Aegis Aged Care - duplicate

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Inspection Details

• Chef Manager

• Email

• Date of last Aegis Internal Audit

  Date

• Number of non Compliances at last Aegis audit?

• Evidence of non Compliances closed out

  Yes

  No

  N/A

• Details of non compliance:

Non Compliance

• Type of non compliance

• Date item completed

  Date

• Evidence of item completed

  Media

General Requirements

• Local Council Food Business Certificate is current?

  Yes

  No

  N/A

• Date of Local Council last audit?

  Date

• Details of Local Council audit.

• Yes

  No

  N/A

• % of Hospitality staff who have completed Excellence in Dining training?

• % of Clinical staff who have completed Excellence in Dining training?

Communication

• Evidence of Facility Staff Meeting Minutes where Excellence in Dining project was discussed?

  Yes

  No

  N/A

• Date of Meeting

  Date

• Details of Minutes

• Evidence of Facility Resident Meeting Minutes where Excellence in Dining project was discussed?

  Yes

  No

  N/A

• Date of Meeting

  Date

• Details of Minutes

• Evidence of Resident Meal Satisfaction Survey before Excellence in Dining project was introduced

  Yes

  No

  N/A

• Date of Survey

  Date

• % above Satisfactory

• Details of Survey

• Evidence of Resident Meal Satisfaction Survey after Excellence in Dining project was introduced

  Yes

  No

  N/A

• Date of Survey

  Date

• % above Satisfactory

• Details of Survey

• Do Staff have access to Aegis Excellence in Dining Program information when the Chef Manager is not on duty?

  Yes

  No

  N/A

• Details of System for Access;

Environment

• Servery Information

Servery

• Servery Name

• Level of Care

  Select Low Care High Care Dementia Extra Services

  • Low Care
  • High Care
  • Dementia
  • Extra Services

• Meal Period

  Select Breakfast Lunch Dinner Morning Tea Afternoon Tea Supper N/A

  • Breakfast
  • Lunch
  • Dinner
  • Morning Tea
  • Afternoon Tea
  • Supper
  • N/A

• Are the dining tables clean and set according to Excellence in Dining standards?

  Yes

  No

  N/A

• Take photo of dining table settings

  Media

• Dining room noise level appropriate for eating meals

  Select very quiet low level of noise moderate level of noise very noisy extremely noisy

  • very quiet
  • low level of noise
  • moderate level of noise
  • very noisy
  • extremely noisy

• Is there any music playing?

  Yes

  No

  N/A

• If music is playing; is it appropriate for eating meals and is the level of music suitable?

• Is the TV on?

  Yes

  No

  N/A

• Are there any off-putting smells in the room?

  Yes

  No

  N/A

• Is there nice food smells in the room that entices the appetite?

  Yes

  No

  N/A

• Is the environment pleasant, relaxed and conducive to eating?

  Yes

  No

  N/A

• Is the lighting suitable for eating meals?

  Yes

  No

  N/A

Food Service Delivery

• Tray Service Information

Tray Service

• Wing Name

• Level of Care

  Select Low Care High Care Dementia Extra Services

  • Low Care
  • High Care
  • Dementia
  • Extra Services

• Meal Period

  Select Breakfast Lunch Dinner Morning Tea Afternoon Tea Supper N/A

  • Breakfast
  • Lunch
  • Dinner
  • Morning Tea
  • Afternoon Tea
  • Supper
  • N/A

• Meal trays are set as per Aegis "Excellence in Dining" standard

  Yes

  No

  N/A

• Resident name tag with photo is on the tray? (Name tag is clean)

  Yes

  No

  N/A

• Correct resident meal is plated on tray?

  Yes

  No

  N/A

• Crockery and cutlery are clean with no chips?

  Yes

  No

  N/A

• AIN's are ready to collect the food trolley for meal service?

  Yes

  No

  N/A

• Is the plated Food Temperature within acceptable temperature range >60

  Yes

  No

  N/A

• Hot Food Temperature is;

• Cold Food Temperature is;

• Is the Food Quality to Aegis "Excellent in Dining" Standard?

  Yes

  No

  N/A

• Level of Food Texture

  Regular

  Texture A

  Texture B

  Texture C

• Take Photo of Plated Meal

  Media

• Servery Information

Servery

• Servery Name

• Level of Care

  Select Low Care High Care Dementia Extra Services

  • Low Care
  • High Care
  • Dementia
  • Extra Services

• Meal Period

  Select Breakfast Lunch Dinner Morning Tea Afternoon Tea Supper N/A

  • Breakfast
  • Lunch
  • Dinner
  • Morning Tea
  • Afternoon Tea
  • Supper
  • N/A

• What is the meal ordering system used?

  Select Pre-ordered one day ahead Orders taken at the table

  • Pre-ordered one day ahead
  • Orders taken at the table

• Servery is ready for meal service; Bain Marie preheated/heat lamps on, plates preheated, servery is clean and organised

  Yes

  No

  N/A

• AIN's are in the Dining Room ready for service

  Yes

  No

  N/A

• Correct meal period menu is displayed

  Yes

  No

  N/A

• Crockery is clean, no chips or stains?

  Yes

  No

  N/A

• Cutlery is clean?

  Yes

  No

  N/A

• Plastic Thermal Equipment is clean?

  Yes

  No

  N/A

• Clearing trolley is ready with splash guard, plastic scrapper, cutlery bucket with water/detergent, wiping cloth and spray bottle

  Yes

  No

  N/A

• Staff Questions

Staff

• What can you tell me about Excellence in Dining?

• Can you explain the food items on today's menu?

• Staff are in Uniform with Name Badge?

  Yes

  No

  N/A

• Kitchen Hand & AIN (in charge) are working together with meal delivery system (Resident Meal Ordering Form being used to check resident diet analysis)

  Yes

  No

  N/A

• Were residents told that meal service was due to start?

  Yes

  No

  N/A

• Is the resident positioned in such a way as to enable them to eat safely and promote maximum independence?

  Yes

  No

  N/A

• How is the resident positioned?

  Select dining chair wheelchair day bed chair bed

  • dining chair
  • wheelchair
  • day bed chair
  • bed

• Is the table positioned within reach for the resident?

  Yes

  No

  N/A

• Were drinks within reach for the resident?

  Yes

  No

  N/A

• Did anyone assist the resident to set up items for their meal?

  Yes

  No

  N/A

• Assisted by;

  Select AIN EN RN Family Member Catering Staff Member

  • AIN
  • EN
  • RN
  • Family Member
  • Catering Staff Member

• Is the meal within reach?

  Yes

  No

  N/A

• Was the protein at 6 o'clock on the plate when served to the resident?

  Yes

  No

  N/A

• Did staff serve from the right?

  Yes

  No

  N/A

• Did staff clear from the right?

  Yes

  No

  N/A

• Did staff follow suitable dining room etiquette during meal service?

  Yes

  No

  N/A

• Did staff scrap left over food and stack dirty plates quietly?

  Yes

  No

  N/A

• Is the Food Quality to Aegis "Excellent in Dining" Standard?

  Yes

  No

  N/A

• Level of Food Texture

  Regular

  Texture A

  Texture B

  Texture C

• Take Photo of Plated Meal

  Media

Assistance

• Was the resident fully independent?

  Yes

  No

  N/A

• Was the resident given assistance to cut food / open lids if required?

  Yes

  No

  N/A

• Was the resident given assistance to eat or drink as required?

  Yes

  No

  N/A

• Who gave assistance?

  Select AIN EN RN Family Member Catering Staff Member

  • AIN
  • EN
  • RN
  • Family Member
  • Catering Staff Member

• Did the staff member giving assistance with the resident meal use a chair/stool while assisting?

  Yes

  No

  N/A

• What did the assistance involve?

Monitoring

• Did you see anyone monitor how much the resident consumed?

  Yes

  No

  N/A

• Who

  Select AIN EN RN Family Member Catering Staff Member

  • AIN
  • EN
  • RN
  • Family Member
  • Catering Staff Member

• Was an alternative offered if the meal was not eaten?

  Yes

  No

  N/A

• If the resident ate less than half of their meal was encouragement provided to eat more?

  Yes

  No

  N/A

Activities / Staffing

• Did planned regular activities occur during the meal service?

  Yes

  No

  N/A

• What occurred;

  Select medication round assessments visitors other

  • medication round
  • assessments
  • visitors
  • other

• Were family members or carers present at the meal service?

  Yes

  No

  N/A

• Did their presence appear to distract the resident from eating or did it appear to encourage the resident to eat more?

  more

  less

  no difference

Meal Interruptions

• Was the resident able to eat their meal without interruptions?

  Yes

  No

  N/A

• Comment on what / who interrupted their meal?

• How many interruptions did you observe?

• What were they?

• Which of those interruptions were urgent?

Resident Information

• Resident Diet Analysis Records are followed?

  Yes

  No

  N/A

• Resident Information

Resident

Additional Information

• Additional Notes/Comments

• Resident Name

• Level of Care

  Select Low Care High Care Dementia Extra Services

  • Low Care
  • High Care
  • Dementia
  • Extra Services

• Diet

  Normal

  Diabetic

  Gluten Free

  Vegetarian

• Texture

  Regular

  Texture A

  Texture B

  Texture C

• Meal Size

  Small

  Medium

  Large

• What did you enjoy about today's meal?

• What would you like to see improved with the meal service?

• Action Required

  Select None Correction Action Record Record of Conversation Warning Letter

  • None
  • Correction Action Record
  • Record of Conversation
  • Warning Letter

• Re-inspection Required

  Yes

  No

  N/A

• Time before next inspection

  Week

  Fortnight

  1 Month

  3 Months

  6 Months

• DECLARATION: I have read this report and understand the contents

• Chef Manager / Facitily Manager signature

  Sign

• Central Office signature

  Sign

• NOTE: assessment report contains findings from date/time of inspection only

Contact Details

• Aegis Aged Care Group

• Address: 90 Goodwood Pde Burswood Perth WA 6103

• Telephone: (08) 6254 8200

• Fax: (08) 6254 8299

• Email: operations@aegiscare.com.au

• Web: www.aegiscare.com.au
  
  
  www.aegiscare.com.au

• ABN: 97 377 986 723