Nailing the nutrition for older Australians

After serving dishes in exclusive resorts and fine dining restaurants, French chef Stephan Blant said that working in residential care has offered a different type of reward.  

“It’s life changing,” he told Aged Care Insite.

“Unlike in a hotel, where you only see people for two nights, here you have more contact with the customers. They are here for months so you can talk with them and get to know them properly.”

Stephan is the catering manager for Peninsula Villages, a local residential facility on Sydney’s central coast, where he manages food service for over 300 people each day. 

Alongside cooking his traditional Mediterranean and French dishes, Stephan said that he and his staff make a point to incorporate meals that residents say they wish to eat.

“Some of our clients come from different aged care places where they don’t have a lot of choices,” he said.

“Since I started, I’ve tried to focus on customer service, and I’ve explained to my staff that if someone asks for something and we can do it, we do it.”

After training in Switzerland, the third generation chef travelled to Australia 10 years ago without speaking a word of English.

Stephan then travelled around the country, catering for a restaurant on Sydney's harbourside, then moving to two exclusive hotels on the Whitsundays.

It wasn't until he relocated to his wife's hometown on the central coast that he discovered his passion for cooking for the vulnerable

Landing a job as a chef for one of the largest providers in the country, he found that the quality of food offered was poor and inconsistent.

“I was really shocked," he said.

“If you don’t have good skills, then you can’t produce a good meal for someone under $9 a day.”

Stephan moved on to Peninsula three years ago and found that because they spent more money on food, he was freer to base his menus on residents' choices, rather than on budget.

With his European heritage, his signature plates include boeuf bourguignon, Italian roasted vegetables, and chicken cordon bleu.

“When you go to the sit-in dining room, and the residents are happy and they have a smile on their face, it’s rewarding,” he said.

“Some of them don’t have families, so the time they spend with us is where we make a difference with them.”

Nutrition has been under a spotlight as aged care providers prepare to submit their first round of food reports under the new rules of the royal commission.

Homes must submit quarterly details about the types of meals that residents are eating, total food intake, and spending on ingredients.

Stephan said that he supported the new regulations but was concerned about the accuracy of measuring how much food is eaten per day.

“The reporting is very difficult, especially knowing where they are going with it in the future,” he said.

“I think it’s good for people doing the wrong thing, but for people doing the right thing, it’s really time consuming.”

The requirements are part of the federal government's 2021 Basic Daily Feed subsidy, which will allocate providers an additional $10 per resident for daily meals.

Ninety-nine per cent of the nation's providers have applied for the initiative.

Dr Judi Porter, a professor of dietetics at Deakin University, said the requirements were a step forward for creating a level of acceptable food quality in the sector.

"If we actually had national standards, then we would have a chance of people needing to deliver at least to a minimum level of care, but we don't have those," she said.

"Often providers are doing their best, but they're working with a workforce that's untrained in this area."

Evidence shows that as people age their appetite typically declines, making higher energy foods more important.

Nailing the nutrition for older Australians is therefore essential, Porter said, to avoid serious complications in later life.

"If providers are unable to meet residents' nutritional needs through their menu, then that individual's nutritional status will decline.

"That's got all kinds of follow-on implications, such as becoming a falls risk, having an increased risk of getting pressure ulcers, becoming malnourished or losing muscle mass."

The royal commission highlighted food and diet as critical issues within the aged care industry.

During the final phase of the commission, Porter was one of the research leads for Dietitians Australia, a leading organisation for nutritionists and dietetic professionals. 

Having consulted with industry stakeholders, she found that the delivery of food service across the sector was inconsistent.

“Some places will be receiving exemplary food where they're meeting all of the residents' nutritional requirements, other food may not be, perhaps, dare I say, restaurant standard,” she said.

“Acknowledging it's not just about the money, it’s also about having trained and competent, committed staffing across the whole of the home to actually provide that mealtime service that residents need.”

Studies have found that over half of older Australians living in aged care homes are at risk of malnutrition or are malnourished. 

An estimated 15 per cent of Australian residents are on texture modified diets. Dr Porter suggests to make every mouthful count, chefs should opt for high protein ingredients.

“Rather than them filling up on thin broths and soups, we really need, if they are going to have soup, for it to be an energy-dense soup: that it's got meat in it, cream, that’s really full of impactful energy and protein,” she said.

“It's not just about the food and the food budget. There are certainly other aspects to the care that really mean we're going to deliver all of the nutritional needs that the residents need.”

After leaving the world of upscale dining behind him, Stephan said that he plans to stay in aged care as it makes a genuine impact in people's lives.

“The quality of food matters at every stage of life, and I like to make people happy with my food," he said.

"I like to think that by creating dishes I am proud of, it shows them just how much I care.”

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