Catering for special diets is an area of increasing concern in social care, but some providers are stepping up to the plate
Social care caterers are serving up everything from halal meat to dairy-free milk to meet increasingly diverse dietary needs.
So that people can eat what they want, and what they require nutritionally, some care homes are partnering with community groups to mark occasions such as Eid and Ramadan, to ensure authentic Jewish cuisine is on the daily menu, and to throw vegan festivals.
“The sector needs to pay as much attention to what people want to eat – whether their preference is Kosher food or vegetarian meals – as to what they need,” says Phil Benson, service manager at EachStep in Blackburn, part of Community Integrated Care, which teamed up with local mosques and community groups to celebrate Eid last year.
“Serving a meal made with halal meat, or one without tomatoes if someone has an allergy or prefers not to eat them, does not cost any more money. But those choices are important to individuals so we need to respect them.”
Part of respecting food preferences is about making sure anyone can join if they want to, says Hannah Mulholland, who threw an autumn festival at the Harper Fields care home in Warwickshire last year.
Mulholland decorated a marquee with hay bales, scarecrows, pumpkins, marrows and onions. With the help of a chef, she made traditional dishes residents would remember from their childhood – but with a twist.
All the food served was vegan, from dairy-free margarine on the jacket potatoes and homemade bean sauce, to plant-based hot dogs, toffee apples and mugs of hot chocolate with whipped soya milk.
Everything was suitable for residents who are lactose-intolerant or vegetarian. For Mulholland, who is vegan, the festival was also a way to answer residents’ questions about what on earth she eats for dinner if she doesn’t have meat, fish or dairy.
“I wanted to show that there are care homes that cater well for alternative diets, and that take people’s beliefs and preferences into consideration,” says Mulholland. “I’m horrified when I hear stories about caterers not respecting people’s diets, particularly when they have dementia or are unable to articulate their needs.”
Catering for special diets in the social care sector is a subject of increasing concern to charities and nutritionists. They fear that the sector is failing to meet the challenges of an ever more dietary diverse society, and that menus that cater well for special diets – be it allergy-related, religious or ethical preference – can be few and far between.
“We are stuck in a time-warp,” says Dr Karen Harrison Dening, head of research and evaluation at Dementia UK. “We have an uninspiring, risk-adverse approach, where older people are served mass-produced, re-heated frozen slop and are expected to just get on with it. Little attention is paid to what people might actually like to eat and their dietary preferences.”
Some charities report cases of care home residents with coeliac disease routinely being offered cake that contains gluten, and vegetarians with dementia being fed meat sausages “because they won’t know the difference”. While Allergy UK points out that, by law, care homes are required to provide food that meets individual needs, its understanding is that some care or nursing homes do not have specific policies on allergies.
“It’s a challenge for the sector,” says Neel Radia, chair of the National Association of Care Catering. “The UK is a diverse society and we need to cater for different religious and ethical preferences, such as kosher food and halal meat, as well as ensure patient safety when it comes to labelling allergens.”
Problems can arise due to a lack of understanding of how to cater for certain diets, say charities, and a fast-paced sector where insufficient time is given to presenting appetising meals that cater for specific needs.
And even when dietary preferences are catered for, individuals aren’t always given the meals they want. Those who tick the box for a vegetarian meal, for example, can be given spicy curries which some older people find unpalatable, says Jane Clarke, nutritionist and author.
She says: “The meals then go uneaten. I know a case where an elderly man was surviving on Cup a Soups because he couldn’t eat the spicy food caterers were giving him. His physical and mental health deteriorated and it’s no wonder: he wasn’t getting the nourishment he needed.”
In instances like this, says Clarke, individuals are simply slipping through the net.
“There’s a lot of misunderstanding about dietary preferences,” says Amanda Woodvine, chief executive of Vegetarian for Life, a charity which supports elderly vegetarian and vegans, and trains chefs to cater well for special diets. “While we do hear positive stories, there are also are mix ups with diets. If you’re vulnerable – if you have dementia, for example – and you’re unable to request the food you want to eat, it’s a real struggle.”
The challenge needs to be addressed as in later life or when suffering with poor health, eating tasty food can be more important than ever, says Clarke.
To support people living with health challenges, and their carers, to cook nourishing meals, Clarke has launched a new online resource called Nourish. It includes recipes for dairy-free carrot and coconut soup, gluten-free pesto, and easily-fortified, soft orange bread pudding. Clarke aims to build a community for everyone – including carers, chefs, and caterers – to find inspiration for affordable and thoughtful meals.
She says: “We’re showing how to prepare simple, affordable food that fits dietary needs and will restore people’s spirits as well as their health.”