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The Newcastle upon Tyne Hospitals NHS Foundation Trust

Trust Food Hygiene Policy

Version No.: 5.1

Effective From: 29 October 2019

Expiry Date: 25 May 2021

Date Ratified: 28 October 2019

Ratified By: Clinical Policy Group ( subsequent paperlite aligned)

1 Introduction The Newcastle upon Tyne Hospitals NHS Foundation Trust has a moral and legal responsibility to protect its patients, staff and visitors from food poisoning. According to Food Law Code of Practice England March 2017 which is issued under section 40 (1) of the Food Safety Act 19901 Regulation 26 (1) of

The Food safety and Hygiene (England) Regulations 2013 and regulation 6 (1) of the Official Feed and Food Controls (England ) Regulations 2009 food hygiene practices are essential to support the wellbeing of patients, staff and visitors, whilst delivering continuous improvements within food service and preparation to ensure a high level of food safety is delivered by Trust Catering Services, nominated contractors and associates. 2 Scope

Providers should have a food and drink strategy that addresses the nutritional needs of people using the service. The Sister or Charge Nurse is responsible for ensuring maintenance of day-to-day standards of hygiene in ward kitchens and beverage bays. It is also their responsibility to ensure that staff attend annual, mandatory training sessions on food hygiene. All staff have a responsibility to ensure food hygiene standards are maintained within their work areas. This policy aims to standardise good practice throughout the Trust.

3 Aims To ensure that all staff who have a responsibility for food handling, work within the legal parameters to meet safe food handling and practices. This is aligned to the Care Quality Commission Regulation 14, Meeting Nutritional and Hydration Needs Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 14 and Food Safety Act 19901,

The Food Safety and Hygiene (England) Regulations 20133.

4 Duties (Roles and responsibilities) The Deputy Directors of Nursing, Directorate Management teams, Sisters/Charge Nurses and Heads of Department including Hotel Services Managers, are responsible for ensuring the application of this policy. It is the Sister, Charge Nurse or Seniors Nurses responsibility to ensure food safety training has been completed within 13 weeks of any new employee commencing employment who has a direct

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role within patient food & beverage service. Food Safety training can be completed online. 5.1 Occupational Health A food handler is defined as a person employed in the production, preparation, storage and transport of food stuffs who is directly in contact with the product. However, this also includes anyone who may touch food contact surfaces or other surfaces in rooms where open food is handled. “No person suffering from, or being a carrier of a disease likely to be transmitted through food or afflicted, for example, with infected wounds, skin infections, sores or diarrhoea is to be permitted to handle food or enter any food-handling area in any capacity if there is any likelihood of direct or indirect contamination.“ People who work around open food while suffering from certain infections (mainly from bacteria and viruses) can contaminate the food or surfaces the food may come into contact with. This can spread infection to other people through the food. In order to help managers and staff to prevent the spread of infection, the Food Standards Agency (2009) advise that any food handling staff should report symptoms of:

Diarrhoea and/or vomiting as these are the main symptoms of illnesses that can be transmitted through food.

Staff handling food or working in a food handling area must report these symptoms to management immediately.

Managers must exclude staff with these symptoms from working with or around open food, normally for 48 hours from when symptoms stop naturally.

In addition, all staff who handle food and who work around open food must always: Wash hands with soap and water and dry thoroughly before handling food, or surfaces likely to come into contact with food, especially after going to the toilet. This is because it is possible to be infected but not have symptoms. The most common symptoms of a gastrointestinal infection are diarrhoea and vomiting. Other symptoms can include stomach cramps or pain, nausea and fever. Although diarrhoea is a very common condition in the community, it is difficult to define so to exclude all normal variations of bowel habit it usually involves a change in bowel habit with loose or liquid stools which are being passed more frequently than normal. Three or more loose stools in 24 hours are a very general indication of diarrhoea that may be infectious, but this can vary. If this is not followed by any more symptoms or further diarrhoea then it is not likely to be infectious, but should be discussed with your manager before attending work.

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(Food Standards Agency, 2009). Food Handlers: Fitness to Work Regulatory Guidance and Best Practice Advice For Food Business Operators 2009 (Palmer, Brown, Hobson 2013) Fitness for work the medical aspects Fifth Edition Oxford University Press

It is important that managers monitoring sickness inform the OH department and Infection Prevention and Control if they have more than one member of their staff off duty at one time with a gastrointestinal illness. Excluding unnecessary visitors from food handling areas and minimising the amount of direct contact with food and food contact surfaces will help to avoid the risk of spreading any infections people may have. (Food Standard Agency 2009) 5.2 Patients Patients admitted with or developing diarrhoea of an unknown cause, whilst in the care of the Trust, are potentially infectious and should be nursed in standard isolation. Please refer to the Isolation Policy. Where appropriate, consider investigations for food poisoning, stool specimens should be sent to the Microbiology Laboratory at Freeman Hospital. Patients should be asked to inform the nurse in charge immediately if they develop diarrhoea. Infection prevention and control must then be informed. Infection Prevention and Control advice can be sought 7 days a week Infection Prevention and Control Nurses RVI Dect 21662, FH 27431 or CAV Ext. 26470 Out of hours the on-call microbiologist can be contacted via switchboard 5.3 Hand Hygiene The hands of health-care workers are the most common vehicle for the transmission of micro-organisms. All food handlers are required to wash their hands before and after contact with food. See Hand Hygiene Policy.

Prior to and post meal service, hands must be washed using liquid soap and running water, then dried thoroughly to render them socially clean as per Hand Hygiene Policy . It is important to offer patients hand washing facilities, this may include hand wipes for individual patient use. Nails should be kept short to make hand washing easier. Gloves can be used to cover damaged skin or protect hands from risk of developing skin conditions such as dermatitis, which can be caused by prolonged food handling and wet work such as dish washing. (Food Standards Agency, 2009) Hand wash basins are for hand washing only and must not be used for any other purpose.

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5.4 Protective Clothing Ward based staff are required to don a clean, blue, plastic apron, from a dispenser immediately prior to handling and serving food and beverages. This must be replaced each time non-food handling duties are carried out. A supply of aprons for this purpose must be stored in the ward kitchen or store cupboard and not in a clinical/sluice area. Ten Golden Rules of Food Hygiene

The Ten Golden Rules for food hygiene must be applied when handling food. (Appendix 1) 5.5 Temperature Control The Food Safety and Hygiene (England) Regulations 2013 states that chill holding requirements for cold food is below 8c and Hot holding requirements are above 63c To maintain food at a safe temperature, i.e., hot food above 63°C and cold food below 8 °C, it is essential that:

Food is transported as quickly as possible

Food trolleys are plugged in where appropriate

The delivery Porter informs ward staff of the trolley’s arrival

The regenerated food temperature (RVI) is recorded using a probe thermometer to confirm that the food is safe to serve. The temperature should then be recorded on the appropriate record sheet. (Appendix 3) The probe must be cleaned after each use with ‘probe cleaning wipes’. The probe must be stored in the kitchen/beverage bay or zone kitchen. When using food temperature probes always follow the manufacturer’s instructions and ensure that food is served promptly following regeneration.

Food provided by the catering departments must not be reheated. * If a patient is unable to eat at planned meal times, an alternative meal will be made available on request to the Catering Department. Under no circumstances should meals be kept at ward level for subsequent use. Please note snack boxes are available from the designated access points. * Wards may hold a supply of canned soups, baked beans, spaghetti and milk puddings which can be reheated within the ward kitchen/beverage bay if required.

Freeman Hospital – Catering Services Department provide patient snacks 24/7 which are located in the snack fridge in the restaurant. To access the fridge staff collect the key from Freeman main reception and record the snack they remove.

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RVI Snack Fridge Provision is widespread in adult and paediatric areas, please contact the catering department for a list of locations:

High risk contents of snack boxes, e.g. sandwiches and yoghurts, must be discarded within 2 hours of service. These must be labelled appropriately with the date and time of storage. Out of hours, a record of food taken from the fridges must be maintained by the ward hosting the snack fridge

Sip feeds (such as build up) made with milk should not be left standing on the bedside locker for more than 4 hours, after which time they must be discarded

All sip and baby feeds must be labelled accordingly with date and time, please refer to Expression, Storage and Administration of Expressed Breast Milk Policy

All unused food, hot or cold, must be returned to the kitchen with the trolley.

5.6 Refrigerator (Ward) The Sister/Charge Nurse is responsible for ensuring that the following refrigerator controls are maintained:

Clean and defrost weekly, clean spills as they occur.

Check door seals to ensure clean and intact and replace if damaged.

Use only for short term storage.

Restrict storage of staff and patients (including parents) personal food. Where storage is essential, all items must be wrapped or sealed and labelled with the person’s name and the date it was placed in the refrigerator.

Expiry dates should be checked daily by a nominated member of the ward staff. Any food found to be out of date must be discarded.

All patient food should labelled with the patients name and no canned foods should be stored in the fridge.

Carrier bags must NOT be put into refrigerators as they have a high risk of external contamination.

Refrigerators should be used for food storage ONLY.

Under no circumstances should raw meat, vegetables or poultry be stored in the ward refrigerator. The refrigerator temperature should be checked in the morning and evening and recorded on the standard temperature sheet (Appendix 2) the refrigerator should operate between 1ºC – 5ºC. The nurse in charge should be informed of any rise in temperature. Where there is a rise in temperature, the door should not be opened for 15 minutes when a second reading should be taken. If the temperature remains incorrect, notify the Estate’s Department via the fault line immediately. Out of hours, contact the on-call Estates Shift Craftsman via switchboard in order to escalate repairs.

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All new appliances should be fitted with a digital temperature display and be designed to operate between 1ºC – 5ºC.

Staff fridges

Where staff fridges are utilised it is the responsibility of staff to maintain and follow the above good practice. Please note the fridge operating temperatures for staff fridges should be between 1ºC-8ºC.

5.6a Freezers The use of freezers in wards areas is restricted to those areas which have been defined as suitable by IPC, Catering Services Management and Dieticians. The operating temperatures of ward freezers should be monitored daily AM and PM, temperatures recorded and the temperature record held within the ward kitchen. Freezers temperatures should be maintained below -18oC. Freezers that are operating outside and above this temperature should be reported to Estates fault line by telephoning 21000.

No Drugs should be stored in a ward fridge or freezer

Storage of patients’ food within ward freezers should be kept to a minimum and frozen foods requested just in time to ensure efficient stock utilisation.

Frost free freezers should be purchased to allow for cleaning without the need to defrost.

Food should be date labelled and if for a specific special diet the patients’ name should be recorded.

Food held in ward freezer storage should be stored for no more than (3) three months from receipt of goods. Food Safety Due Diligence – Record sheets should be kept for 12 weeks 5.7 Bread Bread should be stored in the ward kitchen/beverage bay, in its original packaging and should not be used after the manufacturer’s expiry date. Strict stock rotation must be observed at all times and stored in pest proof containers. 5.8 Eggs The preparation, cooking and use of eggs at ward level (other than supplied by NHS Catering Service) are prohibited. 5.9 Condiments

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Sachets of condiments can be stored at room temperature, once opened they must be discarded. Bottles of sauce must be stored in the refrigerator once opened and should not be used after the manufacturer’s expiry date. Bottles must never be taken into any patient area, decant into single use container and then discard. 5.10 Butter and margarine Butter and margarine portions/tubs must be stored in the refrigerator in their original containers/wrappers and stock rotation maintained. They must not be used after the manufacturer’s expiry date. Tubs of butter or margarine must never be taken into a patient area, decant into single use container, and then discard. Consider single patient use portions.

5.11 Dry Foods Inspect packaging for damage and check the use by date on receipt and before use, store in sealable, separate, clean containers and ensure strict stock rotation to avoid unnecessary waste. Storage containers must be washed and thoroughly dried once per week. 5.12 Microwave Ovens The use of microwaves should be discouraged. They can pose a serious risk to health through incorrect use. Where they are deemed necessary, they must be of commercial design and cleaned after use. It is the user’s responsibility to ensure cleanliness of the equipment at all times; this will be monitored by the Ward Sister or Charge Nurse. All new microwave ovens should operate at 850 - 1,000 watts. If microwave ovens are not cleaned and maintained adequately, they will be removed.

Under no circumstances should they be used to reheat patients’ food. They may be used for:

Boiling of fresh milk for beverages and cereals

Heating of canned baked beans, spaghetti, soup and milk puddings

Further advice can be sought from the site Catering Services Manager 5.13 Beverage Trolleys (RVI sites only) Please follow the manufacturer’s instructions for their use, maintenance and cleaning. Contact the Catering Manager if problems occur.

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5.14 Medicine Pots Should be washed in the kitchen sink using hot water and detergent, not in the hand wash basin, and thoroughly dried. Disposable medicine pots must be discarded following use. 5.15 Dishwashers These must be of a commercial design WRAS (Water Regulations Advisory Scheme) approved, the department manager or Sister/Charge Nurse is responsible for ensuring effective cleaning takes place. The dishwasher must be cleaned weekly or if visibly dirty; door seals must be regularly checked. 5.16 Meal service Before being returned to the hospital kitchen/zone, trays should be checked for any extraneous items, i.e. dentures, sputum cartons, dressings, sharps etc. which must be removed at ward level. All waste food must be returned to the main kitchen/zone kitchen. 5.17 Access to ward kitchens Patients/parents should not have access to the ward kitchen/beverage bay and refrigerator. 5.18 Reporting Responsibilities Faulty equipment should be reported to the Estates Department immediately using the fault line extension 21000

Any signs of pest infestation, e.g. mice, cockroaches, ants, etc., must be reported to the Estates Department. Out of hours, contact the switchboard who will notify the on-call Building Officer / Shift Craftsman.

Any comments or concerns with regard to food should be reported to the Catering Services Manager on telephone extension 48681or 31570 at Freeman and 20248 or 24714 at RVI. 5.19 Maintenance/Repair The Estates Department will carry out Planned Preventative Maintenance on essential equipment, e.g. fridges, dishwashers, and respond as a matter of urgency to breakdowns. Estates contact number 21000. 5.20 Suspected Food Poisoning Outbreaks Immediately report to Infection Prevention and Control, out of hours contact the microbiologist on call. Refer to the Trust policy for dealing with Major Outbreaks, Investigation and Control in Newcastle Hospitals.

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5.21 Bringing Refreshments into Hospital

High Risk Foods The following foods may constitute a serious risk to health if inappropriately handled, and must be avoided by immunocompromised patients (please refer to local guidelines). Patients and visitors must be strongly discouraged from bringing the following foods into hospital: Sandwiches Cooked Meats Cooked Rice Fish Paste Fresh or synthetic cream e.g. trifles, cream cakes, etc. Shell Eggs Take Away Foods

Patients who choose to accept the risks associated with bringing high risk foods into hospital must complete a disclaimer (Appendix 4)

Permitted Foods

Providing that there are no clinical contraindications, the following items may be brought into the hospital by the patient/visitor/carer:

Pre wrapped biscuits Fresh fruit* Confectionery Bottled or canned drinks Yoghurts (must be refrigerated)*

Specific dietary requirements should be discussed with the Nurse-in-charge of the ward. *Foods that impact upon the wellbeing of immune compromised patients should not be brought into the Trust 5.22 Sabbath Boxes for Jewish Patients, the following list illustrates items stored in the Sabbath box.

Prayer book Bible 3 187ml bottles of grape juice 1 jar of fish (long life can be kept at ambient temp) 1 box matzos (religious crackers) Box of biscuits 2 bars chocolate Sweets Snood (female head covering) Bottle water Disposable cups, plates, knives, folks and spoons Box tissues/toilet paper

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5.23 Monitoring A formal inspection of all ward kitchens is undertaken on an annual basis via the Cleanliness in Hospitals Audit and the Customer Services Audit via the Catering Management Team. The kitchen environment (acute Trust) is monitored on a monthly basis via the Clinical Assurance Tool.

The Senior Estates Officer will be responsible for planned preventative maintenance and external audit. 6 Training All food handlers must complete the annual food hygiene training on-line following induction. Training undertaken will be recorded in ESR. The Catering manager will provide additional training upon request. 7 Equality and diversity “The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds.” 8 External Catering Companies Any consideration for the utilisation of external catering companies should be discussed with the site catering manager in advance of any booking.

The definition of external companies does not refer to staff bringing in their own pack lunches for individual use. Furthermore the Trust would expect staff to utilise good food safety practices when providing foods for colleagues in terms of events such as “bring a plate day”. This is strictly confined to small personal use and should not be construed in any terms as being given permission to engage external contractors and thereafter endeavouring to pass these companies off as personal use.

Method By Committee Frequency

Ward Hygiene Inspection Audit Team.

steps in the process (see section 5.23 above)

Multi-disciplinary team carry out cleanliness inspection via a set Proforma. The Ward kitchen is appraised upon been visually clean and all steps to manage stock control and storage. Fridge and Ward re-therm trolleys are monitored at the point of inspection and further audit carried out

Cleanliness Audit Team Annually, Sister/ward Manager daily

Director of Nursing

Annually via Cleanliness Audit team and Catering Management

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to ensure consistency of temperatures and equipment (FRIDGES) are repaired and/or replaced appropriately.

9 Consultation and review This document was produced in consultation with the Trust Nutritional Steering Group, the Trust Catering Management, Infection Prevention and Control Committee, Equality and Diversity and Occupational Therapy. 10 Implementation (including raising awareness) The implementation of this policy is through Trust Local Induction, the Trust Health Care Academy training, and departmental induction. 11 References

1. Food Safety Act 1990 (c. 16), ISBN 0105416908 2. The Food Hygiene (England) Regulations, 2006. (SI 2006/14).

3. The Food Safety and Hygiene (England) Regulations 2013

Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance (revised 2015). 12 Associated documentation

Major Outbreaks, Investigation and Control

Trust Handy Hygiene Policy

Trust Isolation Policy

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Appendices List of definitions The following are key words with associated explanations: Environmental Health Officer (EHO) – Environmental health officers monitor and enforce public health and safety regulations. They carry out inspections at locations where food is kept to ensure that it is handled and stored in a safe and hygienic manner. Food - Any substance or product, whether processed, partially processed or unprocessed intended for human consumption, including drinks and ice Food Handler – A food handler is someone who is involved in the preparation, cooking and serving of food, including transportation, in any part of the Trust. Food Probe - A small pointed rod about 3 to 4 mm in diameter which measures the internal temperature of food.

Food Safety Act 1990 - The Food Safety Act 1990 is an Act of Parliament of the United Kingdom. It is the statutory obligation to treat food intended for human consumption in a controlled and managed way.

Hand wash basins - a basin or bowl solely for washing hands

High Risk Food - In simple terms this means food that does not require cooking/any further cooking before it is consumed and that can become harmful to the consumer Probe Cleaning Wipes – usually an alcohol based infused tissue for the sole purpose of cleaning food probes Protective Clothing – Additional clothing such as disposables aprons, designed to provide a protective barrier to support safe food handling practices Responsible Person – Person who is the lead with responsibility for all ward staff within their designated area for food safety, safe food storage, temperature checking of food and fridges/freezers Sabbath Box – a selection of kosher foods which are provided to support Jewish patients with their meal provision during the Sabbath, the boxes are located in A&E at the RVI and at the Main Reception Freeman Hospital Snack Fridge – Provide a 24 hour food provision for patients, primarily when they have missed a meal or require additional food Food Safety Golden Rules – the essential rules for safe ward kitchen hygiene practices which should be displayed in ward kitchens.

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Appendix 1

Ten Golden Rules of Food Hygiene

Maintain high standards of personal hygiene at all times. Hands must always be washed before handling food and in accordance with Trust policy. Broken skin must be covered with a BLUE, detectable waterproof dressing. Fingernails must be kept clean, short and avoid wearing nail polish/false nails/jewellery. Hair must be worn short or tied up in accordance with Uniform/Dress and Appearance policy. Avoid touching face, nose and mouth while preparing or serving food and do not eat whilst preparing or serving food. When handling food always wear a clean BLUE disposable plastic apron. Remove apron and wash hands on completion of food handling task. Keep all equipment and surfaces clean. Keep food covered and either refrigerated or piping hot. Use utensils/BLUE disposable gloves for handling food.

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Appendix 3

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Appendix 4

…………………………….HOSPITAL

DISCLAIMER FORM

None-Approved NHS Patient Food Patients are asked to utilise the NHS Catering Foodservice and NHS Foodservice outlets within the confines of the Hospital for the purpose of buying cooked foods, snacks and sandwiches. Exclusions to the aforementioned include outlets within the RVI such as Costa Coffee. Exclusions also extend to outlets at Freeman Hospital. The exclusion furthermore extends to food brought into the hospital for patient consumption for the purpose of religious needs. Please note that Newcastle Upon Tyne Hospitals (NUTH) operates within the confines of both The Food Hygiene (England) Regulations 2006 and Infection Prevention Control Policy (Ward Food Hygiene). If the patient (adult/child) eats food outside the aforementioned areas/parameters they do so at their own risk. In doing so the Patient will render NUTH free from all liability with regard to The Food Hygiene (England) Regulations 2006. The Trust cannot accept responsibility for food or beverages retained by patients. I have read the above notice and I accept sole responsibility for any food consumed which has been purchased outside the Trust. SIGNATURE OF PATIENT/PARENT/CARER………………………….. PRINTED NAME……………………………………………………………. WITNESSSED BY ………………………………………………………….. PRINTED NAME…………………………………………………………….. DESIGNATION……………………………………………………………… DATE………………………………………………………………………… IF PATIENT REFUSES TO SIGN DISCLAIMER FORM Print patient’s name and obtain a confirmatory signature of a second member of staff as a witness PATIENT REFUSED TO SIGN DISCLAIMER FORM WITNESSED BY (Signature)…………………………………………….. PRINTED NAME ………………………………………………

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: e: The Newcastle upon Tyne Hospitals NHS Foundation Trust

Equality Analysis Form A This form must be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. PART 1 1. Assessment Date: September 2017 2. Name of policy / guidance/ strategy / service development / Investment plan/Board Paper:

Ward Food Safety Policy

3. Name and designation of author:

Infection Prevention and Control Committee and Members of the Nutrition Steering Committee.

4. Names & Designations of those involved in the impact analysis screening process:

Geoffrey Moyle

5. Is this a: Policy Strategy Service Board Paper

Is this: New Revised Who is affected: Employees Service Users Wider Community 6. What are the main aims, objectives of the document you are reviewing and what are the intended outcomes? (These

can be cut and pasted from your policy)

This policy provides an overview of the Newcastle upon Tyne Hospitals NHS Foundation Trust’s aims and objectives in relation to the food safety provision of food and drink services for patients. It applies to those accessing hospital and community services provided by the Trust and services to both adults and children.

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The policy has been developed via a multi-disciplinary team approach to ensure that the Newcastle upon Tyne Hospitals NHS Foundation Trust continues to provide safe food and drink services.

7. Does this policy, strategy, or service have any equality implications? Yes No

If No, state reasons and the information used to make this decision, please refer to paragraph 2.3 of the Equality Analysis Guidance before providing reasons:

Protected Characteristic

Evidence What evidence do you have that the Trust is meeting the needs of people in all protected Groups related to the document you are reviewing– please refer to the Equality Evidence within the resources section at the link below: http://nuth-vintranet1:8080/cms/SupportServices/EqualityDiversityHumanRights.aspx

Does evidence/engagement highlight areas of direct or indirect discrimination? For example differences in access or outcomes for people with protected characteristics

If yes what steps will be taken? (by whom, completion date and review date)

Race / Ethnic origin (including gypsies and

The Trust will provide Interpreters and menus in other languages, pictorial menus are also available. Food provided to meet

Communication support for patients needs to be available to support their nutrition requirements.

Action

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travellers)

the cultural needs of patients.

Sex (male/ female)

Single Sex accommodation policy. Mandatory EDHR Training

No No

Religion and Belief

An individual process implemented for Kosher food to ensure adherence to strict guidelines is in place. Kosher food is outside of the food temperature control protocols. The food is doubled sealed and ward staff are discouraged from food probing. The risk to health in terms of pathogenic bacteria is negated via the prolonged, high heat retherm system at RVI. In terms of Freeman the Kosher food is heated via traditional oven using time and temperature to ensure core temperatures above 82°C are achieved. Halal food is managed in the same process as core patient foods, the maintenance of scrupulous food hygiene is maintained and cross contamination is negated via the same process.

Food Safety outcomes [Kosher food] are supported by Gateshead Jewish Community via NUTH Chaplaincy Services. Training and Development opportunities are supported to leverage awareness of Jewish culture and food services. Further support and training is available from Punjab Foods who carry out training as and when required to support the Muslim Patient food journey

Sexual orientation including lesbian, gay and bisexual people

No No No

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Age

Elderly Medicine Services and Children and Young People’s Services. Trust work in relation to Dementia Care. Adapted crockery and cutlery. SALT input and modified diets such as soft diets and thickened fluids to support any swallowing difficulties (Dysphagia).

Older people are more at risk of malnutrition. Staff can access guidance for clinical management of complex feeding problems in adults with cognitive impairment. http://policies.app/cgdocs/ComplexFeedingProblemsandCognitiveImpairment201408.pdf

Include issues related to equality in training related to this document. Promote Dementia and Children and Young people friendly spaces. Utilise support of Trust volunteers to support older patients and make mealtimes a more social event.

Disability – learning difficulties, physical disability, sensory impairment and mental health. Consider the needs of carers in this section

Accessible Information Standard Provision of BSL Signers and Deaf Blind Guides LD Liaison Nurse, flagging of learning disability and patient passport. Trust work to support Carers through John’s campaign.

People with a disability may be more vulnerable to malnutrition.

Include issues related to equality in training related to this document. Information should be widely available to promote support available. Trust carers’ packs and the sign up to John’s campaign. Carers are very welcome and can be provided with meals to support them in their caring role. This also promotes a more social aspect to mealtimes.

Gender Re-assignment

No No No

Marriage and Civil Partnership

No No No

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Maternity / Pregnancy

Maternity Services available for advice and support including the Trust Infant Feeding Co-ordinator. Breast Feeding Policy and signage

Staff can refer to the clinical guidelines Nutrition: Improving maternal and child nutrition. Quality standards 98 NICE. Maternal and child nutrition | Guidance and guidelines | NICE

Include issues related to equality in training related to this document.

9. Are there any gaps in the evidence outlined above? If ‘yes’ how will these be rectified?

No

10. Engagement has taken place with people who have protected characteristics and will continue through the Equality Delivery System and the Equality Diversity and Human Rights Group. Please note you may require further engagement in respect of any significant changes to policies, new developments and or changes to service delivery. In such circumstances please contact the Equality and Diversity Lead or the Involvement and Equalities Officer. Do you require further engagement No

11. Could the policy, strategy or service have a negative impact on human rights? (E.g. the right to respect for private and

family life, the right to a fair hearing and the right to education?

No, this policy supports the principles of dignity and respect

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PART 2 Signature of Author

Print name

Geoffrey Moyle

Date of completion

25/05/18

(If any reader of this procedural document identifies a potential discriminatory impact that has not been identified, please refer to the Policy Author identified above, together with any suggestions for action required to avoid/reduce the impact.)