Spreadsheets? We Don’t Need Spreadsheets. (Texas)
An assisted living community was cited during their annual survey for failure to provide adequate nutrition to their residents. The community had worked with resident physicians and the Registered Dietitian to liberalize all resident diets to Regular diets. The resident population at this community had an overall low acuity level so the diet liberalization to regular diets worked well in this environment. Because the community did not have any residents on a therapeutic or texture modified diet the Dining Service Director did not see the need to post and utilize the diet spreadsheets.
During the survey, the surveyor spoke with a few residents who voiced their concerns regarding the food portions at meal service. These residents stated they felt the portions were often too small. During the meal service observation, the surveyor asked how the staff determined the correct portions to serve of each of the meal items. The staff member stated the portions were listed on the recipes. The surveyor reviewed the portions listed on the recipes against the portions being served during meal service and found the incorrect portion utensils being utilized and, in some cases, just a slotted spoon that did not have a portion indicated was being used. The portions being served were smaller amounts than what was listed on the recipe.
This community was in a state that did not require routine Registered Dietitian visits, so opted to not have a quarterly consultant visit. Had quarterly Dietitian visits been occurring it is likely this would have been observed and proper training and guidance could have been given to the dining staff. The community contacted the Crandall office for help since they utilized the Crandall menu program. Guidance was given on the use of spreadsheets during meal service. The community was able to print a spreadsheet that contained only the information for the regular diet. This tool has the portion sizes noted for each item that is served all on one report. It is the best tool for a cook to easily reference prior to and during meal service to ensure the correct portion utensils are being utilized for each food item.