It Ain’t Necessarily So – 5: Why don’t staff eat with residents?

Posted on May 3rd, by geoff in Caring Times head, CT Extra. No Comments

Caring Times, May 2013

Food and conversation are at the very centre of homeliness and therefore at the heart of good care, so why wouldn’t everyone share this time together? Most people would agree that mealtimes are one of the most important times of the day for residents of care homes, yet it’s very unusual to see the staff and residents enjoying a meal together.

When I went to manage a large local authority home in the early 80s, having previously managed a children’s home where eating with the residents seemed an essential part of the job, I asked exactly this question: “Why don’t we eat with the residents?” My colleagues were as incredulous as I was but for the opposite reason because it seemed to them so obvious that we wouldn’t . . . or couldn’t . . . share mealtimes with the residents.

First, what would happen to their lunch break? Second, they paid for their meals and they appreciated being able to eat without too many distractions, and some of the residents’ eating habits were disgusting. Third, how could this be work when there was an ingrained assumption that work consisted of doing things to or for residents rather than with them? We’re inclined to think that attitudes have changed since then but I still hear the same sort of reactions to this proposal.

We all know how difficult it is for some people with dementia to settle down and enjoy a meal – sometimes even to eat anything. But imagine if you were “sat down” at a bare table with very little on it, and perhaps another one or two people who had also been “sat down” waiting there for 10 or 20 minutes . . . waiting for something to happen.

A plate of food and a knife and fork arrive (if you haven’t already wandered away) but you may find it difficult to associate what’s in front of you with a meal for eating and enjoying. Imagine the alternative. You go to the dining room with a helpful friend; the table is laid nicely (there are familiar things like salt and pepper, napkins and place mats, a jug of water and glasses, clean, shiny cutlery) and the food is put out on the table, and your friend serves out the food asking you what you would like, the conversation flows, and it’s such a familiar scene. It feels good: an occasion to look forward to and linger over.

Many new homes have been built with kitchenettes in rooms and some capacity for food and drinks storage and preparation in dining rooms but how much of these facilities is used? Often not much: electric kettles are stowed away in cupboards, fridges are empty, staff heat up their own meals and drinks in the microwaves, while the hot trolley from the main kitchen is relied on for the meals.

Too often we allow a culture of separateness to prevail over our innate human instinct of togetherness. Care and homeliness (as in care home) start with people relating to each other, sharing their common humanity – connecting, engaging, interacting – and no matter where you are in the world, eating together is the way it’s done.

It’s one thing to get someone a cup of tea and a biscuit; it’s even better to say “Let’s make ourselves a pot of tea and have a biscuit, sit down and watch the news.” And it’s fantastic when a resident says to a member of staff, “I’ll make you a cup of tea and we’ll have some of the cake we’ve just baked.” Togetherness is what care and homeliness are all about, and food and drink are its common currency.

We found a different way: Caring Times readers tell their stories

Joanne King Home manager – Lamel Beeches, York:

When I was working as a senior care assistant our home manager decided that staff should eat with the residents – this did not work as we sat at our own table, not with the residents, so the social interaction that this was meant to generate was lost. I have been a manager in a care home for the past 11 years.

I strongly feel that staff breaks should be protected as much as possible. Staff, however, eat their meals in a public sitting area. Our residents sometimes pop along and sit down for a chat but that is fine and the staff don’t find it intrusive. If we have a poor eater they may well ask them if they would also like something to eat. At points throughout the year we celebrate events and these are times when staff and residents socialise and eat together. On a general daily basis staff not on a break are working in the dining room sitting with residents who need more help and ensuring that everyone else’s needs are attended to.

Most residents choose to have breakfast in their rooms and I wonder if this goes back to an old ruling, set by a resident, that all residents must be correctly dressed to breakfast in the dining room! I encourage people to go to the dining room for lunch as it is the only time in the day that the residents all socialise together and there’s something special about sitting at a proper table to enjoy a meal.  We prioritise good nutrition. For example we use stay-warm plates for slow eaters and we’re trying blue plates for those with dementia. Lifetime habits can cause difficulties, for instance the busy mum who had always stood in a corner in the kitchen to eat their lunch – does it really matter if someone is sitting down or standing up? The most important thing is that they eat and it’s up to us to manage people’s little individual quirks.

Home manager, West Country:

I would love to get staff eating with residents but I’ve got my company, the staff and the unions all against me. I can’t get my company not to charge staff for the food they would eat. They say it’s too difficult to distinguish between meals taken with the residents and without, and they don’t trust me to make the distinction. So, it’s not surprising that the staff and unions are reluctant to take part because they’re not trusted anyway. No-one seems to be able to put the residents first in this.

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