Inspiring Your
Frontline Staff
An organization Dining Services Plan must
inspire its staff to employ critical thinking principles that promote a “Culture of Food Safety”. This plan should includes more than the
Dining Service Team; it must includes everyone that could possibly interact with a
residents or serve someone who may ask for any type of food or beverage service. Creating a culture of food safety in a LTC setting must place
an emphases on serving an At-Risk-Population, with policies
and procedures that directly affect, or correct quality of life issues for residences. Every person from Nursing, Housekeepers, Maintenance,
even Administrative staff will play a role in ensuring the community keeps everyone
safe.
The Director or dining service manager’s
serves as the leader, but the Frontline Staff interfaces, directs and or promotes most of the interaction; reenforcing policies
and or principles that inspire “The Community” around the details of ensuing food
is served safely throughout the community. An updated resident preference tray ticket (card), and or ensuring departments that serve food or beverage have a list with residents diet, restriction and are ready available on hydration carts, at nutrition centers and activities department.
A Culture of
Food Safety
It is said “it takes a community to raise
a child”, it is in-kind that it
takes a community to promote a Food Safety CULTURE (a way of life or a way of doing things) ensuring food or beverages are served
safely.
Food Safety in LTC settings is
not just a clean kitchens, or serving good food, but ensuring conditions that may place a resident at
risk are known by those that serve those residents, at the same time honoring their privacy. Coffee or hot beverages served
above 150º (most coffee brews at 170 or above) may create 2nd or 3rd degree burns when your skin
is sensitive as those in senior community.
A resident that requires a modifications of consistence of their food (ground, chopped, puree) or thickened
beverages (honey, nectar, pudding), add another level of potential food safely. Meals passed 20 minutes after a cart has been
delivered to the floor can render items’ unacceptable or unpalatable. A meal that is unpalatable places residents
who are already at risk for dehydration, and or weight loss at further risk because
now the meal is undesirable. A meal
served to one resident at the table or in their room, but not served to another
resident in the same room or at the same table, bring to light possible resident dignity
issues. All these conditions may result in a F-Tag
for Dining Services.
Plan/Policies Must
Reach All That Interact With Residence Food Preferences
The Dining Service Plan should includes
your Frontline Dining Service Staff, but also must reach, and inspire Community Staff
Members that interact with residence during food delivery. Staff Orientation in serving foods safely must
include auxiliary staff member, who by chance will be asked for food or beverage items, something as
simple as a drink of water can put a resident at risk. Staff not educated in availability of snacks, food, or beverages also add to the quality of life, but also place Dining Services in a position to receive a F-Tag.
The Dining Service Plan must focus on creating a Culture of Food
Safety, where all new hire’s must complete orientation to the facility,
department practices whether in Dining Service or other
departments. Dining Service Staff are required to complete regular (monthly
or frequently) In-Service education, Cook Training, as well as re-education of
staff members that fail to perform critical task that put residents at risk. Food Safety Certification for the manager and or supervisors are all part of
the facility HACCP Plan, and CMS regulations.
When assessing risk, and the potential for harm levels, we will find out in the last part of this series that the
survey team also must calculate the potential for harm to a resident, based on incidents that happened, and even incidents that could potentially happen, but have not!
Policies,
Procedures Should Inspire Compliance
A
HACCP Plan is mandated as part of a Food Service Department Standard Operation
Procedures, and should be viewed by your staff as a means of deploying,
correcting and maintaining the circle of compliance. The survey team will expect 1) Dining
Services Policies and Procedures, to include a written HACCP Plan, Logs,
Checklist that both document and monitor, 2) Integration and evidence of Dining Service
Staff Orientation, Training, and corrective measures if and when policies have
not been employed, 3) Administration, (managers) and supervisors, qualified to complete
the circle. The ability to document policies or updating procedures that ensure resident
safety, as well as monitoring Frontline Staff daily interactions, correcting staff members
that do not maintain standards, as well as ensuring records are maintained for
review at a later point are also part of the expectation.
Training and Certification Helps Keep Food Safe
The Dining Service Team Is Only As Strong as Its Weakest Link
Donna Racine, retired State Surveyor,
Nursing Instructor and LTC Consultant famously quotes; “a facility is only
as strong as its weakest link or staff members”. She points out and identifies the need for on-going
training, and interventions that ensure a resident’s needs are being met, as
well as ongoing self-audits, that produce quality indicators, a measure residents
quality of life. So why then are nursing
homes targeted as not delivering what is necessary to ensure quality of life?
While
food safety training and certification reduce the likelihood as well as
identity potential risk of foodborne outbreaks; a facilities ultimate goals should
be procedures or policies that ensure resident safety, add to their quality of life, as well the need to
preserve an organizations brand. Training and certification programs are
a necessary step, yet even these factors have been shown to be decreased in effectiveness
when they are not developed around an organizations culture. One Food Safety
Trainer voices his frustration by identifying “managers that achieve 98% on the certification exam, the next day
finding a stock pot of chili cooling in the walk-in not cooled down properly". Residents of LTC Facilities are already at
risk, so when Dining Service Staff employ risky food handling behaviors, it
places residents at a greater risk.
While It has been found “training
may bring about an increased knowledge of food safety but this alone does not
always result in a positive change in food handling behavior[i]”,
which is the finding of a 2001 study of “Food handlers’ beliefs and
self-reported practices”. This post also points out this is not just about
food safety systems or a clean kitchen, but factors that hinder deployment of a
culture, and resident safety. This is best
seen when The Dining Services Staff understands and are educated around other issues
that affect resident rights, choice, culture (we work in their home, protect
their privacy), offering an enhanced dining experience (options to eat when they want, and
opportunities to dine where they want), as well as offering foods that take
into consideration personal preferences, and will as their alter of health status.
Driving Home
Culture
A Department of Social and
Behavioral Sciences study, by the University of California, San Francisco, CA, 2010
Nationwide Study, conducted by Dr. Harrington (Harrington Study). It showed 39.68 percent (5, 950+) facilities were given deficiencies for inadequate food sanitation while 8.75 percent (1, 312+) received citations for inadequate food, 7.38 (1,
100+) for nutritionally inadequate menus,
and 3.43 (510+) inadequate therapeutic diets. Retooling
of LTC Communities continues to improve the landscape, but for over a
third of the senior population continue to be at risk according to the
study.
So the focus has turned during the survey process to creating Communities that promote Senior Quality of Life (Culture Change Models). The process of ensuring policies and procedures are in place to know every staff member understands how to best serve the residents of that community and practices are in place that promote residents quality of life. So the survey team does not come to pass or fail a department or facility, but insure that residents needs are carried out. This principle should further highlight that regulations are not written to limit residents rights, but to ensure administration or an organizations are delivering an acceptable level of care, that enhances residents quality of life.
When
a survey team comes into your facility the first impression, including how
residents embrace your Dining Service Program tells the story of how well you
are meeting The Enhanced Dining Experience test. The real test of how safe your residents are or if you have been delivering food safely, over the last year will be told by documentation that is also require (training materials, menus, purchase orders, logs, recipes, cleaning logs, temperature logs). With everyone on your Dining Service Team equipped, inspired to deliver choice, everyone employed in that Senior Community can now deliver food safely, 24/7.
The final phase will focus on the
actual survey process…
Part 3 of 3 Part Series- Survey Process As Experienced By Dining
Services Manager
There
Is More To A "Deficiency Free Survey" Than A Clean Kitchen - Part 1 of 3
Part 3 of
3 Part Series- Survey Process As Experienced By Dining Services Manager
Definition:
HACCP
Seven Principles to prevent Biological, Chemical and Physical Hazards
1)Conduct a
Hazard Analysis, 2) Identify the Critical Control Points, 3) Establish Critical
Limits, 4) Monitor CCP, 5) Establish
Corrective Action, 6) Verification, and 7) Record-keeping
Also
see- World Wide Web... (PDF Documents)
