Old folks miss out on food

Two sausage rolls, a banana and sandwich without filling - that is claimed to be dinner at one Auckland rest home. Photo / Supplied

This is what some of our most vulnerable people seem to be getting to eat for their evening meal.

A Herald on Sunday investigation into rest home food has uncovered a disturbing picture.

And two high-powered reports into rest home food show many elderly not getting enough, in either qualtity or quantity, to eat.

However, the Aged Care Association denies there are systemic issues.

But when the Herald on Sunday went to several rest homes and asked to see what residents were eating, we were refused entry or even escorted off the property.

In two homes where we did manage to see what some were eating, much of it was bland and of low quality - like the two sausage rolls, a banana and an empty sandwich sent into the paper from a concerned reader after recent negative publicity about rest home food.

The reader said it was a meal served up at a home in Auckland.

Last year Auditor General Lyn Provost released a scathing report on the auditing process of rest homes.

Her findings were based on a snapshot from 2002 and she said there had been improvements this year, - partly as the result of snap audits - but she would review the situation in 2011.

About 34,000 people live in 715 certified rest homes across New Zealand, paying an average of $800 a week. Lobby groups Age Concern and Grey Power say profit is the key priority for rest homes.

"They're in the business to bring dividends to shareholders. That's the number one priority," said Grey Power president Roy Reid.

Age Concern spokeswoman Jayne McKendry agreed: "We have long expressed concern about the poor staffing levels in residential care, and inadequate training of those staff."

A former rest home staff member told the Herald on Sunday she rarely saw fresh fruit or vegetables served to residents. She would often sneak them extra food so they would not go hungry.

A recent Wanganui District Health Board study revealed 23 per cent of rest home residents were malnourished. The study, of 336 residents in 15 of the district's 17 rest homes, is regarded as a snapshot of what is happening throughout the rest of New Zealand.

Labour's health spokeswoman Ruth Dyson said it was unlikely Wanganui would be an exception to the rest of the country.

"Unfortunately neglect is commonplace," she said.

An Otago University study completed in March, but not reported in the media until now, revealed some rest homes did not order enough food to go around and others ignored the advice of dietitians.

Research co-ordinator and registered dietitian Julian Jensen said: "Some places just didn't seem to order enough meat and milk for catering for that many people. And of course elderly people don't like to make a fuss."

One hundred rest homes were asked to take part in the survey; 50 agreed. Of those, 19 did not have enough milk products to meet the calcium needs of their elderly residents, and at least eight were under-ordering meat and chicken. Sixteen failed to have enough fish on the menu and 14 did not provide enough grain-based food.

The researchers also found menus were changed after they had been approved by a registered dietitian - a requirement when rest homes are certified with the Ministry of Health - and there appeared to be no follow-up checks by health authorities to ensure the menu was being followed.

Jensen said menus were changed for a number of reasons.

"Staff are too busy or haven't ordered the ingredients or defrosted what they need to. The cooks didn't know how to meet the nutritional needs of the residents. The changes were made without thinking about the consequences [on nutritional balance] and only about half were being approved by the manager," she said.

The researchers also found shortage of staff was a problem.

"One woman wasn't given a knife and fork, so she just didn't eat. There weren't enough staff in the dining room to notice these things.

"Then the meals were being whipped away before they put their forks down, so the residents didn't have the chance to say they wanted to have more."

Jensen said problems in rest homes were probably worse than what had been uncovered in the research.

But the Aged Care Association, which represents 80 per cent of rest homes in New Zealand, said there was no evidence of a serious problems.

"The University of Otago report cannot be used to support any view of poor service delivery," chief executive Martin Taylor said.

"The purpose of the report was not to establish problems but to identify barriers and promoters to achieving an optimum diet. Therefore, it would be wrong to focus on out-of-context quotes to support a view of systemic issues in the aged care sector.

"Satisfying all residents all of the time in relation to menus and meal times is one of a facility's hardest tasks which is why the researchers found positive and negative comments."

"In order to comply with the regulations under the Health and Disability Act, facilities are required to have a suitably qualified individual to review menus and over the last year the sector has had hundreds of audits and no systemic problem with the provision of food has been identified."

He said the food was "generally" of a high quality in rest homes.

But in her report last year, Auditor General Lyn Provost said auditing had been inconsistent and sometimes of a poor quality. The Ministry of Health had been aware of this since 2004, she said.

The Otago report was sent to Health Minister Tony Ryall and the Ministry of Health in September.

He would not comment specifically on its findings but said in a statement that the Government had instituted a spot-audit regime which included checking that nutritional standards were being met. That audit information is available online.