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Managing Malnutrition in care homes

A care home in Shrewsbury has won an award for the innovative and fun ways it encourages residents to eat well. Briarfields in Raby Crescent, a residential home for older people run by Coverage Care, scooped the 2018 Think Food award from the NHS Shropshire Clinical Commissioning Group.

Think Food is a practical pathway to signpost care homes in the treatment of malnutrition with everyday food and drinks.

Older people can suffer from malnutrition for a variety of reasons from ill-fitting dentures, a poor swallow, having difficulty feeding, a medical condition, or their mental state.

Briarfields has introduced a number of initiatives to ensure that residents who are identified to be at risk of under eating can up their calorie intake in a healthy way.

Home manager Denise Morris said: “The Think Food pathway has become a key pillar of our care and all our staff are aware of how it fits in with our day to day operation.

“We always have fruit and cake available and residents can also visit our ‘shop’ to buy a range of snacks. We have a hydration trolley in the summer offering smoothies and fruit, which is a novelty for residents and encourages them to take on extra fluid. We also do special activities like film afternoons where they can have ice cream and popcorn.

“For those people that have specific dietary needs we create individual plans to ensure they are eating enough. For instance, we have one resident with dementia who was burning off a lot of calories, as she was very active walking around the building. She liked to stop in reception so we placed a special jar of treats for her there which helped her to take on the extra food she needed.”

Coverage Care Chief Executive David Coull praised the Briarfields team for its win.

He said: “Denise and her team are to be applauded for the proactive and innovative way they are tackling potential dietary issues among residents. Eating well is crucial if older people are to stay as fit and as healthy as possible and everyone at Briarfields is working hard to make that happen.”

The home was presented with a food hamper for residents and staff for the way it has adopted the Think Food approach.

Managing malnutrition

While malnutrition can refer to either over or undernutrition we are referring here specifically to undernutrition; a deficiency of energy, protein and other nutrients that causes adverse effects on the body (shape, size and composition), the way it functions and clinical outcomes. Most malnutrition is disease-related, although some social and mechanical (e.g. dentition) factors can also have an impact.

Malnutrition can be identified using a validated screening tool such as the ‘Malnutrition Universal Screening Tool’ (‘MUST’) - see professionals using screening tools should have appropriate skills and training.

In most cases malnutrition is a treatable condition that can be managed using first line dietary advice to optimise food.

Managers can obtain The Malnutrition Pathway that is a practical guide to support healthcare professionals in the community to identify and manage individuals at risk of malnutrition and particularly disease-related malnutrition, including the appropriate use of oral nutritional supplements (ONS)


I guess we would all subscribe to the notion that you are what you eat. But just as food is essential for health strength and well-being, eating should also be a sociable and enjoyable occasion.

Briarfields Care Home in Shrewsbury has shown a novel but practical way of engaging service users in the importance of food by following the Think Food Pathway as a means of preventing malnutrition.

In most cases malnutrition is a treatable condition that can be managed using first line dietary advice to optimise food. Managing malnutrition should be at the heart of a service users care plan where there is identified risk of malnutrition. The Malnutrition Pathway will provide care home managers and their staff with a practical guide on the management of malnutrition.

Albert Cook BA, MA & Fellow Chartered Quality Institute Managing Director Bettal Quality Consultancy

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