Ensure Consistent Service at All Levels of Care
When it comes to serving meals, are servers working in the nursing department as caring as the food service staff?
This question often tops the list of challenges in senior living communities, whether I’m working with a skilled nursing home, assisted living community, residential care community, or a Continuing Care Community (CCRC).
A dining director in a CCRC told me servers from their nursing department (caregivers) care about the residents, however many don’t care to learn new skills about meal service. “They don’t see a need to spend the time learning because they believe they already know everything about the residents,” she explained.
In my opinion, in the medical model of care nursing staff are positioned as the “knowers.” They have been taught they know what is good for the resident, often over the residents’ own opinion. And the truth is, they often do know what is best from a clinical standpoint, or even about resdients' personal preferences, such as how they like to bathe, wear their clothes, comb their hair, or what they like to eat.
But there is a different set of skills required to caringly serve a meal to another person. When waiting for a meal, we all have expectations of being served. Residents are no different. When they enter the community dining room, they anticipate being served. These expectations do not somehow change because they are being served by their caregiver. Actually, expectations that servers will be consistently attentive, timely, kind, well-mannered and positive about the food are often greater in a care setting.
I often hear from nursing department staff they don’t feel like serving because they don’t want to be considered a waitress. Somehow, being a waitress has been given a bad rap in many nursing circles. Most nursing department staff are genuinely caring, nurturing people, but many apparently don’t realize what most mothers and properly skilled waitresses know: serving a meal is an excellent way to nurture another person and make a connection with them.
It is time every department in the organization learns the importance of the dining experience to the well-being and dignity of residents. When high quality service is delivered predictably, whether in the dining room or during in-room service, that consistency helps residents believe they can count on your organization.
Build service consistency at all levels of care by providing the same training to the same standards to all staff members who serve meals, regardless of their official title. At minimum everyone on your staff should be trained in basic service skills. It’s cost-effective and essential when the dining room is short-handed. Train your staff to see beyond their title to the bigger picture, understand the long-term benefits of providing quality mealtime experiences, and work together as a team so they feel like they are part of the change and will benefit from it.
Finally, practice genuine hospitality and proper serving skills every day until it becomes ingrained in the culture of your community. You can’t just show an online video and expect staff to be trained. Leaders must reframe their idea of training to be more of an apprenticeship model, where staff receives ongoing coaching and mentoring, if you truly want them to internalize the concepts and deliver genuine hospitality at all levels of care.
Teaming Up for a Better Dining Experience
Lynn Smith, Executive Director and Administrator, and Patrick Miller, Hospitality Services Director, at The Manor in Morrisville, Vermont share lessons learned on the road to higher standards in dining service
By Lynn Smith and Patrick Miller
At The Manor
, we continuously work to improve our dining environment. We started like most communities, with a tray line for all four dining areas. Residents had to order a week in advance and we prepared and served out of one kitchen. We knew we could do better and hired Pat Miller, an experienced local chef who came with culinary expertise and a shared vision toward restaurant style dining.
Over the last couple of years we have built a separate kitchen for the assisted living and implemented dining on demand in our main dining and rehab units. Today we have a computer-based system and residents have more flexibility, choices and better food quality. We have a menu at every meal, residents order what they want, and a few minutes later it's ready.
In August Lynn decided to invest in our success by inviting Cindy Heilman to present Kind Dining® Training
in our community, knowing this is what we needed to help us meet our dining service standards and goals. We’ve worked on improving service in the dining room all along, but there were still areas where we were falling short of our own expectations. Cindy’s program gave us the final brick to complete the foundation of our program.
Giving 18 hand-picked employees two days to focus on dining service was what we needed to formulate our approach to changing the dining experience we offer. Usually, you can’t get everyone to sit down together because we work different shifts and everyone is busy. You’re always limited in terms of how many people can come and how much time you have for a staff meeting. But getting everyone in the same room for two days let us hear the same information objectively. We learned a few new skills, understood better how the changing marketplace of senior care affects all of us, including our residents, and how each individual makes a difference in someone else's day by being here. When staff saw management would sacrifice 18 people for 2 days and pay for that time, it was clear management is making a big commitment. This is important and we are willing to stand behind what we want to do. It also showed the staff we weren’t just trying to push this change down on them; we were making it happen in a grassroots way—together.
Cindy Heilman is a very dynamic person. She sparked a lot of good discussion and ideas about the changes we’re making to improve things in a positive way. Within the Kind Dining® classroom we had a good forum for sharing each other’s problems without blaming or complaining about “how hard I have it.” Now there is more open communication between departments and everyone is looking for ways to change our processes to result in better experiences for residents.
Bringing this experience to The Manor resulted in creating smaller work groups we titled "people," "process" and "product." Everybody rotates through the groups, which helps us see how much crossover there is in the three areas and get on the same page in a better way. Now, for instance, people in operations understand the customer service perspective too and kitchen staff understands the pressures our LNAs are under at mealtime.
We haven’t become instantly perfect. The real work began when our initial training ended. We’re very excited to continue to perfect our community dining experience. We still have processes to work through and getting everyone together in a meeting is tough, but we’re committed to our goal and will get there, all together.
is Executive Director and Administrator at The Manor in Morrisville, Vermont. With over 34 years of experience in long term care finance and business administration, Lynn made her final career landing with The Manor in 2006. “I bring my collective experience and knowledge, combined with my passion to protect the rights of our beloved aged and disabled, to lead our organization to provide nothing less than excellence in everything that we do, every day, period!.” Lynn is a native Vermonter living with her husband in Chittenden County. They have three daughters, Alicia, Emily and Tiernan.
is Hospitality Services Director at The Manor. He has worked in the hospitality/food service industry for 40 years, is an American Culinary Federation Certified Executive Chef (1990); Culinary Arts Instructor at the high school, college and adult education levels; past Board of Directors Chairman of Northern Vermont Cooks and Chefs Association; and an Emergency Medical Technician (EMT).
is a private, non-profit senior care community in Morrisville, Vermont offering short-term rehabilitation and skilled nursing stays, long-term care community living, residential care community living, respite stays, and end of life comfort care. They recently received the Vermont State Nursing Home Quality Award for 2012
and they are 2011 recipients of a Bronze Award from the American Health Care Association