Pureed Food Consistency Not Maintained for Dysphagia Diets
Penalty
Summary
The facility failed to prepare pureed foods in a form designed to meet the individual needs of residents on a dysphagia puree diet, as required by the International Dysphagia Diet Initiative (IDDSI) Level 4 standards. During observation of the trayline, pureed mixed vegetables were found to be too thick and did not pass the spoon tilt test, which is used to assess the appropriate consistency for safe swallowing. Staff responsible for preparing the puree did not perform the required spoon tilt test, instead relying solely on mixing and visual assessment. The Dietary Director confirmed that the puree mixed vegetables did not fall off the spoon as required and acknowledged that the consistency should have been adjusted by adding more liquid. Review of facility policies and recipes indicated that all IDDSI texture modifications must pass established testing methods at the start and every 15 minutes during service. The facility's diet manual and IDDSI guidelines specify that pureed foods must not be sticky, must fall off the spoon in a single spoonful, and must not have liquid separation. Despite these requirements, the puree mixed vegetables served did not meet the necessary consistency standards, potentially affecting all residents on a puree diet at the time of the survey.