Excellent nutrition and hydration for all residents!

Warwickshire’s Nutrition and Hydration Standards were launched in June 2018 with the aim to promote excellent nutrition and hydration in all of Warwickshire’s care homes.

This collaboration by Health and Social Care aims to improve the health of all care home residents, reduce the cost of prescribed nutritional supplements and ensure that care home staff across Warwickshire have the skills and competencies required to support care home residents in maintaining good nutrition and hydration.

Malnutrition facts

Malnutrition affects at least 3 million people in the UK. Malnutrition affects people of all ages. There is a higher prevalence of malnutrition in women.

Estimated cost of malnutrition in England, in 2011-12, was £19.6 billion and is increasing. Malnourished adults account for approximately 30% of hospital admissions. 15% of outpatient clinic attendances. 35% of care home admissions and 10% of those presenting at their GP.


Use the Malnutrition Universal Screening Tool monthly to identify residents at risk of malnutrition in 5 easy steps.

  1. Score for BMI
  2. Score for weight loss
  3. Score for acute illness
  4. Total score
  5. Follow relevant management plan

Training for Care Home managers, staff and caterers is available

Find details, dates and booking information at CETA  (www.cetahealth.co.uk).

– A Caterer’s guide to preparing nourishing meals and snacks.

– Malnutrition in Care Homes – Identification, Prevention and Treatment.

Alternatively contact the Warwickshire Dietetic Service Manager, Anne Davidson to discuss in house training: Dietitians@swft.nhs.uk

Food First approach to nutrition

Residents who are at risk of malnutrition should be encouraged to eat little and often by providing nourishing snacks and drinks between meals. A milkshake could give an extra 500kcal. A thick and creamy yoghurt an extra 300kcal.


The nutritional content of small portions of meals and puddings can by increased by adding  cream, cheese, butter, fortified milk (recipe below), mayonnaise, jam, honey, syrup…..

Fortified Milk recipe                                                                      

– 1 pint full fat milk

– 4 tablespoons dried milk powder

Mix powder with small amount of milk to form a paste before adding the rest of the milk and whisking

200 mls serving = 175 kcals


30% of over 65’s could have swallowing problems. Speech & language therapy can assess and advise if a modified texture diet is required. Dysphagia will lead to a reduced intake of food and therefore modified texture diets should be fortified.

Meeting the Nutrition & Hydration Standards Resources 

Guidelines are available to provide a practical tool to achieve the standards. Additionally a self assessment tool has been developed for care homes to identify where improvements can be made . The standards and supporting documents can be found at www.swft.nhs.uk and www.warwickshire.gov.uk.


Care home residents are at risk of dehydration due to reduced thirst awareness, dysphagia, reliance on staff, medication, and reduced ability to conserve water.

Read the full Nutrition and Hydration newsletter here: Nutrition and Hydration newsletter

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