Last month the Foodservice Australia tradeshow in Sydney incorporated its annual Aged Care Catering Summit, and among the lineup of speakers was accredited practising dietitian Dr Cherie Hugo. With more than 20 years’ experience in private practice, Cherie is the founder of the Lantern Alliance, which has more than 1500 members across Australia and combines action-based research, working groups and national collaboration teams to improve the quality of life for aged care residents through the joy of good food. We spoke to Cherie to find out more about the summit and the work that Lantern Alliance is engaged in.

“Lantern Alliance was established in 2013 as a way of connecting the industry together, to look at some of the pain points in aged care – and there’s a lot of those – from different perspectives,” Cherie tells us. “We have a diverse member base, from hospital managers, catering staff like chefs and cooks, through to clinical managers, aged care CEOs, allied health professionals like speech pathologists and dietitians, lifestyle teams – and these stakeholders come together at each of our collaboration practice meetings. We’ll focus on a particular paint point and have a discussion to really unpack it and identify how best to approach a solution.

“We’re also engaged in action-based research – I undertook a PhD on quantifying the value of food in aged care, and what I found was that if you get the food and the dining experience right, then most of the woes that otherwise might occur will settle, because many problems link back to food and nutrition. For example, if a resident is well-nourished, they’re eight times less likely to fall, they’re less likely to have pressure injuries or injuries generally. The action-based research component then links back into our collaborative communication – we take the research back to industry and show what our findings are, and that way we’re able to get them sense-checked with people on the ground.

 “Our third component is advisory services – we’ve developed tools in collaboration with industry that now measure some of these pain points I mentioned; you can think of them as GPS tools for aged care homes to guide management and staff through those touchpoints we measure. Having said that, you’re never going to have a one size fits all solution, because every aged care site is unique – we’ve found you simply can’t look at one home and say ‘we’ve found the answer and we’re going to roll it out across the other two and a half thousand homes across the country’. What we have to do is work with each individual home to find solutions which will effectively target the problems at that site, with the resident population and staff, skillset and equipment that it has.”

Cherie’s presentation at this year’s Aged Care Catering Summit showcased evidence in support of this connection between better food and nutrition and improved outcomes for residents. “We all innately understand that connection, but when you can show it via site by site case studies which detail things like prevalence of weight loss or reduction of hospital admissions – all those factors that aged care providers have to track – then they can see the correlation between putting good food and nutrition strategies in place and the resultant improvements in resident health, and appreciate it in terms of ROI.

 “One of the things we talked about at the summit is how texture modified diets are a challenge – with every downgrade of IDDSI diet level texture there is a step up in the prevalence of malnutrition. We presented a case study in which an aged care home identified that their residents who required MM5 (minced and moist) and PU4 (pureed food) diets were for the most part malnourished – so we advised on a strategy by which they would bring in pre-moulded texture modified foods for a six month trial. That worked for them, whereas for other homes it may make more sense to prepare their texture modified food on site.

“In this particular case, we revisited the home six months later to measure the outcomes, and we found a huge uplift in the proportion of well-nourished residents. Studies like this demonstrate the link between sound investment – in this case spending more money on bringing in moulded texture modified food – and the improvement in nutrition metrics, which then translates to less falls and less injuries, issues which end up costing the home more over time. What we say to providers is: initially you need to make that investment, but you’ll get a ROI very quickly through reduced food wastage, reduced supplement spend, reduced wound dressings and time spent transferring residents to hospital. The benefits will come as a result of your deciding to make that initial commitment.”

Cherie adds that a key message at the summit was “the fact that we’ve been talking about this for a long time, and we’ve had the Royal Commission into Aged Care and various steps in the reform process, but last year’s federal budget was the first one which spelled out that food and nutrition are important. At the same time as this awareness is increasing, we know that workers within health and aged care are still not being appropriately recognised for the role they play.

“It’s sad that we can have these expectations without remunerating staff – as an industry I think we all need to be pretty vocal about this, because we’re on the cusp of getting that recognition so everyone needs to make a noise about it. Our role at Lantern Alliance is to provide the supporting data about the correlation between food and nutrition and improved patient outcomes to show aged care executives it’s not just a hunch or leap of faith but hard fact.

“It’s also an important principle to understand that if you can’t measure it, you can’t manage it – so what we strive to do with our tools is provide visibility for organisations, so they can see where their weakest spots are and prioritise accordingly.”

To that end Lantern Alliance has designed systems like Epicure, the only industry-endorsed software to perform a full 360° analysis of a resident’s nutrition and dining experience. Epicure’s onsite program can be applied to any aged care setting to assess the quality and process of each dining experience through engagement with residents and staff.

“The aim is to give organisations the ability to say, ‘here are the five most powerful things we can do for the next six months that will give us the best uplift and impact’. We encourage organisations to focus on those areas first and foremost – to put blinkers on, virtually – and map out a six-month quality improvement plan where they understand they’re on a journey and this what they need to measure. We walk beside them to provide moral support and guidance to help them on that journey, with our tools mapping against both the current aged care quality standards and the upcoming new ones, so they have an independent report which shows how they’re progressing on their journey.

“Part of our work has also been as an advisor to the Aged Care Quality and Safety Commission - government have taken on board some of the learnings we've had in last 11 or so years through research, looking at areas that really do impact outcomes, as opposed to those things that are just creating more paperwork and regulation but not necessarily linking to residents having a better quality of life through food.”

Over the Royal Commission years Lantern has worked directly with providers who have approached them – rather than setting out to recruit homes to their cause. But Cherie says, “We’re now putting ourselves out there, because we certainly have capacity to be scaling more. Epicure gives us the ability to measure performance across homes, and if down the track that’s something that’s taken up nationally then the systems are in place to deal with two and a half thousand homes. For those providers who are ready for that journey, and wanting to be set up for the new quality standards and have metrics and the ability to measure what matters, we would encourage them to have a chat with us, we can walk them through some of our case studies, look at what their priorities are and tailor a service.”

While Epicure is the Lantern Alliance’s primary tool, it also measures consumer experience through another tool called Explore, undertakes nutrition champion and dining experience champion training with sites, and has an aged care hospitality training module and Food First program which sites will often employ.

“We have six key solutions that have been developed over the last 11 years, and if providers or staff in health and aged care are looking for extra direction, just reach out via our website - we're a friendly team and our goal is to support you.”

The Lantern Alliance is also a keen advocate for getting more aged care chefs involved in chef’s competitions – as exemplified in the IHHC Culinary Competition held during each year’s National Conference. “The skillsets are there, it’s about showcasing the passion and creativity of chefs within hospitals and aged care homes,” Cherie says. “It takes time and training to get to that competitive level and aged care organisations need to be supporting their chefs.”

 To find out more visit www.lanternalliance.com.au