Agenda item

To receive any question from members of the public which have been submitted in advance of the meeting in accordance with the procedure rules.  The deadline for receipt of public questions in midnight Friday 10 November 2023.

From: Liliana Hera Calle, Co-Ordinator of Right To Food Southwark.

Question:

Malnutrition among older people and meals on wheels services

Background

This week, 6th- 12th November is the Malnutrition Task Force’s National Awareness Week which is focusing on malnutrition among older people.

Right To Food Southwark contributed by holding a community lunch to discuss malnutrition among older people in Southwark and examining the best way to tackle this from a local perspective.

We heard that only two days of insufficient eating can lead to malnutrition. In Southwark, with one in three people over 60 living in income deprivation there will be thousands of older people at risk of, or living with malnutrition.

A third of people in England aged over 65 years are at risk of malnutrition when admitted to hospital. This rises to 50% of older people living in care homes. 70% of people weigh less on discharge from hospital. This translates to hundreds of Southwark’s citizens.

We discussed many issues relating to aging in today’s society that can lead to people eating less: lack of income, loneliness, social isolation, physical and mental wellbeing.

Most people who are malnourished live in working class communities but we find they are often not the people who come to community for help. Some feel shame of poverty and take pride in not asking for help.

We asked what one action could the Council take in order to tackle malnutrition among older people in Southwark?

The answer was: re-establish Meals on Wheels.

We are aware that this public service ended in 2018.  We are aware that since then poverty has increased and the size of our older population is growing. 

We ask the Health and Well Being Board:

1.  Was an impact assessment carried out in 2018?

2.  How does the Council monitor levels of hunger and malnutrition among older people?

3.  Is the Council getting data from our hospitals?

4.  Do you agree that Meals on Wheels service is needed or how are our older citizens coping? 

5.  If you agree, will you fund the re-establishment of a meals on wheels service?

Response:

The contract for Meals on Wheels was with a company called Apetitto ended October 2017.

The decision to end the contract with the provider was mutual. There was insufficient demand for the service and it was no longer financially viable for the provider to deliver the service at a reasonable cost. The unit cost of meals at the time would have been over £16 per meal at 2017 prices.

Demand for meals on wheels had reduced due the larger supermarkets and some small stores offering deliveries. The increasing range of readymade meals available on the market, which include low salt, low fat, gluten free, vegetarian, vegan and culturally specific options.

The service was replaced by:

• Wiltshire Farm Foods, an independently sourced food delivery.
• (Food to You) Shopping service arranged by Age UK.
• Increased Care provision to allow light meals to be prepared and served.
• Provision of microwaves and other gadgets, to support meal preparation.
• The provision of freshly cooked meals in our day services (that had previously been heating up meals, delivered by Apetito).

Following the cessation contract, all service users who had been in receipt of meals on wheels from Apetito were reviewed. The reviews indicated that their nutritional needs were successfully met, with alternative provision and arrangements as noted above.

We have social work teams based at both Kings and Guys and St Thomas’ hospitals who support discharges from hospital. The team are able to access notes on a person’s admission, including London Ambulance Service reports and any other medical assessments undertaken during their admission. This allows the team to assess the care and support needs of the person. Any issues relating to malnutrition are usually in the context of a medical condition, as an indicator of fragility or self-neglect and low appetite.

Adult Social Care has no evidence to indicate that Meals on Wheels should be re-procured to support older adults who are Care Act Eligible, as the above services are able to support the need as appropriate. 

Liliana Hera Calle, thanked the officers for their response and at the invitation of the chair followed up with a comment about community groups who have tenants association halls and provide meals. She suggested that perhaps this  could be something the council could consider in of  terms of community kitchens where older people who didn’t want  anything formal or could not afford Wiltshire Farm Foods, etc could turn up (where supported in their communities) without their finance being impacted.