Mealtime Management Policy and Procedure – Careseekers

Purpose

This policy is developed to ensure that each individual requiring mealtime management receives nutritious meals of a texture that is appropriate to their individual needs, appropriately planned and prepared in an environment and manner that meets their individual needs and preferences, and delivered in a way that is appropriate to their individual needs and ensures that the meals are enjoyable.

Scope

This policy and procedure will be used when workers are supporting individuals who require mealtime management.

Careseekers is committed to:

Supporting individuals to enjoy meals safely and with dignity.
Managing swallowing difficulties and nutritional risks appropriately.
Following health professional recommendations (e.g. speech pathologist, dietitian).
Training workers to implement Mealtime Management Plans safely and consistently.
Respecting individual choice, cultural background, and dignity of risk.

When a Mealtime Management Plan is Required

A Mealtime Management Plan may be required in a range of circumstances, including (but not limited to):

Swallowing difficulties (dysphagia): where there is a risk of choking, aspiration, or pneumonia.
Texture-modified diets: when food or drink must be thickened, pureed, minced, or softened in line with IDDSI standards.
Tube feeding (PEG, NG): where specialised feeding methods are required.
Allergies or intolerances: where food restrictions are medically necessary to prevent harm.
Specialist dietary needs: such as diabetes management, renal diets, or other medical nutrition plans prescribed by a health professional.
Behavioural or sensory issues: where participants require structured mealtime routines, supervision, or specific strategies to manage safety and wellbeing.
Postural or physical support: where the participant must be positioned in a certain way to eat or drink safely.
Complex support environments: such as Supported Independent Living (SIL) homes, where multiple workers may provide mealtime support and consistency is essential.

Careseekers will consult with participants, families, and relevant health professionals to determine when a Mealtime Management Plan is necessary, and ensure that all identified risks are managed appropriately.

Consent and Documentation

Before implementing a Mealtime Management Plan, the following must be in place:

Individual Consent Form: confirming the individual agrees to the support requirements outlined in the Mealtime Management Plan.
Health Professional Plan: outlines the clinical assessment, prescribed food textures and fluid consistencies (aligned to IDDSI standards), medical risk and rationale for the recommended mealtime adjustments. It is written by a speech pathologist, dietitian, GP, or allied health professional.
Mealtime Management Plan: developed for each individual requiring mealtime support, outlining step-by-step texture modifications, positioning, strategies, and monitoring needs.

Roles and Responsibilities

Workers – Follow plans, attend training, support individuals with meal time management plans respectfully, report incidents.
Careseekers – Ensure plans and consent are in place, arrange training.
Individuals/Families – Provide information about preferences, cultural requirements, and changes in health.

Worker training

The individual’s Mealtime Management Plan must be provided to workers providing these services.
Workers must be trained by the allied health professional who wrote the Mealtime Management Plan.
Workers must complete training in mealtime management and safe swallowing techniques, appropriate to their role.
Only workers assessed as competent may provide mealtime support to participants with swallowing or dietary risks.
Training includes recognising and responding to choking, safe food preparation, and cultural awareness in food practices.
Workers must be trained on how to prepare food for the individual to be a particular consistency.
Workers must be trained to modify food texture using the IDDSI Framework.
Refresher training will be provided at least every 2 years, or sooner if the individual needs change.
Train workers in who to report any signs of complications or difficulties during meals.

Procedure

Assessment and creation of plan

Mealtime needs will be assessed by a qualified health professional (e.g. speech pathologist, dietitian).
Recommendations will be documented in the Mealtime Management Plan.
A Mealtime Management Plan can only be written by a suitably qualified practitioner e.g. OT.
If a worker believes that a Mealtime Management Plan is required (and there is not already one in place). The worker must let the individual's support person and Careseekers know that they think the individual needs an assessment for a Mealtime Management Plan.

Mealtime Management Plan

The individual’s Mealtime Management Plan must outline:

Foods and drinks that are safe (including texture modifications per IDDSI standards) and enjoyable. Reflecting the individual’s preferences.
Proactive risk management if the individual has chronic health conditions e.g. diabetes, anaphylaxis, food allergies.
Positioning requirements during and after meals.
Level of assistance required (supervision, prompting, partial assistance, full assistance).
The amount of food and pace of each mouthful during mealtimes (if relevant)
Communication techniques between worker and individual during meals.
Monitoring strategies (e.g. observing for coughing, choking).
Emergency response steps.
Review date and responsible health professional.

Meal Preparation

Meals must be prepared and served in accordance with the Mealtime Management Plan.
Workers must use correct equipment (e.g. blenders, thickeners) for texture modification.
Texture modification of food must be done in line with the IDDSI framework (see IDDSI reference chart at end of policy).
Store meals safely and as per health standards

In a SIL, with multiple residents, worker may need to:

Label each meal to allow differentiation between individuals
Match the meals to the individual’s plan.

Meal support

Seek the individual’s input in exploring ways to enjoy their mealtime.
Consider who the individual wants to share their meal with (sitting with them). This is most relevant to the SIL environment.
Establish a positive environment during mealtimes, for example, avoiding a noisy environment which can be distracting.

Monitoring and Safety

Workers must observe participants during meals for any signs of distress or swallowing difficulty.
Workers must respond to signs of distress or difficulty as set out in the Mealtime Management Plan.
Any incidents (e.g. choking, refusal, vomiting) must be reported to the relevant person and Careseekers through our Incident Reporting and Investigation Procedure.

Emergency Response

If a participant chokes or experiences a medical emergency during a meal:

Call 000 immediately.
Provide first aid within your level of training (e.g. choking response).
Notify the participant’s GP/family/guardian as required.
Complete an incident report.

Mealtime Management Plan Review

Mealtime Management Plans will be reviewed at least annually or earlier if the participant’s needs change.
Feedback from participants and families will be sought as part of the review.

This policy was last reviewed September 2025.