Quality and Safety

Executive Summary of Dietary Requirements in Aged Care

The health risks are very real due to poor quality and safety of food service in aging care. Food can carry harmful bacteria if not prepared, stored, cooked and served properly. Frail people with chronic or acute health problems are weaker and healthier than the elderly who do not have such immunity, so the risk of resistance is lower and the risk of feeding is higher. People over the age of 65 have a higher risk of food allergies because the health system compromises that immunity. In addition, vulnerable health condition raised the requirement to attention on enhancing patient safety by healthcare staff in the aged care. Communication deficiency within all parties accountable for service delivery and improper documentation is a main cause of safety issues that hampers the service quality and deteriorate the patient's condition. Elderly people who have the requirement of special dietary need special care, particularly when they have food allergies. However, food service attendants are not aware about the dietary requirements of the patients in aged care. Therefore, it can cause serious problems with existing clinical conditions. The purpose of the study is to explain the role and responsibility of healthcare staff in protecting patients through effective clinical practice. The practical and theoretical knowledge has an important role in building nursing practice to make sure the quality and safety of services for improved public health in the aged care. The interest of agencies and manpower can be shared to create the implementation plan that include training, education, and other approaches for better communication about the specific dietary specification in the setting of an aged care.

Table of Contents



Guiding principles.

Patient expectations.

Roles and responsibilities.


Clinical governance.

Incident management.



Introduction to Dietary Requirements in Aged Care

The health risks are very real due to poor food security in aging care. Food can carry harmful bacteria if not preserved, prepared, cooked and served properly. People with acute or chronic health problems are weaker and healthier than those who do not have such immunity as the elderly, so the risk of resistance is lower. The growth of the elderly has created the need to meet dietary and nutritional requirements to maintain health and improve quality of life. The importance of diet and nutrition requirements has been significantly identified in highly morbid condition and includes age-related dementia, cancer, and more. While reduced dietary consumption together with imbalanced nutrient intake is the most recognized reason for malnutrition between old aged people (Lee et al. 2017).

Food should not be served or stored at the temperature within 50C and 600C. It is called a temperature hazard zone because it is the perfect condition for food-poisoning bacteria to raise. In addition, aged care chef plays an important role in maintaining food safety in the aged care. They can protect the food given to the people at every stage of storage, preparation, eating, and serving. The high standard of food hygiene practice is important. Solid understanding and knowledge to evaluate the food safety issued and execute the “Hazard Analysis Critical Control Points” (HACCP) system are also an obligation. Having equipment like data loggers and commercial food thermometers helps to read the temperature and records accurately. In the end, the best way to make food safety practice and knowledge is through practical, site-specific, and meaningful training. Food service attendant, dieticians, assistant nurse, and other staff play an important role in keeping a balanced dietary plan in a timely manner for successful medications and registering all allergies (King et al. 2017). Though, food allergies are always identified in older people that lead to the failed intervention failure and affect the upkeep of patient security. Moreover, food is primarily liable for allergies in aging patients and it can make negative reaction in the body and cause concern in the modern healthcare system. Numerous physicians have mentioned the role of training to adopt the new diet care plan to solve the nutritional problems among the aged person.


When specific disease-causing virus, parasite, or bacteria contaminate food, such can make food-related illness. One more term for this type of parasite, bacteria, or virus is "pathogen". As food-related illnesses can be fatal or even serious, this is essential to understand and practice safe food management behaviors to decrease the risk of illness due to contaminated food. As stated by Wang et al. (2020), food safety is a guarantee that food will not make maltreatment to the people when this is prepared and eaten based on its proposed use. Food-related disease is extensive all over the world. The process of spreading foodborne illness starts with the characteristics of the illness, contaminating the food, posing a threat to the health of individuals and communities through food. The causes of food contamination may threaten its safe use and as a result these foods can be harmful to public health. Therefore, it is important to use several resources to prevent food from being contamination at all phases of the food chain from produce to consumption.

Guiding Principles

A significant portion of a healthy diet is to keep food safe. There are four basic food safety principles which can be used to decrease the risk of food-related disease, such as clean, separate, chill, and cook. In this way, hand washing is significant to prevent food contamination with microbe from raw animal items (i.e. meat, eggs, raw seafood, and poultry) and from human (i.e., staph infection, cold, and flu). Hands need to be washed using water and shop after and before making meals (Jennings et al. 2016).

Dietary planning knowledge and related food allergies associated within healthcare staff is also important for enhanced safety and care, emphasizing the need to reduce the burden of further diseases caused by food allergies. Moreover, the experienced physicians have important role during the implementation of effective diet plans for better treatment and safety outcomes in aging patients. Physicians can make sure safety and quality of food service by offering training on food management and demonstrating the separate patient diet chart. But the practical implementation of diet care approach is an important part of the management profession. It became important to use all the methods required for dietary treatment through various trainings related to the new method to improve the effective method in modern health system (Moody et al. 2018).

Patient Expectations

Nutrition plays an important role in disease prevention and disease recovery. In addition to disease and the hospital environment, food choices are also a major factor influencing the diet of geriatric patients. Thus, the hospital should plan based on the preferences of geriatric patient to make sure that they eat what is provided to them. In regard to their food preference, aging patients are more expected to follow their traditional food rather than new food items because of fast growth in the aged care. But some aging parents may change food choices because of their food beliefs and health reason. Aging is related to changes from diet with high in sugar, meat, and calories to diet with rich in vegetables and fruits. They prefer fruits, vegetables, rice, legumes, bread, noodles, cereal, as well as fish rather than red meat, dairy, and milk product. Food choices can be affected by health and disease condition. With elderly, there is a rise in the consumption of vegetables and fruits as well as reduction in the intake of red meat. Women, diabetic patient do not take snack and those who only taking hospital food were more expected to consume the insufficient diet. More female consumed an insufficient diet as well as the proportion of food wastage is slightly higher in female than male (Cortese et al. 2016).

Roles and Responsibilities

Elderly care service managers face many challenges on a daily basis. They need to continue to satisfy their customers by providing quality care. Kitchen staff should ensure that food products are handled safely and properly from start to finish. In addition to ensuring that customers are happy, the managers of the beneficiaries should also monitor and monitor food expenditures while maintaining food safety and recognition standards, which is certainly not easy to do. Staying on budget and maintaining top management while still being effective and costly is still an important goal. Because of this demand, many aging caregivers remain responsive rather than active and do not provide more control than is necessary to meet the requirements of government food legislation and to manage business risks. It must develop and implement a food safety program based on HACCP, including policies and procedures that support aged care facilities that can quickly identify and detect all meal or food product at all stages of this processing. The aged-care facility should carefully check and record every step done for products or meal. The transparency level should be accessible not only in business, but also to health regulators if needed (Westbury et al. 2018).


The Food Standards Australia New Zealand (FSANZ)’s Standard 3.3.1 is the portion of national food safety standards as stated in third section of the Australia New Zealand Food Standards Code. This include the responsibility allowed by the food business to make sure food safety and quality. The aged-care facilities prepare food for the aging patient, including people who are immunocompromised due to treatment they are getting or because of their illness, as they should provide food to the people according to legislative requirement to manage risk of food.

FSNAZ Standard 3.3.1 implements to all aged care that handle food processing, and gives food service to the person that are considered weak. This standard define individual who are caring for allowances recorded in the standard or those who receive food through a meal delivery program in accordance with the food standard code (Sluggett et al. 2017).

In this way, the pattern of facilities that must adhere to the standard, such as

  • Hospital Facilities (e.g. Chemotherapy, renal dialysis, Intensive Care, Psychiatric, and hospice)
  • Aged-care facilities (i.e. low care aged care facility, nursing home, same day aged care facility, and respite care)

Whether the aged care facility must adhere to the standards based on the number of criteria in which Australian territory or state. In Queensland, for example, the aged care facilities provide service in accordance with the food safety standard.

In other words, the aged care that serve or make foods that may be considered risky, such as coffee and tea with biscuits, such as do not have to meet these standards. The organization that only provide food are excluded, such as businesses that only provide ingredients for foods or meals that still need to be processed (e.g. cooking). In this regard, the aged care mainly prepares foods or meals for the aging people but also may sometimes make food for members of the old patient, they are exempt from following the standard.

Clinical Governance

Nurses will use the set of the simulated environment and will monitor of their food-related allergies to enhance patient care and connecting the knowledge and the learning results of the simulation will assist in the real-world application of clinical practice. Showing the relationship between simulated finding and physiological system brings understanding and validity to the assessment. Simulation strategies and depth knowledge can enhance the self-assurance of nurse to think critically and raise awareness regarding all the information about food allergies in separate patients. Moreover, the study material will comprise the simulated recorded assessment tool for about week that reflects their applied work. The registered nurse can use effective communication techniques to build strong therapeutic relationships to know the patients ’preferences for food as well as patient informed related allergies. Nurses should make a checklist associated with food allergens before daily treatment and include the patient in the further treatment process (Sluggett et al. 2017).

The quality of care and well-being of patients is closely related to the clinical learning environment. Theoretical information is provided in most classes but clinical practice provides an opportunity for theoretical information into the practice that later forms the root of nursing practice. It intends to enhance research skills, critical thinking, and decision making that will also improve the clinical practice. Assisted nursing staff should be aware of changes in food allergy policies related to the daily diet to improve patient safety. The session of open questionnaire will assist in improving theoretical knowledge after that doubt clearing session (King et al. 2017).

Nurses need to know and update all the theoretical knowledge associated with the patient safety. Nurses should be aware of the effects of dietary side effects comprised in the patient diet plan. To accomplish educational outcomes, this is important to assume new model of the chapter for food safety to enhance aged care. The active participation of nursing staff in more careful training leads to effective learning and development in the occupation. The significance of shifting theoretical knowledge to practice is the principle of clinical reliability.

Incident Management

Adult care facility that integrate hygiene into business strategies, understand the importance of maintaining hygiene standards, and are familiar with food safety program can manage and comply risks more easily. Moreover, this is essential for the aged care managers to know the purpose of this standard to prepare food safety by confirming that strict standards are effectively and systematically enforced. This is essential for aged care sectors to present that food safety management system is investment instead of cost and inefficiencies will be in the system which lead to profit losses and revenue drains (Garcia, Osburn & Cullor, 2019).

A healthy food safety management process will help streamline flow, help in managing change, and automate reporting requirements. Besides, the aged care activities can get more time with less resources. The automated process will help make kitchen activities smarter, not harder. It can help reduce or reduce the cost of negative business activities by reducing incidents and safe food waste. Since many aging parents are at higher risk of food related disease, every aged-care center must have food safety manager on hand to ensure that the facilities buy healthy and safe food, store and prepare food properly, and cook properly in accordance with the food safety standards. Having trained caretakers ensures that disadvantaged people do not suffer from food poisoning due to disadvantaged or inexperienced trained staff. With proper training, we can learn more about food safety policies and laws and ensure the lowest risk for this aging population (Feng, Bruhn & Marx, 2016).

Conclusion on Dietary Requirements in Aged Care

It is suggested that doctors who observe patients with acute gastroenteritis that consider food related disease as a potential source of contamination and that patients receive diagnostic stool samples. Doctors are fortified to consider older patients as a major source of food safety regulation. Moreover, food management and consumption conduct of superior significance to aging people includes avoiding undercooked or raw seafood, as well as food including undercooked or raw eggs. In aged care, the food service attendants need to concern about the dietary needs of the aging patients. Within the modern aged care systems, this has turned into essential to accept all of the required tactics for diet care using various training program with regard to the new intervention for developing efficient system to manage safety and quality of food service.

References for Dietary Requirements in Aged Care

Cortese, R. D. M., Veiros, M. B., Feldman, C., & Cavalli, S. B. (2016). Food safety and hygiene practices of vendors during the chain of street food production in Florianopolis, Brazil: A cross-sectional study. Food Control62, 178-186.

Feng, Y., Bruhn, C., & Marx, D. (2016). Evaluation of different food safety education interventions. British Food Journal.

Garcia, S. N., Osburn, B. I., & Cullor, J. S. (2019). A one health perspective on dairy production and dairy food safety. One Health7, 100086.

Jennings, S., Stentiford, G. D., Leocadio, A. M., Jeffery, K. R., Metcalfe, J. D., Katsiadaki, I., ... & Peeler, E. J. (2016). Aquatic food security: insights into challenges and solutions from an analysis of interactions between fisheries, aquaculture, food safety, human health, fish and human welfare, economy and environment. Fish and Fisheries17(4), 893-938.

King, T., Cole, M., Farber, J. M., Eisenbrand, G., Zabaras, D., Fox, E. M., & Hill, J. P. (2017). Food safety for food security: Relationship between global megatrends and developments in food safety. Trends in Food Science & Technology68, 160-175.

King, T., Cole, M., Farber, J. M., Eisenbrand, G., Zabaras, D., Fox, E. M., & Hill, J. P. (2017). Food safety for food security: Relationship between global megatrends and developments in food safety. Trends in Food Science & Technology68, 160-175.

Lee, H. K., Abdul Halim, H., Thong, K. L., & Chai, L. C. (2017). Assessment of food safety knowledge, attitude, self-reported practices, and microbiological hand hygiene of food handlers. International Journal of Environmental Research and Public Health14(1), 55.

Moody, K. M., Baker, R. A., Santizo, R. O., Olmez, I., Spies, J. M., Buthmann, A., ... & Carroll, A. E. (2018). A randomized trial of the effectiveness of the neutropenic diet versus food safety guidelines on infection rate in pediatric oncology patients. Pediatric blood & cancer65(1), e26711.

Sluggett, J. K., Ilomäki, J., Seaman, K. L., Corlis, M., & Bell, J. S. (2017). Medication management policy, practice and research in Australian residential aged care: current and future directions. Pharmacological research116, 20-28.

Theou, O., Tan, E. C., Bell, J. S., Emery, T., Robson, L., Morley, J. E., ... & Visvanathan, R. (2016). Frailty Levels in Residential Aged Care Facilities Measured Using the Frailty Index and FRAIL‐NH Scale. Journal of the American Geriatrics Society64(11), e207-e212.

Wang, D., Everett, B., Brunero, S., Northall, T., Villarosa, A. R., & Salamonson, Y. (2020). Perspectives of residents and staff regarding food choice in residential aged care: A qualitative study. Journal of Clinical Nursing29(3-4), 626-637.

Westbury, J. L., Gee, P., Ling, T., Brown, D. T., Franks, K. H., Bindoff, I., ... & Peterson, G. M. (2018). RedUSe: reducing antipsychotic and benzodiazepine prescribing in residential aged care facilities. Medical Journal of Australia208(9), 398-403.

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