Food Services for Older People

1

• Food Services for Older People
• Project speakers
• Margaret Lumbers
• Wendy Hunter

www.foodinlaterlife.org
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What have we done

• Investigated what users of day centres really
  value
• Identified particular areas in the service
  encounter which generate satisfaction or
  dissatisfaction
• Investigated why day centres have a negative
  image
• Discovered what people want so effective
  solutions can be applied
• Identified the gap between users satisfaction
  and providers perceptions of the service
• Investigated the use of service specifications
  and nutritional guidelines

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Who we interviewed

• Sector-specific key informants (n5)
• Local Councils
• Community Health
• Charities
• Food industry

Day centre providers in Surrey (n20) Operations
Managers Centre Managers Cooks Kitchen/catering
assistants
Day centre users in Surrey (n27) 11 males 16
females 17 living alone 12 aged 65-74 15 aged
over 75
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What were the key issues for users and providers?

• Attitudes to the service
• Other activities and themed meals offered
• The quality of the food
• How the service was managed
• Choice of food available
• Environment

5
Providers perceptions of food service
6
Providers of day-care centres satisfiers and
dissatisfiers by category ()
Users attitudes and other factors
Quality of food
Other services/activities
Management of service and resources
Food choice and variety
Environment
7
Why are so many dissatisfying incidents elicited?

• Reporting structure
• De-centralised (centre-based)
• Centralised
• Funding/budgets
• Cinderella service
• Limits type and frequency of service
• Staffing
• Problems with agency staff
• Problems with volunteers
• Meeting customers wants/needs
• Challenges facing the diverse wants/needs of
  older people
• Changing expectations

8
Its more than just the food

• People who come here for line dancing and
  that, dont tend to eat here I dont know why,
  there must be a reason, maybe if we put some more
  adventurous menus on maybe they would. Im not
  saying that would happen but I think there is a
  possibility
• Day-care manager (centre age 60-80)
• they come in because they get a meal, if they
  didnt get a meal they probably wouldnt use the
  day centre ..but its so nice they can have all
  these different things
• Day-care centre manager (centre age 75-95)

9
Again its more than just food

• Seating in the lounge
• We have trouble now with the lounges .. Our
  circle of chairs has always been a dilemma
  hereas soon as anybody else walked in the door
  the first thing they saw was that circle of
  chairs and everyone sitting there and they saw it
  as a frail elderly club rather than saying we
  are a group people
• Manager day-care (centre age 60-80)
• Seating in the dining room
• if weve had new people come in the other guys
  will actually say hello to them rather than walk
  straight past them and thats what weve tried to
  maintain here, other places arent quite so ..
  you cant sit there, thats my chair and Ive sat
  there for twenty years
• Manager (centre age 70)

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The importance of evaluation of service and
products

• We make great assumptions that it is working
  very well, we are very busy, so we cant ask for
  customer feedback and really take that on board
• Local authority key informant
• customer satisfaction surveys are fairly new to
  us in this service and we are having to re-look
  at them because they are really of no value until
  they are honest with us and it is very difficult
  getting it across to this client group that
  actually we would prefer them to be honest rather
  than say everything is fine because we cant
  respond to their needs
• Operations Manager

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The need to focus marketing of services and
products

• We have got to get focussed on what we are
  promoting and where, weve got to look at the
  competition, got to look at buyer behaviour, why
  people buying into this service comes back to the
  end result perhaps as to why are we really
  providing this service because it is not cost
  effective but it is meeting a demonstrated need
  and it is meeting a perceived need
• Local authority key informant

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National Association of Care Catering (NACC)
guidelines only known to some Local Authorities

• Nothing to my knowledge about nutritional
  guidelines and that would be incredibly useful if
  we could find something
• Local authority key informant
• No only commonsense, protein and vitamins you
  know there are things like greens and .salads,
  cabbage and cauliflower and carrots and all the
  things with vitamins in. And sweets with like
  apples and fruit Fresh food is available, only
  really commonsense things, we dont follow any
  specific (guidelines)
• Centre Manager

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Its more than just the foodFood service
users views
Well the reason I go thereis the meal, its so
important and plus the fact you get in the habit
of dining at a certain time over the years
Male, living alone, 77 yr
we got on the floor dancing last Monday night
and I said to (name) come on the men are up and
youve got little old ladies and theyre wiggling
up towards the men and the men are wiggling back
and you just laughJust to see older people
enjoying themselves Female, married 66 yr
15
Users of day-care food services satisfiers and
dissatisfiers by category ()
Quality of food
Other activities
Management of services/resources
Food choice/variety
Environment
16
Quality of food when its good

• Fresh
• Yes, and fresh vegetables, and not just the
  tinned or frozen packets
• Female, 66 years

Presentation Well the chef does them very well,
hes got imagination really, its usually
beautifully laid out, and I just enjoy salads
Female, 82 years
Portion size Yes adequate and if you need a
smaller meal you can have a smaller meal
Female, 83 years
Cooked well I like a good old meat pie. Well the
pastry for one thing. The meat is well cooked and
the pastry is also well cooked Male, 72 years
17
Quality of food when its bad

• Poorly cooked
• baked potato skin was always hardI dont know
  if its the way they cooked them
• Female, 77 years

Taste They (sausages) had no flavour, they
didnt look right somehow, they werent what I
call brown and sizzling brown, they looked
anaemic and they didnt taste right, so I said
right, no more sausages Female, 89 years
Presentation And its not really presented right
you know, they do mashed potatoes on some meals
and its just flopped off the spoon, like theres
no presentation Male, 69 years
Frozen food I do find the vegetables get
overcooked and theyre generally frozen and they
seem to just go mushy Female, 65 years
18
Environment seating arrangements

• there was chairs round three sides of the room
  and in each chair was somebody lying like this,
  they reminded me of these terracotta warriors
• Male, 84 years old
• its a little undignified the way we all
  scramble and save seats for everybody elsebut
  not unless they say oh youre seated on table
  four or table five, then it would be awkward
  wouldnt it? Then everybody would be saying oh
  well I want to sit with Mary or Joe or
  something.
• Female, 82 years

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Winning and keeping customers by delivering what
matters most (Barwise Meehan 2005)

• Users think food is most important and meeting
  others
• Need to undertake systematic evaluation of the
  service, including encouraging honest user
  feedback
• Identify areas of best practice and how to
  attain this across the service
• For providers management issues predominate
  (bridge the gap!)

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How to meet the challenges?

• Creating a culture that continuously responds to
  changing needs of users to refresh the service
• Need to improve image of community food services,
  e,g, managing two tier system of day centres for
  active and high needs users
• Be competitive with other food outlets in the
  community such as cafeterias, pubs

21
General observations from reports from Italy,
Poland, Portugal and UK

• Participants are generally grateful to receive
  the food service
• They feel the burden of preparing food has been
  lifted
• This gratitude is a restraint to users who feel
  they have no right to complain about the quality
  of the food or the choice they are given
• Cost was not a factor for users if choice and
  quality were good