Diabetic diets – clinically appropriate in aged care or not?

When balancing the clinical needs, requests and preferences of each resident in-conjunction with their right to choose, a number of factors need to be taken into consideration.  We all recognise that theory and practice can change over time so when I asked Liz Beaglehole (Registered Dietitian) her professional view on this topic is, she offered the following:

 

The recommendation for older adults with diabetes in aged care facilities with stable diabetes is to provide an unrestrictive diet as much as possible. The notion of a ‘diabetic diet’ is outdated due to the increased risk of hypos and unwanted weight loss.

 

This is very individual however, a frail 80 year old woman with diabetes will likely have no diet restrictions however an obese 70 year old who may be otherwise stable would benefit from a more restrictive diet.  Advice from a dietitian for individuals is recommended.

 

Overall, guidance from the resident about their wants is probably what determines the diet provided. This may be in accordance with recommendations or not.

 

Generally, the medications should be fitted to the usual eating pattern of the resident.  In aged care facilities there are regular meals and generally balanced carbohydrates over the main meals (assuming good food intake) so usually this is fine.  If someone has a reduced food intake, and is on insulin then a unrestrictive diet would be best.

 

For my menu planning I tend not to plan any special diabetic options on the cycle menus.  I may include a low fat / low sugar dessert option if sites request, but generally my philosophy for aged care is not to restrict foods!

 

Liz is involved with a PEN (practiced based evidence in nutrition) review of the question ‘Do institutionalized, older adults (65 years of age or older) who closely follow a diet prescription have better control of their chronic disease (e.g. diabetes) than those who do not?‘ This is due by the end of March so further practice updates from this review may be available then.  Liz noted that generally the evidence suggests there are no benefits with a prescriptive diet vs a more liberal one.

This article was kindly contributed by Liz Beaglehole NZRD (Canterbury Dietitians).

Food Control Plan registration update

Those of you who are members of the New Zealand Aged Care Association (NZACA) may be aware that we (Healthcare Compliance Solutions Ltd) have been contracted by the NZACA to develop what is known as an Industry Body Customised Food Control Plan (FCP). This is to be approved by the Ministry of Primary Industries (MPI) and made available to all NZACA membersThis customised plan comes under section 40 of the Food Safety Act and has been developed with the intention of streamlining audit process for Age Related Residential Care providers to use. There is an extended date for registering under this plan. 31st March was the date noted for registration however for this process, the date for completion of the registration process for use of the Industry Body NZACA FCP will be 31st May 2018. 

 

Instead of registering with the local Council, those members who are taking advantage of the national customised food control plan will register directly with Ministry of Primary Industries.  What is being worked towards currently is for this plan then to be audited by your Certification Designation Auditor Agency auditors in conjunction with your other audits. It is our understanding that the deadline for registering with MPI has changed to take the Food Control Plan approval into consideration so please check with NZACA to verify when you need to have your registration completed by.

 

How far have things progressed currently?  We have submitted the draft of the customised plan to MPI for approval.  The content of this plan goes beyond the standard Food Control Plan as it will need to also meet Certification and ARRC funding agreement audit criteria. This is designed to be an all in one set of documents so that as noted, it assists with the streamlining of audit.  We understand this approval process could take 4 – 6 weeks with a period of refinement if necessary and finalising of the documentation to follow, before a Gazette notice would be published.  This notice is necessary to proceed with association members using the Industry Body customised FCP as part of their other certification audit processes.

 

A huge thank you to Liz Beaglehole (Registered Dietitian) from Canterbury Dietitians who assisted at short notice with the reviewing of documentation contents which form part of the FCP.

 

There is work to be completed behind the scenes in an attempt to align audit time-frames which are not the same for all providers so while the intent is clear, the reality of achieving what we are setting out to do, is yet to be confirmed.

 

We support the work of the NZACA and were very pleased to be able to support the age care sector in this way.  We undertake to do what we can to support this process to a successful outcome.  NZACA will be updating their members as we work through this process.  If you are not a member, this may be a good time to join to take advantage of just one of the benefits they offer to support their members.

If you would like further support with the implementation of your Food Control Plan, please feel free to contact us.

RN – Manager, Kaiapoi Lodge Resthome and Hospital – February 2017

We are a medium sized rest home and hospital. The complexities of the various standards means that without a product such as HCSL we would find it difficult to function. Health Care Compliance Solutions Ltd has ensured we stay up to date and compliant in all areas of our industry.

The recent introduction of the online tool has been a massive invaluable boost, all staff now have access to the latest documents online.

Never before have we been able to compare ourselves against industry. Instant access to current documents, analysis of events and graphical representation are just a click away. Adverse events and infections are recorded and compared against industry.  The ability to log complaints, restraints and complete internal audit has aided in our ability to close the quality circle.

With HCSL we no longer need to worry about the policies and procedures we just need to focus on the implementation.

 

 

Jonathan Prangnell

Registered Nurse/Manager 

Kaiapoi Lodge Residential Care Ltd  – February 2017

Quality Systems Development / Support

Bogged down in paperwork? Wasting your time re-inventing the wheel, creating documents to meet audit requirements? 

  • Are you spending unnecessary time on researching, developing and reviewing policies and procedures?
  • You don’t need to do this any longer!
  • You can now get back to doing what you enjoy!

Healthcare Compliance Solutions Limited (HCSL) supports you in achieving Certification and contractual audit outcomes through provision of a completely integrated tried and tested quality system. This system consists of a set of policy and procedure manuals accompanied by the relevant clinical practice forms. Everything you need in customised ready to use hard-copy manuals AND accessible in-the-cloud   To view a brief video demo of the system click here.

This documented Quality System has been developed and continuously refined by us over the past 15 years taking into consideration all legislation and contractual requirements for Aged Residential Care setting.

Our Quality System package which continues to pass numerous audits in multiple facilities nationally for both Certification and District Health Board contract (ARRC) audit purposes consists of:

  • Policy and procedure manuals to guide meeting compliance requirements
  • Fully indexed and cross referenced
  • Incorporates the requirements of the Health & Safety at Work; and Food Safety Act legislation
  • System accompanied by coaching and mentoring services
  • Flexibility to enable modification to meet the specific requirements of your facility.
  • User friendly format
  • Written in practical common sense terminology

Service contracts ensure ongoing updates are provided as regulatory requirements change.  A number of our clients have achieved Four Years Certification.

Policy and Procedure manuals are grouped as:

  • Human Resources
  • Organisation Management (includes quality  and risk)
  • Entry (admission) and Consumer Rights
  • Safe and Appropriate Environment (Health and Safety; and Infection Prevention and Control)
  • Services delivery (care services)
  • Food Services
  • Village (RVA related policies and procedures for those with Village facilities)

During service provision HCSL work alongside you to ensure that your system is adapted to your specific needs and provides guidance for consistent service which in turn retains happy clients for your facility. Where clinical practices are identified as not complying with current accepted best practice, you will receive mentoring and support in the change management process to achieve improvements.

Don’t waste any more of your precious time – make contact today to gain access to a System that will support you in achieving Certification, and can be maintained on your behalf!

For more information on our national NZ designed bench-marking and online quality and risk programmes, read more here or contact us

Contact us now for more information.

Tracey Dimmock-Rump – Owner / Manager

Amberley Resthome and Retirement Studios

“I was referred to Gillian Robinson (HSCL) through a colleague as I knew I needed expertise help when starting out in the aged care industry. Little did I know I would get the best!
Working alongside someone as passionate as Gillian is a privilege which reflects the level of commitment she makes to you as a client. From the phone calls and emails, to the training sessions, to the continuous improvement guidance and depth of knowledge that is implemented in our system. I can’t thank Gillian enough for her support and have no hesitation in recommending her services to anybody in the healthcare sector.

She knows this industry inside and out and has played a pivotal role in our success as an organisation”.

 

Tracey Dimmock-Rump – Owner / Manager

Electronic records and computer use in residential care facilities

I remember years and years ago hearing about the coming of the paperless society!  Do you recall that?  Have we achieved it?  If anything, we’re surrounded by more and more paperwork.  I receive enquiries on a regular basis from disgruntled nurses that are bogged down in paperwork and wanting to know if there is a simpler way to do things that will allow them time to get back to hands-on nursing; spending time with their residents.

I’m more than happy to help you with freeing up your time and still achieve all the necessities of documenting service provision.  One way to do this is using smart computer software.  I realise that up until recently our industry has not been ready for this however with the surge in uses of Facebook and other social networking sites, computers are not as intimidating as they once were!

I’m committed to getting your nurses back on the floor while working on the basis of continuous improvement and providing excellence in care based on evidence based practice.  In order to help me develop the tools you need I’d appreciate you taking a few minutes to complete this quick and simple survey.

Thank you for your time and look forward to getting a solution that will allow you to get out of the office and back to your residents!

Testimonial – Shoshannim Care of the Elderly – Canterbury

After well over 20 years, I’m retiring and moving on to new ventures.  I just wanted to say a huge thank you for being there when I needed you and being a close colleague and work support. Your systems kept us on track meaning audit was always so much less stressful than it used to be. It does mean a lot to me to know you’re there at the end of the phone.

Thank you

your friend

Trudy Doreen Stevens (Owner – Shoshannim Care of the Elderly (Ohoka, Canterbury)