The CQC responds to Hungry to be Heard

Q. Are you supportive of Hungry to Be Heard, Age UK’s ongoing campaign to end the scandal of people in later life becoming malnourished in hospitals?

A. Yes we are. We believe that access to nutrition and hydration that meets individual clinical and spiritual needs is an integral part of maintaining one’s dignity and human rights. We are very aware that lack of appropriate nutrition and hydration can have a significant impact on people’s ability to recover in hospital and be protected from other related complications, such as risk of infections.

Q. Why do you think malnutrition is still an issue, four years on from the launch of our campaign?

A. We have evidence, which shows that a lack of high-level commitment, inadequate awareness of staff regarding nutritional issues, not adhering to guidance such as that from NICE and finally inadequate monitoring arrangements can all lead to practices around nutritional care that may be less than acceptable.

Q. What is the CQC doing to ensure that people in later life will get the food and help they need at mealtimes?

A. All providers of health and adult social care services that provide regulated activities – for example, surgical procedures, nursing and personal care – must be registered with the CQC. By registering with us, they are expected to adhere to a number of standards. One key standard focuses on nutrition. The standard states that people are to be provided with a choice of food and drink to meet their needs.

Providers must make sure the food and drink they provide is nutritionally balanced and supports their health. We have developed detailed guidance to provide advice on how providers are to meet this standard. Our guidance states that people’s dietary and hydration needs are identified and reviewed though a care plan.

We have also developed an observation tool for the outcome on nutrition in collaboration with the Royal College of Nursing. This is aimed at our inspectors/assessors to enable them to collect robust evidence on whether people in care settings are indeed experiencing nutritional care which is focused on their outcomes. The guidance and the tool are available on the Care Quality Commission's website.

Q. Will the CQC undertake the comprehensive review of hospital mealtimes that Age UK campaigners have been calling for?

A. Our immediate focus is on getting the basics right through registration – ensuring that regulated services for older people and people living with dementia meet essential standards of quality and safety relating to nutrition and hydration. We will look for patterns of poor performance through our Quality and Risk Profiles (QRP) and subsequent follow-up visits and target these early to avoid these poor practices becoming embedded. We believe that our registration system is a strong lever to drive improvement in nutritional care for people in all care settings.

Q. What else will the CQC do to ensure people in later life will get the food and help they need at mealtimes?

A. We will use our five strategic priorities to ensure that issues relating to nutrition and hydration in all care settings are addressed and decisions about the nutritional care involve people and their carers. The priorities are:

• Ensuring care is centred on people’s needs and protects their rights
• Championing joined up care
• Acting swiftly to help eliminate poor quality of care
• Promoting high quality care
• Regulating effectively in partnership