South East Branch Study Day
Menu Planning
RATIONALE FOR NEW NACC
NUTRITIONAL STANDARD
The aims of the standard are:
To simplify existing standards in line with
current best practice
To define one standard across all social
care settings
To provide choice menus that have the
capacity to meet the nutritional needs of
both those at risk of malnutrition and
those with special dietary needs
The reasons being:
• The last decade has seen a massive growth in technology and it is now
commonplace for nutritional information and analysis software to be widely
used by both lay and professional people
• New regulated nutritional standards in the public sector provide a
recognised and easily-understood model for defining nutritional issues e.g.
School Food Trust
• The Care Quality Commission (CQC), the monitoring body for England, will
be monitoring across all care and social settings. Thus uniformity of food
and beverage services standards in all these settings must be designed to
meet the outcomes of Nutritional Standard 5
• All recommendations are based on current government or professional body
advice. The evidence base for best nutritional practice for healthcare is
found in the 1995 Guidelines for Hospital Catering (Department of Health
(DH). These guidelines have been updated and revised to provide the
nutritional decisions that underpin the new Standard
• The multi-agency 10 Key Characteristics of Good Nutritional Care, derived
from Council of Europe Resolution 12/11/2003 Food & Nutritional Care and
in which NACC is a stakeholder, strengthen the levels of good practice in
food and beverage services to be expected in all care settings
• Hence existing NACC standards need to be modified to one clear Standard
that meets these modern requirements and enables service users, their
relatives, healthcare staff and auditors to witness consistent food services
regardless of setting
• It is highly desirable that any nutritional care services for older people
include input from an experienced professional, and the Standard is written
in the belief that a Registered Dietitian (RD) or Nutritionist (RN) should be
engaged at least annually to advise on a menu review (Or CCM?)
The 5 key points
are a mnemonic for
5 fingers of the NACC Caring Hand
2010 campaign:
‘No One Should Go Hungry’
The Standard should be
reviewed annually from
first publication date
Is this October 2010?
Let’s discuss!
Nutritional analysis of menu and
menu items
Nutrient content of all meals and
snacks must be provided.
As a minimum this should include
energy (kcals) and protein content.
Overall food and nutrient content of meal
must meet minimum standards
A ‘meal’ such as is served at lunch, high tea /
suppertime must at least consist of a main course and
dessert course.
Any such meal, whether a cooked meal or a lighter meal
such as a sandwich, must:
• include a good source of protein and a starchy
carbohydrate, and a serving of vegetables or fruit.
Where cooked vegetables are served, the total portion size must
be at least 80g
• provide a minimum of 300kcal of energy
• provide a minimum of 15g of protein.
• An energy dense dessert must be available as a choice
at each main meal and provide a minimum of 250kcal.
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For those providing wider meal services:
Breakfast must provide a minimum of 380kcal
and 8g of protein
5 portions of fruits and vegetables per day must
be available from the menu, some as snacks
Between meal snacks throughout the day must
provide a total of at least 400kcals and 4g of
protein
A minimum of 7 beverages per day (1.5l fluid)
must be offered including the use of a minimum
of at least 400ml full fat milk for drinks and on
cereal where drinks are offered
For practical purposes
the total meal, beverage and snacks
menu per day
must provide a nutritional content
of at least:
2150kcal (revised figure)
& 55g of protein (nutrient)
Support individual meal requirements
The menu should suit a variety of client
needs including:
• Ethnic, cultural and religious
requirements
• Medical /health conditions e.g. gluten
free, modified texture etc.
• Local and regional customs and
traditional practices e.g. fish on Fridays,
roast dinners, culturally suitable menus
Grouped dietary codings for
specific nutritional needs
• “Healthier eating” choices should be available which are moderate
in salt, saturated fat, sugar and total fat thus providing suitable
items for people with diabetes, and those managing their weight,
cholesterol levels and /or blood pressure
• “Energy dense” options should be available for those who require
extra calories
• “Softer” code is useful for identifying which dishes are easier to eat
for those with chewing problems
• Allergen content of meals must be available in accordance with UK
Food Labelling Regulations and Amendments.
Hydration
• Fresh drinking water must be accessible at all
times and a choice of hot and cold drinks
offered at meal times, bed time and at regular
intervals in between
• Over the day, hot and cold drinks together
should provide the client with at least 1.5 litres
(6-8 cups/glasses) of fluid.
Menu planning
Planning pointers
This is your clients’ menu – not yours!
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Budget; proportional cost; waste
% uptakes
Logistics – length of menu cycle; meal timings and menu balance across day; catering skills;
deliveries; style of food service; hot food hot, cool food cool; assistance with eating
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Appropriate to client group
Appeals to clients - mixed and varied
Provides familiarity /comfort
With recognisable dish names
Combinations of colour, texture and flavours to suit recipients’ tastes
Includes clients’ suggestions
Daily / weekly / yearly patterning – specials, celebrations
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Texture (include a Softer choice)
Higher Energy (Energy Dense) to Healthier choices
Can identify good sources of vitamins C and D, calcium and fibre over the day/week
5 A DAY over the day
Other diets?
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Acceptable dish repetition
Check first to last day of cycle repetition
Menu plan checker
Day
Mon
B
Mon
L
Mon
S
Tue
B
Tue
L
Tue
S
Wed
B
Wed
L
Wed
S
Soup
Main
1
Main
2
Vegetarian
Starch
1
Starch
2
Veg
1
Veg
2
Pudding
1
Sauce
Pudding
2
milk /cold
Now let’s take a
leaf out of this
presentation and
try looking at
your menus!!
Jo and I thank you for any
feedback to take with us
to NACC Exec.
anne.donelan@tilleryvalley.com