talked about the lack of interest in food in aged care, the “lack of scent, the lack of aromas”, and how important these can be for the emotions of residents.
“Everybody wants to smell proper food. Without the right budget for the right ingredients, you cannot make good food with bad ingredients,” she said.
The commission heard that food budgets may vary from facility to facility. Larger budgets could be up to $17 per resident, but can be as low as $7. Beer argued that $7 is “absolutely not” adequate to provide nutritious food.
“It’s not possible, because they will have to [use] processed foods, frozen food, frozen vegetables, fish that is usually frozen and imported, not even Australian. It’s just impossible,” she said.
“The minimum I would see would be $10 … but that’s when everything single thing is right.
“That’s when you have a passionate cook or chef that knows it costs no more money to be able to do things from scratch if they have a garden, and if they have the processes in place so that they can use the garden. But that’s when every single thing is right. But [with] $14, you can do really good food.”
Beer also stressed the importance of food presentation (as people lose saliva and taste buds in the ageing process), using proper crockery as well as suggesting homes have fresh herb gardens. She also suggested chefs’ salaries were not high enough to expect good food in aged care.
“[There is a] lack of respect and lack of salary too.”
“We heard… the things that the cook or chef had to do as well as cook and the salary was $54,000. So there’s that lack of respect in the industry that they are faced with. It’s the low wage,” she said.
Beer recommended that research on the relationship between food and emotional and physical wellbeing in aged care be undertaken, and a campaign pushing “for society as a whole, to understand the importance of food, of eating well as we age for health, the how and the what, and understanding the social aspects of loneliness and isolation that lead to depression and malnutrition”.Do you have an idea for a story?
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