Information for care homes

The Food First team supports older people care homes (with over 10 beds) in Luton and South Bedfordshire to improve nutritional care for all residents. The team do this by offering an unique training, audit and accreditation programme (based on CQC regulation 14 and NICE QS 24) which is delivered to all care home staff, regardless of role, focusing on appropriate identification and management of malnutrition.


Our interactive training is carried out by both registered dietitians and dietetic assistant practitioners. The training sessions cover the following:

  • How to identify malnutrition risk using the ‘Malnutrition Universal Screening Tool’ (‘MUST’) which is a validated tool developed by BAPEN.
  • How to manage someone at risk of malnutrition using a food based approach first line, where appropriate.
  • How to manage residents with special dietary requirements e.g. a soft or pureed diet, coeliac disease and diabetes (as per referral criteria).
  • How to provide a healthy, balanced diet especially if a fortified diet is required longer term.

We do not expect care homes to be able to reach and maintain high standards of nutritional care after just one training session, so the team keep in regular contact and are able to offer homes individualised support dependent on their needs.

The Food First team also provide training sessions to other health and social care professionals, domiciliary care providers, charity groups and patients groups upon request within the Luton and South Bedfordshire area. Please contact the team for further information.

Care Home Audit and Award Scheme

Care homes are audited on a 6 monthly basis against the ‘Food First Care Home Award Expectations’, which is recognised by local councils and is based on CQC Regulation 14: Meeting nutritional and hydration needs. The ‘Food First Care Home Award’ scheme was set up to reward and maintain best practice.

The audits are carried out by a member of the Food First Team and measure the care homes performance against 14 different standards. If standards are met, a Food First Certificate will be issued (valid for one year). When a care home is certified, a member of the Food First team will re-audit every six months to ensure that high standards are maintained. For care homes that do not initially achieve certification, the Food First team will provide on-going appropriate support in order for the care home to work towards becoming certified.

How and when to refer?

The referral information below is only for residents in Food First care homes in Luton and South Bedfordshire (for the list of care homes that we support, please see below. If you are a local healthcare professional and would like to refer someone who does not live in a residential or nursing home please email for the relevant referral form.   

Care home staff in Luton and South Bedfordshire can refer at risk service users directly into the service by completing the Food First referral form. To request a copy of the Food First referral form; please email

In order for a care home resident to be assessed by a Food First Dietitian they must have one or more of the following:

  • A ‘MUST’ Score of 1 or above WITH evidence of the Food First approach implemented for at least 1 month (as per ‘MUST’ Management Guidelines) AND continued weight loss the following month.
  • A stable BMI of <18.5kg/m2, be motivated to gain weight and the Food First approach has not led to weight gain.
  • Been admitted to the Nursing/Residential Care Home already on a prescription of Oral Nutritional Supplements (ONS) (for example Aymes Shake, Complan Shake, Fortisip Compact, Forticreme or Calogen). This includes residents discharged from hospital on ONS or started by the GP without a recommendation from a dietitian.
  • A Grade 3 or 4 Pressure Ulcer/Non-healing wound OR has had Frequent Falls AND a MUST of 1 or above WITH evidence of at least 1 month of the Food First approach.

Additionally, we will also provide dietetic support to:

  • Care home residents’ requiring weight management support services who are unsuitable for MoreLife Bedfordshire or Total Wellbeing Luton.
  • Care home residents’ requiring nutrition support/weight management advice who have diabetes which is diet controlled OR managed with metformin, pioglitazone or gliptin AND HbA1c of <58mmol/mol.

Please note that incomplete referral forms will not be accepted. It is also essential that all referrals include a 3 day food and fluid chart.

Referral criteria

Training and audit for West-Mid Bedfordshire

The Food First Team also provides the training and audit programme to older people care homes in West-Mid Bedfordshire. However, the clinical service is provided by Bedford Hospital Dietetic Service. Any referrals for the care homes (below) in West-Mid Bedfordshire please contact:

Nutrition & Dietetics, Bedford Hospital: 01234 792171 or

Prescribing guidelines

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