In Cornwall, malnutrition management in care homes and reliance on oral nutritional supplements (ONS) was highlighted as a training need with care home residents often high users of ONS, frequently prescribed inappropriately. NHS Kernow and the Better Care Fund funded two care home support dietitians (one full-time equivalent post). The aims of the project were to improve identification and treatment of malnutrition risk in care homes and to reduce inappropriate prescribing of ONS for care home residents.
To date, prior to the COVID-19 pandemic, 39 care homes have received training and resources in managing malnutrition, screening, care planning and using 'food first', including a resource pack entitled 'Managing Malnutrition in Care Homes' and face-to-face training. Key outcomes 3 months after training include: 33% increase in the number of homes using the Malnutrition Universal Screening Tool (MUST) on admission and monthly (as per NICE CG32), and a 220% increase in the number of homes using homemade fortified drinks as a first line, rather than using prescribed ONS.
In response to no longer being able to offer face-to-face training due to the COVID-19 restrictions, the project has continued and been responsive to the needs of homes by changing the training into a digital format. The care home support dietitians have also created a website page and video on COVID-19 and nutrition, aimed at helping care homes to meet the nutritional needs and understand the impact of the symptoms of COVID-19 on nutrition. This will allow the audit and training to continue remotely.
