• Complete STEW training as soon as possible, contact the Nutrition Support Team at anhsft.bdcnst@nhs.net to book. The resources are designed for use in residential care settings.
• Malnutrition Management Guidelines contains the BDC Malnutrition Care Pathway and STEW Malnutrition Care Plan as well as a Quick Guide for Primary Care.
• STEW Documentation contains resources to support; accurate identification of residents at risk of malnutrition, quality care planning guidance, and appropriate communication between care and kitchen staff.​
• STEW Recipes and Catering Guides contains practical information for catering and care staff on how to provide appropriately nutrient dense, fortified meals, snacks and drinks for residents at risk of malnutrition.​
• STEW Instructional Videos contains quick step by step visual guides to preparing STEW drinks and fortified food, to ensure they are tasty, appealing and nutritious.
• Safer Eating, Drinking and Swallowing Guidance contains information on how to reduce the risk of these issues and how to provide modified texture diet and fluids that are safe, tasty, appealing and nutritious.​​​

Can any care home use the STEW resources?

Yes. All care homes in Bradford District, Airedale and Craven should be following the BDC Malnutrition Management in Care Homes Guidelines and Pathway. Using the STEW Resources will support them to follow these guidelines and provide the appropriate malnutrition care plan to residents at risk, as well as ensuring quality nutritional care to all residents.

The STEW Training provided by the BDC Nutrition Support Team ensures bespoke support for individual care homes, their staff and residents to meet quality standards.

When should Oral Nutrition Supplements (ONS) be prescribed to treat malnutrition for residents in care homes?  

Bradford District and Craven Health & Social Care Partnership does not support the use of prescribed ONS for care home residents without detailed nutritional assessment and monitoring, and an identified a clinical requirement, meeting ACBS prescribing criteria. ​

Food-based interventions (which contain a similar range of nutrients) as provided in this guidance, should be provided for residents by care homes as the first line of treatment. ​

When admitting a resident, care homes have accepted that they will meet the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 for each resident Regulation 14 which states: “A variety of nutritious, appetising food should be available to meet people’s needs… Snacks or other food should be available between meals for those who prefer to eat ‘little and often’… Where a person is assessed as needing a specific diet, this must be provided in line with that assessment…” ​

A food-based approach to treating identified malnutrition is also supported by NICE: NICE Clinical Guideline 32 (2006) states: “Healthcare professionals should ensure that the overall nutrient intake of oral nutrition support offered contains a balanced mixture of protein, energy, fibre, electrolytes, vitamins and minerals.”  ​

Is the Malnutrition Management Pathway suitable for residents with eating, drinking, or swallowing problems?

Yes, STEW resources and training are available for those residents with eating and drinking issues and those on a modified texture diet and/or fluids. These are produced in partnership with Speech and Language Therapists (SLT’s) in BDC. ​

Thickening Oral Nutritional Supplements (ONS) and homemade fortified/supplement drinks is known to be problematic. A Pre-thickened, dysphagia suitable ONS product is preferable. The NST or other specialist community dietetic teams can advise on suitable ONS for residents on thickened fluids. ​