Information and resources about Dorset's Nutritional Care Strategy for Adults

Malnutrition and dehydration among the adult population is a serious issue. It affects the health and wellbeing of a large number of people and has a significant associated cost.

Recognising this problem, Dorset has created a partnership of Dorset Council, Bournemouth, Christchurch and Poole Council, Dorset NHS, Public Health Dorset and many of the key players in the field. Working together, the partnership has looked at available evidence and best practice and developed a strategy to address the problems.

The partnership specifically wanted to make the strategy concise and easily understood by all who read it. It's not purely written for professionals but for anyone who has an interest in this subject.

Nutritional Care Strategy for Adults

The centrepiece of the work of the partnership is the Nutritional Care Strategy for Dorset Adults. This aims to make a real difference to the problems of malnutrition and dehydration in Dorset's adult population.

Malnutrition and dehydration

Pan Dorset Malnutrition Programme

One of the achievements of the Nutritional Care Strategy is the Pan Dorset Malnutrition Programme.

Malnutrition is preventable through early intervention and The Malnutrition Programme is a fantastic example of joint working across the health and social care partners (Dorset Health Care, Dorset Council, BCP Council, Tricuro and the CCG.) The Malnutrition Programme, overview, objectives and outcomes

Due to the high levels of malnutrition within the community The Malnutrition Programme was developed  for all those patients who live at home (not Care Homes or Hospitals). It consists of all front line staff screening for malnutrition, inputting the data into a 'MUST’ / Nutritional Screening Electronic Form and following agreed care pathways. These pathways Care Pathways ensure the sharing of data and if completed correctly no patient/client can slip through the net and not cared for appropriately. Guidance notes for completing the ‘MUST’ / Nutritional Screening Electronic Form

Any user of the electronic form can also create new users, amend incorrect forms and run reports. Guidance notes for Administration of the ‘MUST’ / Nutritional Screening Electronic Form

The Health and Social Care Co-ordinators role is  essential to  the Pan Dorset Malnutrition Programme enabling  the care pathways to be followed at all times. 

Poor nutrition and hydration at home as well as in care homes and hospitals has been frequently highlighted in recent years.

Statistics show that, in general, malnutrition affects 23% of people under 65 and 32% of people over 65. It's more likely to affect older women than older men. In the UK, 3 million people are malnourished or at risk of malnourishment; 93% of these live at home.

One in three people admitted to hospital have been found to be suffering from malnourishment and every ten minutes, someone in the UK dies with malnourishment in hospital.

Nationally, 37% of those admitted to care homes, and 45% of those admitted to nursing homes, have been found to suffer from malnutrition.

Malnutrition costs the UK £13 billion per annum and will lead to 2.1 more GP visits and 3 times more hospital admissions.

In Dorset, the County Hospital Dietetic Department has estimated that, amongst those Dorset residents over 65, there is the following incidence of malnutrition:

Incidences of malnutrition in Dorset residents aged 65 and over
 Dorset residents aged over 65  Percentage of malnutrition
 General population  14%
 Sheltered housing  12%
 Receiving care at home  25%
 Care home residents  32% to 42% of residents on arrival

The Malnutrition Task Force is an independent group of experts across health, social care and local government, established in 2012. The aim of the Task Force is to reduce malnutrition in older people and so improve their health and quality of life as well as reducing unnecessary public expenditure.

Unintentionally losing weight - 'Build Yourself Up'

Unintentionally losing weight is as serious as being overweight.

If you're concerned that you, or someone you know, is losing weight without dieting, there are simple steps you can take to add extra energy to your diet to gain weight. While trying to put on weight, you should visit your GP to have a general health check up.

For more information see our booklet:

Weight loss and malnutrition resources

Public Health England have launched their guidance Commissioning Excellent Nutrition and Hydration 2015-2018.

Losing weight is not always great

Losing weight is not always great (powerpoint presentation) - This is a 10 to 15 minute presentation that provides background information about malnutrition and dehydration, and how to prevent them. If you don't have Powerpoint facilities, the slides are available laminated. The presentation has its own script and can be presented by anyone to any audience.

The presentation can be accompanied by the following:

The Dairy Council and the Malnutrition Task Force

The Dairy Council and the Malnutrition Task Force have also produced leaflets that you may like to read:


If you're concerned with being overweight, the NHS has advice on obesity.

General dietary information as well as advice on diet for particular circumstances

All through our lives it's important to eat a healthy diet to keep ourselves fit and well. When it comes to a healthy diet, it's all about one simple thing - a balance. This means eating a wide variety of foods in the right proportions, including plenty of fruit and vegetables, meat, fish and dairy products, but limiting the amount of fat, salt and sugar. A balanced diet ensures that our body gets all the nutrients it needs while helping us to maintain a healthy weight. Sometimes healthy eating can seem complicated and expensive but it really doesn't have to be. Change4Life - Swap it don't stop it (or Easy read - Swap it don't stop it) has some helpful tips on eating a balanced diet without cutting out some of the foods you might enjoy the most.

Diet is very personal to the individual and many people will follow a specific diet due to personal beliefs and preferences. Also, many medical conditions can affect the nutrients we need and the types of foods we are able to choose to eat.

People living with dementia

Dementia can cause difficulties with food and eating. Common experiences include: not recognising foods, forgetting to eat, difficulties using cutlery and struggling to chew or swallow. It's likely that this will change from day to day and as the dementia progresses, which can be very frustrating for the person with dementia and their carer.

Drink more water

Almost two thirds of our bodies is water but most of us don't drink enough for best health.

We can't rely on our body to regulate the amount of water we drink - by the time you feel thirsty, you're already slightly dehydrated. Older people are particularly at risk because the sensation of thirst reduces with age.

The benefits of drinking enough include: a reduction in constipation, urinary infections, and headaches. It will also improve blood pressure and sleeping patterns. In general, you are very likely to feel better as a result of drinking more.

The general recommendation is to drink 6 to 8 glasses of water a day. If this seems like a lot here are some tips to help:

  • water may taste better chilled
  • many people find it easier to drink water with a meal
  • squash or flavoured water is OK, but be aware of sugar content
  • skimmed or semi-skimmed milk is also OK, but be aware of the fat content
  • tea or coffee are OK but caffeine can cause dehydration: try decaffeinated instead

Ideally you should drink the recommended amount, but any increase will probably improve your health and make you feel better. Try it!

Hydration resources