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Risk and Safety: Allergens and Other Clinical Conditions

Food safety is something we take incredibly seriously at apetito.  When managing the health and wellbeing of your residents, you of course want to avoid any kind of nutritional risk or issues around food safety when it comes to the meals being served within your Care Home. 

Due to clinical conditions, such as malnutrition, dysphagia or diabetes, or due to food allergies, some residents can have complex dietary needs.  This can mean they require specially formulated food – such as texture modified or food that has been fortified with additional nutrients – or which is free from certain allergens.

Every step is taken at apetito to ensure meals are stringently tested, which includes robust allergen testing from our independently accredited onsite laboratory.  In fact, before ingredients even arrive in our kitchen, we work with suppliers to complete assessments and audits on raw materials.  This is followed by around 210 different daily checks on ingredients at our Trowbridge based kitchen, with approximately 2,800 additional checks during the cooking process itself.

Given the vulnerability of many of our customers, we also operate a positive release system, which involves testing every single batch of food so that if any bacteria is identified, we can detect it before it’s released to be sold.


Management of allergens isn’t the only place where risk can exist in a care home kitchen. You may have residents with conditions such as dysphagia (the clinical term for difficulties with chewing and swallowing). In fact, dysphagia is a condition that, due to the presence of other associated and usually causative conditions (commonly, stroke, cancers of the head and neck, learning difficulties or dementia), can affect up to 51% of older adults in institutional care[1].

A Speech and Language Therapist (SLT) is the Healthcare Professional who is usually responsible for diagnosing dysphagia and will recommend appropriate treatment accordingly. Commonly, this involves residents starting on a texture modified diet, either temporarily or as an ongoing way of managing dysphagia risks. Safety is at the heart of this form of treatment, as well as the maintenance of quality of life that comes from helping someone to maintain an oral diet for as long as possible (I.e., not have to go onto a long-term tube feed).  

If someone living with dysphagia is given the wrong texture diet (food or fluid), this can pose a serious risk to them. They could aspirate on their food or fluid which, over time, can lead to aspiration pneumonia, and can be fatal. Choking can also occur if a resident is given food that is not modified to their requirements, and this can also be fatal. Sadly, choking does occur in care homes and can be due to residents being provided with the incorrect texture diet. Using pre-prepared texture modified meals that are of a consistent texture, can be a solution to managing this risk, providing the recommended texture is provided.

Regular follow up from SLT’s is also recommended, particularly when someone is on a considerably modified diet, as quality of life and nutritional status can be compromised if management is not carried out in a resident-centred and holistic way. Dietitians and SLT’s should work together to support care home residents under the support and guidance of care staff, family, and other healthcare professionals.

Malnutrition is another clinical condition related to nutrition that is prevalent among care home residents. In 2020 BAPEN published the results of the biggest ever survey on malnutrition to have been carried out in care homes. This survey revealed that up to 38% of residents in care homes (to include residential and nursing care homes) were living with malnutrition.

This can pose a significant risk to residents, as they can experience negative effects because of this diagnosis, including altered immunity, a higher risk of trips, slips and falls, poorer levels of concentration and cognition and more frequent GP visits, prescriptions and hospital visits. It is widely believed that losing weight is a normal part of ageing. Whilst it may be common, it is not normal or inevitable, and should be treated with seriousness due to the negative effects on health it can lead to.

Care home residents may be prescribed oral nutritional supplements to help manage their malnutrition and prevent further weight loss, and whilst these supplements are often necessary, dietitians will frequently champion a food first approach. Using ‘food first’, care homes can help to manage the risks associated with malnutrition and demonstrate excellence in care.

Many different types of meals, drinks and foods can be fortified to increase the nutritional value, and pre-prepared meals can also be beneficial. Food first allows residents to enjoy varied meals, snacks and drinks, tailored to their preferences, whilst providing them with enhanced levels of nutrition to help them meet their nutritional needs. Food fatigue is reduced when residents have a wide range of fortified foods on offer, rather than relying on a few flavours of supplements.

apetito can support with managing the risks that can occur in a care home kitchen. We provide an industry-leading range of meals free from the 14 main allergens, a wide range of texture modified meals in IDDSI levels 3, 4, 5 and 6, and high energy multiportion and individual meals.

Get in touch to see how we can support your Care Home Kitchen requirements.

For any more details or to watch one of our webinars on allergens, specialist diets or malnutrition, please contact Annthea Corry:  

[1] Royal College of Speech & Language Therapy (RCSLT) Guidance on the Management of Dysphagia in Care Homes, available: htttps://

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