practical living
Maggie Beer at the royal commission in
Cairns. Photo: Stewart McLean, News Corp
$7 a day for meals
Unacceptable aged care food practices
slammed at royal commission.
By Conor Burke
R
eusing half-eaten meals, reheating food in a cold bain-marie,
and maggot-infested rubbish – these are among the poor
food practices in aged care facilities revealed at the recent
royal commission hearings in Cairns.
The commission heard from a panel of aged care chefs with the
combined experience of over 30 years in aged care food service.
Lindy Twyford, Timothy Deverell and Nicholas Hall covered issues
ranging from training to food budgets and storage practices.
Deverell said all of his industry qualifications and experience could
not prepare him for the dietary requirements and nutritional needs
of an aged care kitchen. “Up to 70 per cent are on texture-modified
diets. Nowhere during any of my training did I receive anything on
texture-modified diet,” he said.
Hall agreed: “You get no training on texture modifications, fluid,
thickened fluids … Nothing prepares you for that side of it. And you
don’t get told what would happen if a resident gets fed the wrong
texture modification or liquid.”
Twyford said her facility has been proactive in ensuring training
for kitchen staff, telling the commission that “they always look at
improving the training for staff to enable them to do their work”.
But Hall, who works as a chef manager at an aged care facility,
believes more needs to be done. “[The training] – if you can call
it training – [is] usually a half-hour session that the staff will do at
home on a computer. There are no trainers provided. There are no
examples. There’s no actual teaching. It’s just read, tick and flick.”
Deverell, who has held executive chef management positions in
aged care, told the commission that menu planning is often taken
out of the hands of chefs.
He also told the commission of some unsafe food practices he has
witnessed: “Reusing food that’s already been served to the resident
and come back to the kitchen. Reheating textured modified food
in a cold bain-marie. Texture-modified food is high risk. I’ve had
one place where the fridge temperature for the whole day was 14
degrees. I reported it to the manager and they said under the food
safety plan they only have to take the temperature once a day, and
they did it at midnight. At midnight, it was four degrees, but the food
was in the danger zone for the whole day. So, yes, I could go on,
there are endless examples.”
The panel cited a lack of food diversity as another issue, saying
meals can be repeated up to “three or four times a week”.
Throughout the panel’s testimony, Hall and Deverell’s experiences
often differed from that of Twyford, highlighting the difference in
approach by providers.
24 agedcareinsite.com.au
When asked if nutritionists or dietitians had input in the design or
make-up of menus, Hall and Deverell gave a resounding no.
“Nutritionists are there just solely so … the home or the third-party
facility can say, ‘We have a dietitian or a nutritionist, have a look.’ But
when I was at the aged care provider, I think I saw her once a month
for one hour,” Hall said.
Twyford told the commission that she had a good relationship
with dietitians and that they have direct input into the details of the
food served at her facility.
“She asks for two pages to be sent to her about everything that’s
in those recipes: the portion sizes, the ingredients, how it’s cooked.
We also have dietitians come in regularly to the facility. If there’s a
resident that needs reviewing, they will review it, then the dietitian
will come and speak with myself or the catering staff so they’re all on
board and know the changes in the diets for that resident,” she said.
“She will advise and see how we cook it, what we add to the
cooking ingredients and everything.”
However, all agreed on the importance of food in the life and
happiness of aged care residents.
“It’s everything. It’s what they look forward to at the end of the
day,” said Hall.
THE COST OF HAPPINESS
The day also saw celebrity chef Maggie Beer give testimony in her
capacity as head of the Maggie Beer Foundation, which seeks to
improve food quality in aged care.
She talked about the lack of interesting food in aged care, the “lack
of scent, the lack of aromas”, and how important these can be for
the emotions of residents.
“Everybody wants to smell proper food. Without the right budget
for the right ingredients, you cannot make good food with bad
ingredients,” she said.
The commission heard that food budgets may vary from facility to
facility. Larger budgets can be up to $17 per resident, but as low as $7
for smaller budgets. Beer argued that $7 is “absolutely not” adequate
to provide nutritious food.
“It’s not possible, because they will have to [use] processed
foods, frozen food, frozen vegetables, fish that is usually frozen and
imported, not even Australian. It’s just impossible,” she said.
“The minimum I would see would be $10 … but that’s when
everything single thing is right. That’s when you have a passionate
cook or chef that knows it costs no more money to be able to
do things from scratch if they have a garden, and if they have the
processes in place so they can use the garden. But that’s when every
single thing is right. But [with] $14, you can do really good food.”
Beer also stressed the importance of food presentation (as people
lose saliva and taste buds in the ageing process) and using proper
crockery, as well as suggesting that homes have fresh herb gardens.
She also suggested chefs’ salaries were not high enough to expect
good food in aged care.
“[There is a] lack of respect and lack of salary too. We heard … the
things the cook or chef had to do [in addition to cooking], and the
salary was $54,000. So there’s that lack of respect in the industry that
they are faced with. It’s the low wage,” she said.
Beer recommended that research on the relationship between
food and emotional and physical wellbeing in aged care be
undertaken, and a campaign pushing “for society as a whole
to understand the importance of food, of eating well as we
age for health, the how and the what, and understanding the
social aspects of loneliness and isolation that lead to depression
and malnutrition”. ■