Supporting the elderly to eat and enjoy food together

Over the last few years, Food for Life has researched intergenerational activity and support for care settings for the elderly. Here, Florence Todd Fordham shares some of the findings

Malnutrition presents a significant health threat to older people and care home residents. In the UK, over one-third of care home residents have been found to be malnourished and require treatment (BAPEN, 2015). This has major impacts on their quality of life, with additional consequences such as social isolation and loneliness. Through the Food for Life Better Care programme we have aimed to positively impact on the lives of older people and care home residents.

What is Food for Life Better Care?
Food for Life Better Care was a two year programme to promote good food for older people and included a focus on care homes and intergenerational work in Edinburgh, Calderdale, Kirklees, Leicester, Leicestershire and Rutland. The team used innovative techniques, based on ethnography and co-design, to identify opportunities for change. Food for Life Better Care sought to be both comprehensive – with a whole settings approach to multiple aspects of food – and developmental – to test out and reflect on what worked and what might be enhanced.

While each area shared a common overarching framework and approach towards engaging partners, it was anticipated from the outset that the team would adapt the delivery of the intervention to fit local circumstances. The programme has consisted of networking, training, support, development and delivery for a wide range of care homes.

This has included creating opportunities to partner with nurseries and schools, some of which are active in the Food for Life schools and Early Years national programmes. Food for Life Served Here, an accreditation from the Soil Association that awards sustainable and healthy catering, was used as a platform for promoting nutrition, hydration and sustainability standards in care homes. Key goals of the Food for Life Better Care programme were to prevent malnutrition and loneliness, to enhance the wellbeing of people in later life, to build capacity within the care sector around food, and to bring communities together through food.

FFLSH and sustainability of food provided
A key aspect of Food for Life Better Care was supporting better access to nutritious food. Through our work in other settings, such as schools and early years, Food for Life has a wealth of experience in improving the food provision, procurement of ingredients and the overall dining experience. To help caterers make good changes, Food for Life supports food providers to meet Food for Life Served Here criteria. Food for Life Served Here is an independent endorsement, backed by annual inspections, for food providers who are taking steps to improve the food they serve, for climate, nature and health.

The aim of the scheme is to encourage and reward caterers who serve fresh food, source environmentally sustainable and ethical food, make healthy eating easy, and champion local food producers. Food for Life Served Here accreditation is available for all organisations who serve food. The fixed bronze standards apply to all caterers while silver and gold are assessed using a points-based system. Points are achieved at silver and gold for sourcing environmentally friendly and ethical food, steps taken towards making healthy eating easy and championing local food producers.

If you see a Food for Life Served Here logo you know that the majority of food on the menu will be freshly prepared, it will always be free from undesirable trans fats, sweeteners and additives, be cooked by trained chefs, and use ingredients from sustainable and ethical sources.

What did we find?
The evaluation of Food for Life Better Care was led by the University of the West of England, collaborating widely and building on related research to ensure relevance across the UK.
Through the evaluation we were ultimately testing a hypothesis: if older people have better access to nutritious food, therapeutic food activities and shared mealtimes across care homes, community care services and hospitals, will they be less susceptible to malnutrition and loneliness and enjoy enhanced health and wellbeing.

The programme introduced individuals and organisations to the methods and benefits of co-design and whole settings approaches. Greater collaboration helped move beyond the fragmented and isolating working practices that often feature in adult social care. The programme therefore illustrated an approach that holds the prospect of being transferable and scale-able.  Overall, the Food for Life Better Care activities were linked to promising evidence of benefits for care home residents in terms of positive social interactions, mood and mental wellbeing, improved diet and enjoyment of meals and eating.

Case study
In November 2017, the Food for Life Better Care team collaborated with staff and residents at Summerfield House Care and Nursing Home, a large privately-owned care home in Calderdale, to test a whole settings approach to food using a co-design test-and-learn approach.

Over an 18-month period, the Food for Life Better Care team collaborated with staff and residents at Summerfield House Care and Nursing Home to focus on food and food-related activities as a social experience and a bridge to the surrounding community. Food for Life Better Care sought a comprehensive approach, in that the programme was informed by a whole settings approach to consider multiple aspects of food. The team adopted a ‘test and learn’ approach to the programme. This involved consulting with residents, care home staff and others on types of activities to run, testing them out, and reflecting upon the learning.  

There were several benefits of the programme to residents, staff, residents’ relatives, schools and the care home itself. The analysis led by the University of West England showed that residents derived social, affective, nutritional and general wellbeing benefits from the programme. Staff who engaged in the programme were noted to feel valued, supported and developed a higher sense of morale in the care home. Communication between staff and residents were observed to have improved during the implementation of the programme. There were testimonies from staff about residents’ relatives’ satisfaction of care due to residents’ exposure and engagement in the Food for Life Better Care activities.

The activities had a positive impact on school pupils who visited Summerfield House Care and Nursing Home to undertake intergenerational growing, gardening and other food-related activities with residents. There were observed and reported increase in empathy for older people; counter-stereotypical behaviour towards older people; and development of friendships with residents through the intergenerational work. The quality of food was noted to improve during implementation of the Food for Life Better Care programme in Summerfield House Care and Nursing Home and management had realised savings on food cost and reduction of plate waste.  

The future of Food for Life Better Care
Because of the experience of successfully delivering Food for Life Better Care, we have learned that therapeutic food activities, dining room experiences and nutrition training activities are greatly beneficial to residents, care home staff and catering teams. This experience and the expertise we have built around improving the health and wellbeing of older people through food related activities, means we know how to support care homes to develop an outstanding food culture and service.

We can offer tailored support to you if you’re a local authority, care home company, caterer. We can provide help by delivering consultancy, staff training and activities for nutrition and dining experience, and for our Food for Life Served Here accreditation scheme.

If you are interested in developing a Food for Life Better Care programme where you work, please get in touch with Florence Todd Fordham on and we would be happy to build a programme that would best support your needs.