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Does this system meet the regulations of providing nutritionally balanced food service to the residents?

Nutritional standards within many jurisdictions for Adult Care Facilities are based on the menu. The menu provided to residents must be healthy and nutritionally well balanced. However, what the resident decides to choose from the menu is a different issue. Currently, we know of no regulations based on what the resident must choose. If a resident chooses to eat an unbalanced meal from a balanced menu, this is the resident’s choice and has to be respected. It is thought that it’s better for residents to choose what they want to eat, rather than hand them a plated food that is “nutritionally-balanced” but goes to waste. If a resident continuously makes poor choices, then an opportunity is provided for a Registered Dietitian to intervene, educate and motivate the resident to make healthier food choices.

How long does the food stay hot once the SuzyQ cart is unplugged?

The cart stays hot and maintains food temperature for approx. 45 minutes after unplugging it. Most facilities meal service for serving food is approximately 30 – 40 minutes so this has not been a concern for any facility to date. One facility told us that they used the cart for a big summer BBQ and the hot food stayed at/above the hot hold temperatures for over 55 minutes. This is because the hot water in the steam wells takes a very long time to cool down.

How many residents can you serve from one cart?

Each cart can hold entrees (regular, chopped, minced, puree) and warms plates for a maximum of 40 residents (20-40 residents per cart is ideal!). Using 6″ deep, narrow inserts is the trick! It may seem like a jigsaw puzzle at first trying to get the inserts to fit but it will fit! You may have to look at your food service inserts that you have in your kitchen and analaze if you need to increase your selection. The insert sizes that work well are; 1/3, 1/4, 1/6 and 1/9 and are either 4″ or 6″ deep. For instant, on one side of the cart (which is one full size pan) you can use three – 1/9 inserts, two – 1/6 inserts, and one – 1/3 insert for all your texture modifications. The other side of the cart can use two – 1/2 size regular or long. Just get creative with your inserts and before you know it, it will be second nature. Hot cereal can be put on the SuzyQ cart or start a cereal wagon! This is a great idea with bulk, see-thru containers for the cold cereal (i.e. Kellogs supplies these free!) and a crock pot for Hot Cereal. Same can be done with a soup wagon (with a basket of crackers or croutons ready to go), and dessert wagon (and whip cream – one facility I know puts a can of whip cream on the dessert wagon, and the care aid or dietary aid garnishs the dessert right in front of the residents – they just love it!)

Does the outside of the steam table get hot?

The outside of the SuzyQ cart only gets slightly warm if one put their hand there for a while. It doesn’t get hot enough on the sides to burn anyone because the cart is well insulted. Also, the SuzyQ cart is usually manned by a staff person during meal service so safety risk to residents is very minimal.

How do you keep track of all the diet types and textures without the use of menu cards?

The following methods have been used in other facilities very successfully:
  • Draw up a map of the Dining Room showing where each resident sits. By the resident’s name, list the diet type. This map can be used by the Dietary staff and kept on the SuzyQ cart during meal service. IDEA: put sheet in a protective sheet, and attach with a large ring
  • Make attractive table tent cards and place them on each table with the diet type listed
  • On a card, write up the diet type for each resident at the table. Tape the card to the edge of the table.
However it is interesting to note that at most facilities where the SuzyQ cart system has been in use for some time, the Dietary staff do not use any of the above methods. Why? It’s because the staff now knows the residents and their diet texture so well – and that’s what resident-focused food service is all about!

Isn’t food service a Dietary staff responsibility, not a Nursing one?

Resident attendants’ duties fall under “assisting residents with the activities of daily living”. As dining is one of the major events of the day for residents, the care staff need to be an important part of the food service system. It must be a team approach!

But what if all the food won’t fit on the SuzyQ cart?

With practice, Food Service staff will quickly learn how to stock the SuzyQ cart effectively. Deep, narrow inserts (6” deep) work well. The condiments fit into the side shelf, and the lower drawers can hold extra cold food items. Evaluating your menu for consistency and practicality may also be needed.

How are leftovers on the cart used?

Because food left in the SuzyQ cart has only been touched by Dietary staff using utensils, any leftover food can be used in soups, snacks, nourishment, etc. Examples: Breakfast muffins/scones becomes evening nourishments Lunch sandwiches becomes the evening nourishments Supper vegetables becomes the vegetables in next day’s soup Leftover dessert fruit becomes the garnish for next meal You will notice a large difference in the utilization of leftovers!

Won’t using the SuzyQ cart take more time to serve residents, causing other work to pile up?

With time and practice, it will take the same or even less time to serve meals to the residents with the SuzyQ cart system. This is because staff responsibilities are the only change. Instead of staff running back and forth serving pre-plated food, the staff are all in the Dining Room serving different parts of the meal from juice, beverages, hot food, and dessert. Before and After Time Studies have been done at several facilities during the change-over of the food delivery system. It was noticed that after staff became familiar with the residents and the carts, serving time was not an issue. It is recommended that your facility do a “Pre/Post Time Study”, and show the results to staff. It is extremely important to remember that 90% of resident socialization is in the Dining Room during mealtime. This should be everyone’s focus and there shouldn’t be any efforts made to rush mealtimes. It is considered that there should be at least 45 minutes from the beginning to the end of food service in order to give enough time for residents to socialize and dine. Clearing the Dining Room early is strongly discouraged.

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  • "The numbers are eye opening as well,, with improved control and less waste…we have a savings of $90,000 - for a non-profit society this is a massive savings. The savings paid for the extra staffing to serve the food. My plan for this year is to purchase 3 carts and employ them at another site."

    Wayne Maki
    Executive Chef & Food Service Administrator, Excel Society

  • “Residents were happier as they had choices. Staff felt more fulfilled being able to offer a more resident focused service. By interacting with the residents every meal, it has allowed them to get to know our residents individually. It has helped foster relationships with the residents in which they talk, laugh or are jus there for each other. It has brought the “humanness” back to a system that was impersonal and task focused. The dining room environment now resembles that of a restaurant and not an institution. The change to a more resident focused food service continues to be an example of how systems can change positively without significant cost increases.”

    Cathy Mesner
    RD – Morgan Place

  • “A testimony from one of our residents is “I think all of us really like the choice we have about what we eat and how much. I like that we are all served at the same time and the food is hot when it is given to us. I always come to the dining room when we have the SuzyQ cart now.”

    Cara Clark
    Cara Clark, RD, Administrator - Cambridge Place

  • “Since we started offering our residents choices, we have noticed a reduction in our food cost and waste, for example a drop in our weekly milk order by four-four liter jugs of milk. Our residents enjoy the interaction they have with the staff at meal times, and some ladies even enjoy flirting with our head cook. These changes have allowed us to focus on the resident and to understand how simple gestures of communication, being verbal and/or body are very important to the resident. We have also created a team that is resident focused and understands how communicating and working together benefits not only our residents but us as a whole.

    Donna Weiss
    Administrative Service Coordinator, Echo Lodge Special Care Home

  • "The patients are really enjoying the New “choice meal service” provided. We only got complaints on our surveys before so getting positive notes from patients is a big improvement. The SuzyQ cart System is working wonderfully, and it is sooo much fun. Can’t believe the patient “happiness”. Thank you.”

    Gail Weleschuk
    Supervisor, Patient Food Services - Tofield Health Centre

  • “The SuzyQ cart System allowed for improved interaction and relationship between the dietary and nursing staff, as they started to work more together at serving our residents the better. Our food and beverage waste has decreased as well, which means we are saving money. Our cooks for the first time are leaving the kitchen and serving residents direct, which has allowed them more understanding of the needs of our residents. The cart moves very easily, and we love it. The table side dining has allowed the staff to spend time before and after with the resident, engaging them in their meal choice and receiving feedback in the moment. As soon as the blessing for the meal and the staff is complete, the lids come off with a flourish and the steam escapes causing excitement as they anticipate the choices to come. Thank you for your passion and investment in our residents satisfaction.”

    Angela Ross-Fehr
    Manager of Dining Experience, Menno Housing Society

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