Mealtimes for care home residents can be among the most enjoyable times of the day, but for those who have difficulty using cutlery, the dining experience can be problematic.

There can be several reasons why a person may have difficulty using cutlery. These include conditions such as dementia, Parkinson’s disease, arthritis or a stroke. According to the Alzheimer’s Society, 69% of care home residents have dementia or memory problems.

At the same time, it is crucial to ensure that residents who are unable to use cutlery receive nutritious, appetising meals. Jo Crossland, Head of Dementia Care at Avery Healthcare, says “Traditionally residents struggling to use cutlery were frequently served finger food – the type of food expected at a party. Unfortunately, the reliance on this increases the risk of undernourishment due to the lower nutritional content.”

Avery Healthcare has introduced a cutlery-free dining programme through a collaboration between Avery Healthcare and Premier Foods. Workshops for chefs have been held, delivering the necessary skills and information to introduce the cutlery-free programme into their care homes.

Simon Lawrence, Head of Culinary and Hospitality at Premier Foods says “By thinking differently, we can modify most meals. We are only limited by our imagination. A roast dinner can be adapted in many ways. By adjusting how we cut and cook vegetables and potatoes, small Yorkshire puddings can be filled with creamed potatoes and gravy, either spooned over each item or a small dipping pot for gravy can be added. Curry can also be adapted, as most traditional curries are eaten with chapatis or naan bread and do not include cutlery.”

Soups can become cutlery-free by adding tomato, cheese and bacon to fresh bread, providing layers of flavour when the bread is dipped in the soup.

Simon says “Desserts can be challenging to present as cutlery-free. We have found making small bite-size portions, in effect mini versions of desserts, work better. Once again, sauces, cream and ice cream can be served in a dipping pot or with assistance. This can be spooned over each piece or individual portion, to add sauce to each bite or mouthful.”

Breaking Meals Into Bite-Sized Pieces

At Runwood Homes, a bite-sized food initiative has been developed by Chris Williams, Group Hospitality Manager and James Cotton, Group Development Chef.

The primary objective of the initiative is to promote dignity and independence and provide a nutritionally balanced diet. “We used one of our homes as a pilot and are gradually introducing it to other homes. Initially we work on a one-to-one basis with the chef to produce the bite-sized recipes and then cascade the information to carers and hospitality staff.”

The challenge was to condense nutritional everyday meals into bite-sized portions. Chris says “There are a number of different ways including using silicone moulds, ice cube trays and mini tart cases. With meat-based products we find that blending them with cream and adding butter before cooking works well when combining two or more ingredients to the mouthful.”

Examples of bite-sized dishes include sausage and mash with onion gravy, where the sausage and mash are moulded together in a bite sized piece and served with onion gravy.  Apple crumble uses bite sized cooked and flavoursome apples coated in a crumble mix, baked, sprinkled with cinnamon sugar and served with a custard dipping pot.  Chris says “The list is endless and we are creating new ideas all the time.”

Chris’ advice for other care homes interested in introducing bite-sized portions is to develop recipes and arrange tasting sessions with residents to see what works. “What works well in one care home might not necessarily work in another. Presentation is key – make sure food looks inviting, is colourful and presented on the correct plate, dish or serving platter.”

Sample menu of bite-sized food from Runwood Homes

Mains

Roast Chicken & Stuffing Bites with A Gravy Dipping Pot

Steamed Cod & Pea Bites with a White Wine Cream Dipping Sauce

Steamed Salmon & Parsley Bites with a White Wine Cream Dipping Sauce

Chicken Ham & Cheese Nuggets with Mayonnaise

Desserts

Apple Crumble Bites with a Custard Dipping Pot

Rice Pudding Tartlet

Mousse, Served in a Cone