ENABLE Scotland supports adults and children with learning disabilities living in their own homes, or shared accommodation, to achieve their personal goals. Since 2007, it has encouraged its staff to train in nutrition to ensure people using their service receive consistent food and health messages and support.
ENABLE Scotland is a dynamic charity run by its members, employing around 2000 support staff.
It has developed a wide range of services across Scotland for people with learning disabilities and their families since it was begun by a group of parents in 1954. This includes employment support, support at home and in the community. It works in partnership with a range of other organisations and campaigns for better opportunities for people with learning disabilities.
It provides information and training which can be accessed by anyone in the care sector. Individuals who are eligible for a Scottish Government Individual Learning Account (ILA) can use this to pay for ENABLE training.
In 2007, ENABLE received a small grant from CFHS to develop a half-day nutrition and health course to add to its training programme.
How it worked
Staff training in food and health
The half-day course was designed for anyone who assists people with learning disabilities to plan menus and make meals. It covers:
- a basic introduction to the relationship between food and health;
- practical information and advice on healthy eating;
- factors that affect food intake and choice;
- a basic understanding of nutrients, their sources and functions; and
- the importance of a balanced diet and how to promote healthy eating.
ENABLE has ensured comprehensive provision of this course by training its staff in several regions to deliver it locally. Staff must complete the six-hour Royal Environmental Health Institute of Scotland (REHIS) accredited Elementary Food and Health course and an ENABLE ‘Becoming an Effective trainer’ course before they are able to run the half day course. A small core group of ENABLE staff regularly deliver the half-day course and as the result, most team leaders and a range of other staff from across Scotland have completed it.
The core group of staff trainers meet two or three times a year to keep up to date and share good practice. They have found that that people using the service are now more likely to receive more consistent information about food and health – catering staff have improved menus and staff are more likely to be asked about their cooking skills during recruitment.
Staff training in Argyle and Bute
Since the nutrition and health course became available, Mary-Rose Crofts, an ENABLE team facilitator has delivered the half-day course to most staff in her area. She is passionate about food and its link with health and had a background in catering when she started working with ENABLE. She regularly delivers both food safety training and the half-day nutrition course. She has further enhanced her food and health knowledge by completing the Royal Society for Public Health diploma in Nutrition.
Those attending her course are encouraged to work together to develop practical solutions to any challenges they feel they might face, such as implementing any changes to menus or supporting someone with their food choices. They discuss challenging issues around supporting people with their daily food choices and aim to achieve a balanced approach. Mary-Rose follows up staff who might need support after the course and provides an informal mentoring role if requested.
Training for people with learning disabilities
In the last year Mary-Rose has expanded the work beyond staff by piloting a training course for six adults using the service. She used the Scottish Consortium for Learning Disability (SCLD) ‘Healthy Eating, Healthy Living’ training pack which aims to be suitable for people with a range of learning disabilities. It has 22 training sessions outlined and covers topics such as fat, salt, sugar and fibre, using practical activities.
Mary-Rose used a flexible approach to work through the whole training pack – taking about a year to complete it, which ensured that all six participants did not miss sessions because of holidays or other absences.
To maintain momentum and learning in-between sessions, all the participants were given ‘homework’ activities to complete. Two Personal Assistants (support staff) regularly attended with a couple of the participants.
Mary-Rose used any opportunities during the course to incorporate physical activities or messages, such as learning about and checking food labels by walking to, and around all the food outlets in Helensburgh, where the course was held.
Overall, approaches that helped ensure a successful course were:
- buy-in from support staff – participants sought help from staff in order to complete homework tasks and this worked well
- the visual activities from the training pack, and others such as the FSA eatwell plate mat were easy to use and participants enjoyed using them
- working with the same group of participants (and Personal Assistants) throughout the course – other potential participants were interested in joining the course after it had started, however, Mary-Rose felt this might compromise both the participants learning and the social cohesiveness of the group
- a team facilitator from another team came in to monitor the physical outcomes of this pilot course – they encouraged participants to take part in monitoring their BMI and blood pressure before and after the course, this left Mary-Rose to focus on training
Staff and participants were on an equal footing on the course – they learnt together and applied their learning in their own life choices away from the course.
Participants were empowered to take control of their own lives and health.
By the end of the course, all six participants and two Personal Assistants that had regularly attended reported that they had improved their food and health skills; both of the Personal Assistants and two participants had lost significant excess weight and two others had reduced their blood pressure.
The Keys to Life is the new learning disability strategy in Scotland. It follows on from, and builds on the principles and successes of ‘The same as you?’ the original review of service for people with a learning disability. The emphasis of the Keys to Life is on health, and reducing health equalities that are experienced by people with learning disabilities. Upholding human rights are integral to its approach.
In terms of diet, the strategy reports that less than 10% of adults within supported accommodation consume a healthy, balanced diet. It also reported that people with learning disabilities are more likely to be overweight or underweight compared to the rest of the population. The work of ENABLE and other organisations is essential in tackling these important health issues.
Other learning disability support organisations in the area have heard about the delivery of the ‘Healthy Eating, Healthy Living’ course and were keen for those using their services to be able to attend. The Argyll and Bute Wellbeing group and Argyll Voluntary Action recently awarded ENABLE Scotland funding so that Mary-Rose can offer the training course to people being supported by four other organisations in the area over the next few years. The course already has a waiting list. Mary-Rose will also continue to support the initial group of participants, who will continue to meet informally each month.