1. High quality care for all, now and for future generations Caroline Lecko Patient Safety Lead

2. Setting the scene – what high quality care isn’t Three million people in the UK suffering from or at risk of malnutrition 93% of these people are in the community Over a million of these people are over 65 33% of older people are already malnourished or at risk on admission to hospital 37% of older people who have recently moved into care homes are at risk The scale of dehydration in the UK is unknown 2

3. We know people in our care and their families live with the consequences of poor nutrition and hydration...... and the resulting harms ……….. 3

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5. Policy Context Francis Inquiry into Mid Staffordshire NHS Foundation Trust Recommendation 241 “The arrangements and best practice for providing food and drink to elderly patients require constant review, monitoring and implementation.” The NHS Mandate 2013-15 states “No one going in to hospital should have to worry about being left in pain, unable to eat or drink, or go to the toilet.” Health and Social Care Act 2008 requires health and social care settings to meet nutritional needs CQC DANI thematic reviews in 2012 17 per cent of care homes and 12 per cent of hospitals still failed to meet basic standards on nutrition and hydration. 5

6. Setting the scene – last 10 years or so Patient Environment Action Team Assessments (annually) Now PLACE Essence of Care x 2 Better Hospital Food Protected Mealtimes Council of Europe resolution Age UK Hungry to be Heard National Institute for Health and Clinical Excellence RCN Nutrition Now Campaign NPSA/RCN Hydration Best Practice Toolkit DH Nutrition Action Plan NPSA10 Key Characteristics of Good Nutritional Care Toolkit High Impact Actions for Nurses CQC Essential Standards for quality and safety NICE Quality Standards Nutrition and Hydration Action Alliance Malnutrition Task Force 6 To name but a few………

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8. Developing a ‘Nutrition Care Culture’ 8 Effective Tools Effective Systems Right people – right tasks

9. Developing a ‘Nutrition Care Culture’ Executive support and management structures Nutrition and hydration care pathways Education and trainingScreening and assessment Nutrition Care Culture 9

10. The Players 10 National Leadership Associations Healthcare professionals Industry Hospitals and Care Homes Nutrition Care Culture

11. Developing a ‘Nutrition Care Culture’ We need a social movement 11

12. Nutrition and Hydration Week 2014 #NHW2014 12 Hospital Caterers Association National Association of Care Catering Patient Safety First

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15. Thank you for listening Enjoy the rest of your Seminar #NHW2013 15