Releasing Time to Care Progress Report

Module Title
Mealtimes
Contact Person
Michael Carroll/Annette Buckmaster
What are the Concerns and Issues?
Staff experience
Kitchens were becoming congested with maybe two or more residents wishing to cook at the same time and making different meals. This resulted in the dilution of the therapeutic aspect of the interaction and presented us with a potentially hazardous situation with up to three or four residents and staff occupying a cramped space with hot food and liquids.
Furthermore there was also a problem with supervision of meals with limited amounts of staff especially at evening meal, as two members of staff could be occupied serving the residents who received their meals from hospital kitchen leaving only one member of staff to supervise and support residents who were cooking their own meals.
There was also a feeling among staff that during set mealtimes, especially lunch, there were constant interruptions from residents, medical staff, incoming phone calls, relatives, AHP’s and nursing staff.
Service user experience
The residents who were on house keeping programme voiced very little concerns, indeed they reported that they liked the way they were supported to make individual choices in both when they had their meals and having the opportunity to choose what they had to eat. They also felt that access to the kitchens was “good” and the level of staff supervision was appropriate.
What were the baseline measurements at start of module?(CQI’s, Waste walks, activity trackers,etc)
A Safety cross was commenced and ran for one week. It showed the level of interruptions from phone calls was the biggest cause of interruptions with it being more problematic at lunch times. There was also interruptions from medical staff especially on a Wednesday which was our review day. Nursing staff also accounted for some interruptions and patients on housekeeping also accounted for some interruptions.
What were the implemented improvements? (What tools/techniques did you use?) Please provide any examples.
We asked that the unit secretary with hold any phone calls at mealtimes that were not urgent.
We also asked medical and nursing staff to observe protected times.
Residents agreed to respect mealtimes as well. They also agreed to one person in the kitchen cooking at any one time.
Notices of mealtimes were posted around unit detailing mealtimes.
It became clear very quickly that it would not be easy to improve mealtimes within Glencairn. Due to the need to protect mealtimes for residents who receive their meal from the hospital kitchen and accommodate residents who choose the times and content of their meal, it was difficult to reduce the request for help from residents. However, a further safety cross indicated that there had been some small improvements in respect of reduction in interruptions from phone calls, medical staff and patients
What were the measurable outcomes/ improvements/benefits?(including Cost savings)
Patient benefits
Housekeeping
Patients noted very little difference, although initially there were some complaints that they had to wait sometimes to cook their meal due to protected mealtimes.
However, they did agree that it was better if there was only one person cooking at a time in the kitchens.
Hospital Kitchens
When asked if they felt that the new ways of working were better all reported that they had noticed no difference to the way their meals were provided
Staff benefits
Staff noticed a reduction in interruptions which allowed them to concentrate on the task they were carrying out and provide more therapeutic, focused one-to- one interactions.
Organisational benefits
Better use of nursing time and skills
Improved care delivery
Improved safety therefore less chance of accidents and litigation
What does the process look like now
Because of the way we provide meals to our residents it was not easy for us to make changes. However we did make some improvements and with the introduction of protected mealtimes we reduced levels of stress and improved safety and quality of interactions during mealtimes.
How is the change sustainable
Ongoing audit and ensuring that all changes are adhered to.
Intended plan to roll out this example of best practice to other areas.
Placed on R drive