T117 Competencies for Food Service Employees Handouts/T117.pdf•Food is procured form sources...

CE Spotlight 2019 ‐ Health Technologies

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Competencies for Food Service EmployeesAmy Bollam, RD LD MPS – Health Technologies, Inc.

Learning Objectives

• Identify CMS regulatory requirements for employee competency

• Interpret competencies topics for food service workers

• Review observation and testing methods for evaluating competency

What is a Competency?

Competencies are sets of skills, knowledge, abilities, and personal characteristics that enable employees to perform their jobs successfully.


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Why Competencies for Food Service?

CM§483.60(a) Staffing

• The facility must employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, taking into consideration resident assessments, individual plans of care and the number, acuity and diagnoses of the facility’s resident population in accordance with the facility assessment.

How Should Competency be Measured?

• Post‐test only

• Pre‐test and Post‐test

• Observation

• Self‐assessment

• Interview

How Should Competency be Measured?

Proficiency Ratings:0 – Is not able to perform basic tasks

1 – Understands basic principles; can perform tasks with assistance or direction

2 – Performs routine tasks with reliable results; works with minimal supervision

3 – Performs complex and multiple tasks; can coach or teach others

4 – Considered an expert in this task; can describe, teach, and lead others


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When Should Competencies be Evaluated?

• Consider evaluating competencies on a regular basis

• Competency should be established during and after initial employee orientation (90 days)

• Competency areas may be re‐evaluated on at least an annual basis

• Keep employee records up to date with in‐service attendance

Educating to Competency Areas

Lecture

Audiovisual instruction

On‐the‐job training

Role play

Case study

Competency Areas for Food Service

Infection Control & Hygiene

Infection Control & Hygiene

Disaster Preparedness

Disaster Preparedness

Resident RightsResident Rights EthicsEthics

Food SafetyFood Safety NutritionNutrition Customer ServiceCustomer Service


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Infection Control and Hygiene

• Properly washes hands

• Covers open sores or cuts

• Uses hair restraints

• Employs hygienic practices before and during food handling

• Handles cups/glasses on the outside and tableware by the handles

• Practices appropriate glove use

CMS Regulatory Standards ‐ Hygiene

Determine whether staff are using proper handling techniques, such as: Preventing the eating surfaces of plates from coming in

contact with staff clothing;

Handling cups/glasses on the outside of the container; and

Handling knives, forks, and spoons by the handles

Observe whether staff used proper hygienic practices such as keeping their hands away from their hair and face when handling food

Education and Evaluation ‐ Hygiene

Education period New Employee OrientationOngoing education, recommended at least one hygiene topic quarterly

Training type In‐service (Lecture)Case study

Education resources Food handler program

Evaluation of competency

ObservationTesting


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Disaster Preparedness and Safety

• Knows procedure for use of fire extinguishers and/or fire suppression systems

• Knows procedures for reporting accidents and injuries

• Maintains system for labeling chemicals

• Ensures elimination of possible trip hazards

CMS Regulatory Standards – Disaster/Safety

• The emergency preparedness program must describe a facility's comprehensive approach to meeting the health, safety, and security needs of their staff and patient population during an emergency or disaster situation

• Interview the facility leadership and ask him/her/them to describe the facility’s emergency preparedness program

• Ask to see the facility’s written policy and documentation on the emergency preparedness program

Education and Evaluation – Disaster/Safety

Education period New Employee OrientationAnnual education

Training type In‐service (Lecture)Case studyOn‐the‐job training

Education resources


ObservationTestingInterview


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Resident Rights

• Knows and respects residents’ rights to refuse treatment

• Honors resident’s preferences when providing drinks and food

• Knows and follows facility abuse reporting for all types of abuse situations (verbal or physical)

CMS Regulatory Standards – Resident Rights

• Determine staff response to a resident who refuses to go to the dining area, or refuses the meal or meal items offered, or requests a substitute.

• If concerns are identified, interview the resident to determine whether: • The resident was involved in choosing when to eat; • The resident was involved in choosing where to eat; and/or • The food offered takes into account the resident’s food preferences

• Interview staff regarding the facility protocol to identify where and when a resident eats, how staff knows whether a specific resident eats in a specific dining room or other location, and how food preferences are identified and submitted to the dietary department.

Education and Evaluation – Resident Rights


Training type In‐service (Lecture)Case studyRole play

Education resources Guideline and procedure manualResident counsel participation


ObservationInterviewTesting


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Ethics

• Avoid Conflicts of Interest ‐ avoid any relationship or activity that might impair the ability to make objective and fair decisions when performing your job• Hiring or supervising family members or closely related persons• Accepting gifts, discounts, favors or services from a customer/potential customer, competitor or supplier, unless equally available to all employees

• Be Loyal ‐ do not disclose confidential and nonpublic information without a valid business purpose and proper authorization• Company resources, including time, material, equipment and information, are provided for company business use

Ethics ‐ HIPAA

• HIPAA stands for the Health Insurance Portability and Accountability Act

• Protected Health Information (PHI) is information created, transmitted, received or maintained including demographic information, related to the individual including, but not limited to:• Name

• Date of birth

• Room number

• It is the responsibility of the employees to protect and maintain HIPAA standards

Education and Evaluation – Ethics


Training type In‐service (Lecture)Case studyRole play

Education resources Company HR representativeCode of conductEmployee manual


Annual testing


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Food Safety

• Uses thermometers correctly to check food temperatures

• Ensures food cooling procedures to minimize potential foodborne illness

• Cooks food to the correct minimum internal temperature

• Demonstrates procedures for preparing modified consistency diets (e.g. pureed, mechanical soft)

Food Safety

• Assures hot foods are held at 135°F and cold foods below 41°F

• Implements rules of safe practice for handling and discarding leftover foods

• Demonstrates thickening drinks and liquids to appropriate dysphagia thickness

• Understands potential risk for cross‐contamination and threat of foodborne illness

• Stores chemicals away from food and other food‐related supplies

• Store food 6” off the floor and 18” from the ceiling

CMS Regulatory Standards – Food Safety

• Food is procured form sources approved or considered satisfactory by federal, state, or local authorities

• Food is stored, prepared, distributed, and served in accordance with professional standards for food service safety


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Education and Evaluation – Food Safety

Education period New Employee OrientationOngoing, recommended at least one food safety topic quarterly


Education resources Food handler programGuideline and procedure manual


ObservationTesting

Nutrition

• Dependent on resident population and acuity, staff members should be able to identify diet order information and basic nutritional components

• Identify food allergens and associate correctly to ingredients and recipes

• Demonstrate understanding of available substitutes and alternate food items

CMS Regulatory Standards – Nutrition

• Determine whether staff attempt to determine the reason(s) for the refusal and offer a substitute item of equal nutritive value or another food item of the resident's choice.

• If staff do not offer an alternative item, interview the resident to determine whether he/she is provided a substitution when he/she does not wish to have the item being served.

• Interview staff in order to determine what is available for substitutes for the meal observed.


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Education and Evaluation – Nutrition



Education resources Diet manualDiet spreadsheetAllergy training


ObservationInterview

Customer Service

• Speaks with residents politely, respectfully, and communicates personal information in a way that maintains confidentiality

• Respond to resident's requests in a timely manner

• Talk with residents for whom they are providing assistance rather than conducting social conversations with other staff who are assisting other residents;

• Allow residents the time needed to complete eating their meal

CMS Regulatory Standards – Customer Service

• Observe whether staff (for example – list not all‐inclusive): Provide meals to all residents at a table at the same time;

Provide napkins and nondisposable cutlery and dishware (including cups and glasses);

Consider residents’ desires when using clothing protectors;

Wait for residents at a table to finish their meal before scraping food off of plates at that table;


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CMS Regulatory Standards – Customer Service

• Observe whether staff (for example – list not all‐inclusive): Sitting next to the residents while assisting them to eat,

rather than standing over them; Talk with residents for whom they are providing assistance

rather than conducting social conversations with other staff who are assisting other residents;

Allow residents the time needed to complete eating their meal;

Speak with residents politely and respectfully and communicate personal information in a way that maintains confidentiality; and

Respond to resident's requests in a timely manner.

Education and Evaluation – Customer Service


Training type In‐service (Lecture)Case studyOn‐the‐job trainingRole play

Education resources YouTubeRestaurant Field Trip


ObservationTesting

Your turn!Mock In‐Service


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Resources for Employee Competency

• ANFP Competencies for Food and Nutrition Services:http://www.anfponline.org/docs/default‐source/cbdm/anfp‐template‐competencies‐for‐dietary‐employees.pdf

• CMS Food service observation form: https://www.cms.gov/Medicare/Provider‐Enrollment‐and‐Certification/SurveyCertificationGenInfo/Downloads/Kitchen‐Food‐Service‐Observation.pdf

• CMS Dining observation form:https://www.cms.gov/Medicare/Provider‐Enrollment‐and‐Certification/SurveyCertificationGenInfo/Downloads/Dining‐Observation.pdf

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