In her final forum as chair of the NACC, Sue Cawthray outlined the challenges facing the sector. “Brexit and Covid have meant staff left and many have not returned and so we must persuade the Government to see the importance of making it easier to get the staff we need.
“Chefs in care catering do one of the most important jobs and so the sector must continue to do everything to celebrate the work they do and to encourage young people to see it as a viable career option.”
She lamented the £2.5bn funding gap in social care, saying: “We need to look at the future of integration and funding to make the case for better funding.”
And she championed the efforts of the pan-sector PSC Alliance, which she described as an important voice ‘to lobby to shout out on behalf and that of our clients’.
Meanwhile, NACC Ambassador Baroness Liz Barker said food price inflation offered an opportunity: “I think there’s a role for our sector to present food that’s cheaper but good quality. Your niche is not just food, but care and that’s your niche ingredient.
“You have some of the best trained people in catering because you are trained in all the difficult parts of catering. We are going to have many more older people who won’t necessarily be in care homes but will want to go out with families in restaurants, so why wouldn’t they want to have people trained like you to help provide the offer that these people will need.
“Perhaps one of your future roles is around providing the specialist training and skills that chefs will need to do this.”
The forum also heard from NACC ambassadors Chris and Jayne Roberts. Chris was diagnosed with dementia in 2012.
He said: “Dementia doesn’t take away your intelligence, it just makes it difficult sometimes to find the right words. We did lots of research after I was diagnosed, and it gave us hope I wasn’t on the scrap heap just yet.”
He described how many dementia consultations took place without anyone who actually has the condition, and the couple have since been pushing hard to address this.
This has included getting three people with the experience of dealing with dementia onto the consultation for the Welsh dementia plan, and persuading them to find £50m to fund the action plan over the next five years.
Fraser Rickatson, the Care England policy and public care officer, told delegates: “Social care will affect all of us sooner or later, but it’s in an extremely precarious state with many providers having to shut their doors. It remains a hopeful sector, though. It can’t continue to be provided on a shoestring budget, it needs a long-term funding commitment, also needs less red tape.”
He outlined a ‘shopping list’ of actions Care England would like to see the next Government introduce. These included the professional registration of care staff, £15 minimum care wage, closure of the Fair Cost of Funding gap, and a national tariff of £1,500 for each hospital discharge to support Integrated Care Systems and providers to prevent bed blocking.
“We need a different culture that measures the benefits that are brought to communities.” Jane Ogden of the University of Surrey set out to explain that ‘food is more than biology’.
She said that when people moved countries their bodies took on the average weight of the country they move to.
“Bodyweight is socially contingent – the biggest predictor of weight gain is the weight of your friends, less so with family. So it’s more than just biology.”
She said experiments had shown that watching TV means you eat more regardless of your hunger – just because you are distracted.
“We eat for psychological reasons. Food means comfort, pleasure, boredom, it’s a treat, a celebration, denial, guilt, it comes with a massive part of family love, power, religion, control, and culture.
“How does psychology relate to all this? Providing food for people in a care setting is a powerful means of influencing mood, it can provide a punctuation to the boredom, it can bring pleasure, a biscuit can be a treat, feeling good about yourself, eating with others is a powerful social good and makes you feel good.
“You can build relationships through food, it can provide a trigger for conversation with others and with those serving it. It can also bring family in to make visitors part of their world. Cooking together can also be part of building relationships.”
And Dr Angeliki Papadaki, lecturer in nutrition at the University of Bristol looked at the evidence for the importance of the meals on wheels service.
“We expect it to be more and more essential with rising numbers of older people and those living with complex needs, but fewer and fewer local authorities are providing it.
“The benefits of service go beyond simply delivering food, drivers encourage people to eat and move more, they carry out well-being checks, they can also do simple chores like changing a light bulb, which all help promote independent living.
“They act as the ‘fourth emergency service’ for people, for example, who have collapsed. They also can contact families. And they are reliable, delivering no matter the weather.”
Nadim and Tanya Ednan-Laperouse, who have helped drive the introduction of Natasha’s Law in the UK to tighten food allergen labelling, talked about their work in driving research into helping people live more safely and fully with food allergies.
Tanya said: “Our hope is that you and all those you represent will make yourselves even better at all the touchpoints where allergies affect us. Everyone deserves to be able to eat without fear.
“Death can happen, but even short of that so many people live with the fear every day that they might eat something that triggers an allergic reaction. And their parents and family members also have to live with that fear.”
Nadim said the Natasha Clinical Trial in that began in May 2022 was a three-year immunotherapy trial focused on peanuts and cow’s milk – among the most common and dangerous food allergies.
“They find the dose that starts to trigger a reaction and then start to offer daily an amount that’s slightly less, then slowly build the amount up over time to ‘de-risk’ the situation for these people. It’s called de-sensitisation, and the really good thing is that the treatment is food, not expensive drugs.
“We hope the data will prove to the NHS that this is the way to treat people. It’s not a cure but it re-programmes your immune system to help you be able to handle the foods that you are allergic to.”
Helen Ream, healthcare and foodservice dietitian with Compass Group and Alison Smith, Prescribing Support Consultant Dietitian, NHS Herts Valley CCG outlined to the forum the British Dietetic Association (BDA) Menu Planning Guidance for Care Homes that they are working on.
The BDA already has a Nutrition and Hydration Digest document for hospitals, and they felt it would be good to have a version aimed at care homes.
Helen said: “Why is it needed? Because we must meet nutritional and hydration needs under CQC regulations, but there is no guidance.”
Alison added: “The Care Chef competition has highlighted the issue, because we help judge it and among the criteria is the CQC regulation, but we don’t have anything to measure this against other than what people already know.”
Sections will cover Nutrition & Hydration, Food Service Systems, Menu Planning Guidance, and Special Diets. They hope the final draft will be ready by the end of the year and that it will be launched in the spring of 2024.