Enter and view: Henry Nihill House

Healthwatch Barnet carried out an announced Enter and View visit to Henry Nihill House on 11 June 2018 to assess residents’ mealtime experiences. Henry Nihill House is a 30-bed care home, and at the time of the visit 29 residents were living there, including a number requiring specialist nutritional support, pureed diets or diabetes management. 

The inspection found that meals were freshly prepared on site by experienced catering staff and that the home made considerable efforts to cater for individual dietary needs and preferences. Lunch was the main meal of the day and was served in two sittings, with residents requiring additional support eating in a quieter first sitting and more independent residents attending a later sitting. 

Inspectors were particularly impressed by the preparation of pureed meals. The home had introduced a system that allowed pureed foods to be shaped and presented attractively without moulds, making items such as sandwiches and cakes look realistic and more appealing. The overall presentation of meals was considered good.

The dining room environment was pleasant, well lit and clean, with music playing during meals and tables attractively laid. Residents generally sat in established places, and staff were aware of residents’ preferences and social relationships when arranging seating. Drinks were readily available throughout meals, with a selection of fruit juices and water offered. 

Feedback from residents was overwhelmingly positive. Many praised the quality of the food, variety of choices and attentiveness of staff. Comments included descriptions of the food as “excellent”, “wonderful” and “very good”, although a small number felt that meals could occasionally be warmer or that menus could become repetitive. Residents also reported that they were not rushed during meals and could obtain drinks whenever they wished. 

The home offered flexibility around dining arrangements, with some residents choosing to eat in their rooms. Residents also had opportunities to eat out regularly, including trips to local restaurants and cafés. Relatives reported that alternative food choices were available for residents who were particularly selective about meals. 

Healthwatch found staff to be caring, supportive and attentive. Staff received training in supporting people to eat safely, and detailed food and fluid monitoring systems were in place. Consumption was recorded carefully, and residents at nutritional risk received additional monitoring and dietary support. 

However, Healthwatch identified several areas for improvement. Residents were not routinely encouraged to clean their hands before meals, and inspectors did not always observe staff cleaning their hands or wearing disposable aprons when assisting residents with eating. Inspectors also observed one resident receiving a meal while asleep, resulting in a delay before assistance was provided and concerns that the food became cold before it was eaten. 

Some residents remained in wheelchairs throughout meals, and Healthwatch suggested that, where appropriate, residents should be offered the opportunity to transfer into dining chairs. The report also recommended ensuring food was served at the correct temperature, displaying menus on tables and making condiments easier for residents to identify and use. 

Overall, Healthwatch concluded that Henry Nihill House provided a positive dining experience with good-quality food, effective nutritional support and caring staff. Residents were generally very satisfied with mealtimes, and the home demonstrated a strong commitment to meeting individual needs. 

The home accepted the recommendations and introduced several changes, including offering hand wipes before meals, improving monitoring of food temperatures, ensuring staff supporting residents wore protective aprons, displaying daily menus more prominently and strengthening oversight of mealtime support.