Food service operations in senior living communities are increasingly getting attention as a source of competitive advantage. David Koelling, president of Strategic Dining Services, a dining service and hospitality management provider, knows the strategic importance of the dining operation. “For many operators, dining is the number one controllable expense, and the biggest driver of resident satisfaction. Increasingly, hospitality is what we do. Dining and hospitality needs to be part of the vision. It needs to match, fit, and in some cases lead an organization’s strategy,” he said. That strategy includes safety—food safety and worker safety in the kitchen.
At Market Street Memory Care Residences, a Watercrest Senior Living community in Viera, Fla., menu design goes beyond having a tailored, nutritionally-balanced, and dietary-compliant menu creation process. The community offers a mostly Mediterranean diet, with a lot of fresh fish, chicken, and turkey. “Our freezers are really small,” said executive chef Ryan Gorsuch. High quality, fresh food improves the dining experience—and it’s also easier to manage from a food safety perspective.
In fact, Koelling makes a direct connection between quality ingredients and safe food handling. “When you have quality food, you handle it differently. You store it differently. You hold it for the shortest time possible. If you’re committed to fresh, great food, the handling looks very different—and so do the outcomes. Ninety percent of sanitation and health issues go away if you’re committed to quality food.”
While senior living communities are bound by the same laws and regulations that apply to restaurants, there are some special considerations that make it necessary to “take it up a notch above what you might see in a restaurant,” said Lynne Eddy, an associate professor of business management at The Culinary Institute of America. Eddy teaches students in her senior-level courses on human resource management and foodservice management in health care (see p. 38) to combine expert level culinary skills with the technical knowledge and cultural sensitivities they need in a health care or senior living setting.
Eddy reminds students that seniors may have compromised immune systems; this means kitchen and dining areas must be extra clean, and special attention must be paid to food temperatures and food storage. “Food poisoning can be devastating [in this population],” said Eddy.
William Weichelt, director of food safety and industry relations at the National Restaurant Association (NRA) agreed. “This is more of an at-risk population; you want to make sure things aren’t undercooked, and that there are processes in place for monitoring [food temperatures].”
Special dietary requirements may also factor in to food safety in a senior living or health care setting. Gorsuch, who had extensive experience in restaurants, hotels, and country clubs prior to joining Market Street, needed onsite training in some of the food preparations his residents required. Eddy teaches her students both the “what” and the “why” of special dietary requirements. For example, she brings in speech pathologists to teach about swallowing mechanisms using medical terminology. “This is how we teach about food consistencies and why it matters to someone with dysphagia,” she said.
Beyond the technical requirements of maintaining a healthy and safe kitchen and dining area, Eddy sensitizes students on resident privacy issues as they relate to diet. For example, “someone handling trays could be unaware that residents may not want to be acknowledged as having swallowing disorders, diabetes, or other conditions that affect what they eat or how their food is prepared.” Without this training, students (or staff) may not be cognizant that a resident’s diet is a confidential matter. “If you have food service experience in a restaurant, this may not be quite so obvious,” she explained.
Weichelt, who was previously responsible for the ServSafe® Food Safety training programs offered by the NRA, said “don’t take what [food handlers] know or don’t know for granted” when designing a worker training program. Weichelt recommended ServSafe food managers be recertified every three to five years, with food handlers recertifying every two years or so.
Gorsuch uses the ServSafe curriculum to certify his staff, then supplements that training by regularly reinforcing safety and compliance topics with in-service meetings and on-the-spot coaching. Weichelt endorsed this approach: “Managers need to be observant and give immediate feedback and remedial training as and when they notice issues. Just training once and walking away isn’t ideal.”
A workplace training program should cover not just each person but also each piece of equipment at a community. Gorsuch tailors his training program by community, as each has different equipment. Koelling noted that “in a kitchen, it’s the technical side of things that typically needs reinforcement. Like what’s going on inside your ice machine? If not properly cleaned and inspected, it could be the single biggest risk in your community. There’s not much exposure to a topic like that outside of a health care or senior living community; it’s important to train.”
According to Gorsuch, daily reinforcement is the key to the inspection success at his communities. “We know what to look for daily, and we stay inspection ready. We don’t have to worry about ‘getting’ ready for inspectors. That’s the way I was trained.”
Koelling uses a checklist “game” to introduce some fun into the process of getting and staying “inspection ready.” Strategic Dining Services creates tailored checklists such that each piece of equipment gets inspected, and each employee gets a set of tasks to complete. The goal is that each checklist is completed without any issues found, in less than four minutes. “When the four minutes are up, we look at the corrections needed. And we talk about not just ‘what’ needs to be corrected, but also ‘why’ and ‘how.’ So, we’re playing a game, but learning in the process.” They also use it to get others familiar with the inspection process and build an understanding across the entire team, by having an executive director or the maintenance director take a position in the drill. A nice side effect of the training is it can increase inspection scores by helping avoid minor findings, Koelling said.
Training and reinforcement of best practices and community-specific processes is critical to maintaining food safety. Training is also essential to worker safety. Weichelt noted that food service communities “are busy, very high pressure. Things get busy, there are many moving parts, and things can change rapidly.” If equipment is not working properly, or staff is not trained to use it correctly, injuries can occur. Beyond the increased workers’ compensation expense of injuries, workers have a legal right to a safe working environment. Koelling noted that keeping workers safe starts with the hiring process. “Are you hiring people that are equipped to be in a kitchen setting where things are hot, sharp, heavy, and fast-paced?” He noted worker shortages and difficulty in hiring can sometimes also rush the onboarding processes that are so critical to keeping dining staff safe.
If a senior living executive doesn’t have a food service background and isn’t sure where to start with improving a food service operation, Koelling offered this advice: “Start with your instincts. Those are going to be your best tool for evaluating what’s going on. What does it look like in the kitchen? Smell like? If the kitchen doesn’t seem right, trust me, it’s not right. Start with your instincts, and then work out a plan or get help to address the concerns.”
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