NACC South East Christmas Seminar Dysphagia Diet Food Texture Descriptors

1. NACC South East Christmas SeminarDysphagia Diet Food Texture Descriptors Caroline Lecko Patient Safety Lead NPSA/RCN

3. Dysphagia Diet Food Descriptors • Launched in April 2011 • Developed by: • NPSA • RCSLT • NNNG • HCA • Supported by: • NHS Supply Chain • Endorsed by the NACC August 2011 • Engagement with industry

5. Why did we need new descriptors? • Original descriptors issued in 2002 by the BDA & RSCLT • BDA review document published in 2009 • Recognised that there needed for engagement with industry and caterers • Compliance with National Descriptors for Texture Modification in Adults was poor • Requests from industry and caterers fro detailed guidance on categories of texture

6. Examples from the National Reporting and Learning System • patient requires soft moist diet . however soft options on menu not suitable as contains lumps . patient started to cough and choke . patient was asked to stop eating and rest for 30 minutes . patient recovered and to commence of puree diet • Patient was transferred to ward .... on .... , had been seen by colleagues and it was recommended she have a syrup consistency fluids and soft diet due to dysphagia . Went to review patient and found patient drinking normal fluids , with difficulty . Spoke to a nurse who informed that the recommendations had not been handed over , however the recommendations are recorded extensively in notes , including nurses entry immediately prior to transfer . • Pt previously assessed by SALT as requiring a Soft Grey Diet / meal arrived with boiled pots, whole peas & sweetcorn, should have been mashed pot, mushy peas & no sweetcorn.

7. What new? • Endorsement from all of the key professional organisations • All care settings are required to have 2 available textures: • Texture C (Thick Puree Dysphagia Diet) • Texture E (Fork Mashable Dysphagia Diet) • Texture D ( Pre-mashed Dysphagia Diet) & Texture B (Thin Puree Dysphagia Diet) may be required in some care settings • Have been developed to include children

8. What does the new document include? • Specific standards for each texture B, C, D, & E • Audit checklists so that food can be measured can be measured against the standards for each texture

9. For example C Thick Puree Dysphagia Diet C C Thick Puree Dysphagia Diet C General description: √ Food has been pureed or has a puree texture. It does not require chewing. √ It is a thick puree* √ It is smooth throughout with no ‘bits’ (no lumps, fibres, bits of shell/skin, bits of husk, particles of gristle/bone etc.) It may need to be sieved to achieve this. Check before serving: × No hard pieces, crust or skin have formed during cooking/heating/standing × Fluid/gravy/sauce/custard in or on the food has not thinned out or separated off. • Note – definition of ‘thick’ puree Holds its shape on a plate or when scooped. Can be eaten with a fork because it does not drop through the prongs.

10. Who are the descriptors for? • Primarily designed for food producers • Useful for staff teaching and training

11. So why is it important?

14. Impacts on both the potential life threatening risks and quality of life issues

18. The Global Picture The Tango has just began ...... Potential for International Dysphagia Descriptors Potential collaboration with interest from UK, Canada, Australia, Ireland, so far Discussed at the European Society of Swallowing Disorders (ESSD) in September 2011 Watch this space .......