Exam Pass Notes

Use these notes for a final review before the assessment. They summarise the course's main points but do not replace local nutrition and hydration policies, dysphagia plans, consent guidance, or individual care plans.

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Core messages

• Supporting nutrition and hydration means recognising changes in needs, helping people eat and drink safely, and acting early when intake changes.
• CQC Regulation 14 requires people to receive suitable, nutritious food and drinks and support to eat or drink when needed.
• Older adults may not report thirst or weight loss; staff should compare current intake with each person's usual baseline.
• Warning signs include reduced intake, looser clothing, poor appetite, dry mouth, dark urine, dizziness, constipation and increased tiredness.
• Do not apply generic fluid guidance where a person has a swallowing plan, fluid restriction or is receiving end-of-life care.

Support and safety basics

• Mealtimes should be person-centred, flexible and unhurried.
• Correct positioning, oral care, well-fitting dentures, adapted utensils, preferred cups and sufficient time can improve intake.
• Respect consent, cultural and religious needs, and lawful refusal, while checking whether pain, illness or distress is reducing intake.
• For dysphagia, follow the current prescribed food and fluid textures exactly and escalate any new coughing, choking or wet-voice signs.
• Use accurate food and fluid charts, record weights where staff are trained to do so, and follow local screening pathways such as MUST if used by the service.

Escalation and teamwork

• Poor intake may be caused by infection, constipation, pain, nausea, mouth problems, delirium or medication side effects.
• Dehydration red flags include increasing drowsiness, confusion, dizziness, very low urine output and acute illness.
• Frontline staff should report the pattern of change clearly and escalate promptly rather than guessing the diagnosis.
• Family members often know baseline routines and preferences that help assessment and care planning.
• Depending on the concern, involve dietitians, GPs, speech and language therapists, pharmacists and nurses.

For the exam, remember the practical shape of safe practice: notice change early, support eating and drinking, follow the agreed plan, record accurately and escalate before risk becomes harm.