Food in aged care is more than just sustenance – it’s a vital component of residents’ quality of life.
Dr Morgan Pankhurst, Research Fellow at Flinders University, along with team leader Professor Michelle Miller and Dr Alison Yaxley, are leading a groundbreaking initiative that’s set to transform how we approach food service in residential aged care. The team’s creation, the Flinders Food Enjoyment and Satisfaction Team (FEAST) Toolkit, is addressing a long-standing issue in the sector with a fresh, evidence-based approach.
The nutritional crisis in aged care
“The quality of food in residential aged care in Australia has been of concern for many years,” Dr Pankhurst says. The gravity of the situation became clear in 2021 when the Royal Commission into Aged Care Quality and Safety highlighted food and nutrition as a priority area needing urgent attention.
Dr Pankhurst reveals a startling fact: “Residents who are dissatisfied with the food service in their aged care home are up to 20 times more likely to be at risk of malnutrition.” This risk isn’t just about hunger – it’s linked to poor quality of life, increased risk of hospital admission, and even death.
But there’s hope. Dr Pankhurst emphasises a simple yet powerful truth: “Food has zero nutritional value if it is not eaten, and residents are far more likely to eat if presented with food they enjoy in an environment conducive to eating.”
With almost 200,000 people living in Australian residential aged care homes, the potential impact of improving food service satisfaction is enormous.
The birth of FEAST
Born from a decade of industry engagement, FEAST has developed what Dr Pankhurst calls a “world-first Food Service Satisfaction Toolkit.” But what inspired its creation?
“Despite the demonstrated importance of food service satisfaction, residents are often either not asked about their satisfaction at all, or are only asked a single question, often a version of ‘Do you like the food here?'” Dr Pankhurst explains. This absent or narrow view provides no practical way forward for aged care organisations to choose appropriate areas for continuous quality improvement.
The FEAST Toolkit changes this. It contains three scientifically developed and tested questionnaires, each tailored to one of three key stakeholder groups: residents, their families, and staff. “Each stakeholder group offers a unique perspective that, when viewed together, displays a complete picture of food service in a residential aged care home,” Dr Pankhurst explains.
The FEAST Toolkit isn’t just about improving food satisfaction – it’s about helping aged care organisations meet accreditation standards. Dr Pankhurst details, “Our Toolkit supports aged care organisations to improve their food service and meet accreditation standards outlined in the strengthened Aged Care Quality Standards.”
The development process was rigorous and inclusive. “Questionnaire design was informed by a comprehensive literature review, interviews with the target group, and expert opinion; and the questionnaires have been scientifically validated with almost 4,000 people nationally,” Dr Pankhurst shares.
During the Toolkit’s development, FEAST worked closely with local South Australian aged care organisations. These partners corroborated that, until now, there has been a lack of tools for measuring stakeholder satisfaction, recognising the uniqueness of the FEAST offering.
Key components of FEAST
The FEAST Toolkit is comprehensive and user-friendly. Dr Pankhurst says, “To support aged care homes in administering the questionnaires and interpreting the results, the Toolkit also includes comprehensive user guides and instructional videos, along with an evidence-based library providing practical, research-informed strategies to support quality improvement.”
The Toolkit includes three validated questionnaires:
- The resident food service satisfaction questionnaire
- The food service satisfaction questionnaire for families of aged care residents
- The aged care workforce food service satisfaction questionnaire
Each questionnaire was developed in collaboration with its target group, informed by literature and expert panels. Dr Pankhurst notes that the family questionnaire “demonstrates excellent internal consistency and moderate to almost perfect temporal stability.”
A leap forward in benchmarking
The FEAST Toolkit represents a significant advancement in how we measure and improve food service satisfaction in aged care. Dr Pankhurst contrasts it with current practices: “To date, the most common method of benchmarking food service satisfaction is to compare the results of the Consumer Experience Survey. Currently, the Department of Health administers the survey to residents during annual accreditation audits wherein residents are asked a single question, ‘Do you like the food here?'”
In contrast, the FEAST benchmarks are based on responses from a much larger and more diverse group: 1,546 residents, 1,100 family members, and 1,078 staff members across Australia. This comprehensive approach allows providers to compare results across a range of domains and more easily identify targets for quality improvement.
Addressing diverse nutritional needs
The FEAST Toolkit is designed to address the diverse nutritional needs and preferences of aged care residents. Dr Pankhurst shares insights from a recent scoping review commissioned by Dietitians Australia: “Our findings suggest a dietitian reviewed menu alone does not prevent unintentional weight loss. Food has zero nutritional value if not consumed and unless residents are satisfied with their mealtime experience, food will remain uneaten.”
The Toolkit tackles this challenge head-on. It helps residential aged care homes “identify gaps in satisfaction with the menu and mealtime experience and, critically, recommend appropriate, low-cost options for improvement from an Evidence-Based Library of proven strategies.”
Real-world impact and future directions
The FEAST team’s work is already making waves in the aged care sector. They’re currently collaborating with the Maggie Beer Foundation on an Australian Government initiative, “Improving Food in Aged Care through Education.” As part of this initiative, “a FEAST report and Toolkit questionnaires were made freely available for one-off, trial use at all aged care organisations across Australia.”
FEAST is also working with a local organisation to evaluate the magnitude of improvement in stakeholder satisfaction resulting from their implementation of research-informed strategies suggested from the Toolkit’s Library.
Throughout the development process, FEAST engaged deeply with key stakeholders. Dr Pankhurst shares feedback from a member of the South Australian aged care workforce: “Those [are] the sorts of questions that you would want to see in a questionnaire, that reflects the things that are important and covers a lot of the issues that we’re facing.”
A recipe for a brighter future
As the aged care sector continues to evolve, the FEAST Toolkit stands as a beacon of innovation and hope. By placing food satisfaction at the heart of care, Dr Pankhurst and her team are not just improving nutrition – they’re enhancing quality of life, dignity, and wellbeing for thousands of aged care residents across Australia.
“Regular application of the questionnaires is a catalyst for continuous quality improvement and allows organisations to tailor changes to meet the needs of residents,” Dr Pankhurst concludes. In a world where the simple pleasure of a good meal can make all the difference, FEAST is serving up a recipe for a brighter, healthier future in aged care.
Dr Morgan Pankhurst was one of the speakers at Aged Care Week 2024. We are gearing up for a better and bigger event next year! Stay tuned here.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
