Failure to Provide Properly Prepared Pureed Foods for Residents
Penalty
Summary
The facility failed to provide food prepared in a form designed to meet the individual needs of residents on a puree diet. Observations revealed that the puree cheese enchilada was grainy, the puree rice contained rice grains, and the puree vegetables had a runny consistency with liquid separating from the product. These issues were identified during meal preparation and trayline assembly, where it was noted that the foods did not meet the required smooth, pudding-like consistency for pureed diets. During a test tray evaluation, both the Dietary Supervisor (DS) and Registered Dietitian (RD) confirmed that the puree cheese enchilada was not smooth enough, the puree rice still had chunks, and the puree vegetables were excessively runny with liquid separation. The RD stated that the puree foods should be smooth, lump-free, and hold their shape, as outlined in the facility's diet manual and standardized recipes. The DS also noted that the runny puree vegetables would likely be unappealing to residents and could result in decreased food intake. A review of the facility's policies and procedures, diet manual, and standardized recipes indicated that all pureed foods should meet the International Dysphagia Diet Standardisation Initiative (IDDSI) Level 4 guidelines, which require foods to be lump-free, not sticky, and able to hold their shape without liquid separation. The facility's failure to adhere to these guidelines during food preparation and service resulted in the provision of pureed foods that did not meet the prescribed consistency and texture for residents requiring modified diets.