Eating for Health: Older adults in care homes
A nutritionally balanced menu provides the following:
- At least 1 portion of starchy food at each meal
1 portion = 1 slice bread, 1 bread roll, 2 tablespoons rice/pasta, 2 egg size potatoes, a scoop of mashed potato, 2 tablespoons chips - At least 2 portions of vegetables each day
1 portion = 2 tablespoons of cooked vegetables (not including potatoes), 1 cereal bowl of salad - At least 2 portions of fruit each day
1 portion = 1 banana /apple/orange, 2 satsumas/plums/kiwis, ½ tablespoon dried fruit, 150ml fruit juice, 3 tablespoons stewed or tinned fruit, 1 cupful of berry fruit (e.g. grapes, strawberries) - At least 2 portions of protein foods each day
1 portion = 2 slices of meat, 1 large fish fillet, 1 chicken breast, 4 tablespoons beans/ lentils/ baked beans, 2 eggs, 1 tablespoon peanut butter - At least 3 portions of dairy foods or dairy alternatives each day
1 portion = 1/3 pint milk or calcium fortified plant-based alternatives, 1 yoghurt, 1 ladle of custard/milk pudding if made with milk/ milk alternative, 1 small matchbox size of cheese.
All products should be full fat* - Nourishing snacks between meals and a milky drink at supper
Mid-afternoon and supper snacks should not always be a biscuit. Examples are cake, teacake, malt loaf, cheese and crackers, mousse, fromage frais, trifle, fruit and cream, ice cream, yoghurt, nut butter on toast.
If your resident is malnourished or at risk of malnutrition please fortify meals and drinks where possible.
* If you are concerned about an increase in a particular resident's weight, then use low fat options and/or smaller portions.
The Eatwell Guide
The Eatwell Guide shows how much of what we eat overall should come from each food group to achieve a healthy, balanced diet.
'Eating for health' means including foods from all the food groups on the plate. Older people shouldn't be restrictive in their protein and energy intake and therefore adequate quantities of foods that provide these should be included in their diet. Women past the menopause and men aged over 55 may have increased requirements for calcium so it is important to ensure residents are regularly including dairy or calcium fortified dairy alternatives in their diet.
Vitamin D is essential for bone and muscle health, and supports a healthy immune system. Most residents should take a daily supplement containing at least 400IU (international units)/ 10 micrograms which should be purchased over the counter - speak to your dietitian, GP or pharmacist for more advice.
Image: OHID in association with the Welsh government, Food Standards Scotland and the Food Standards Agency in Northern Ireland.
Sample menu for well-nourished residents:
- Breakfast
Bowl of cereal with full fat milk
1 slice of toast with butter
Glass of pure fruit juice - Mid-morning
Cup of coffee
2 biscuits - Lunch
Cottage pie with peas and carrots
Bread and butter pudding with custard
Cup of tea/dilute squash - Mid-afternoon
Cup of tea
Scone with butter and jam - Evening meal
Scrambled egg & tomato on toast
Tinned fruit & cream
Cup of tea/dilute squash - Supper
Cheese and biscuits
Food First Advice
All residents who are identified as malnourished or at risk of malnutrition should receive the following 'Food First' treatment every day*, in addition to a balanced menu where possible, to help increase their intake:
- 1 pint of fortified whole milk per day
- 2 nourishing snacks or drinks a day
- 3 fortified meals every day
*Please refer to the 'Nutritional Care: Food First advice to promote weight gain' diet sheet for further details.
Sample menu for malnourished or at risk residents
- Breakfast
Bowl of cereal with full fat fortified milk
1 slice of toast with butter, jam/honey/other
Glass of pure fruit juice
- Mid-morning
Cup of milky coffee (made with fortified milk)
2 biscuits - Lunch
Cottage pie (mashed potato with butter and cream/cheese) with peas and carrots (add butter)
Bread and butter pudding with custard (made with fortified milk)
Cup of tea/dilute squash
- Mid-afternoon
Homemade milkshake/smoothie/soup
Scone with butter and jam - Evening meal
Scrambled egg & tomato on toast
Tinned fruit & cream
Cup of tea/dilute squash
- Supper
Cheese and biscuits
Cup of Malted milk (made with fortified milk)
*Fortified Milk - 4 tablespoons of milk powder (Marvel, supermarkets' own) added to 1 pint full fat milk.
Add cream, butter, cheese, milk powder etc to food and drinks where possible.
Breakfast Ideas
If your resident is malnourished - fortify food and drinks
Omelette with fried mushrooms and buttered toast
Scrambled egg with baked beans and buttered toast
Wheat biscuits with sultanas, toast and jam
Porridge with prunes
Roast turkey with stuffing, roast potatoes, broccoli, carrots and gravy
Macaroni cheese with salad
Gammon ham with pineapple, mashed potato, broad beans and parsley sauce
Poached salmon steak with mashed potato, spinach and grilled tomato
Omelette with oven chips, peas and grilled tomato
Dessert ideas
If your resident is malnourished - fortify food and drinks
Apricot sponge with custard
Sliced banana and custard
Baked apple with sultanas
Rice pudding with dates
Images owned by The Caroline Walker Trust.
Fortified recipes - drinks
Milkshake
399kcals and 19g protein per serving
Serves 1
Ingredients:
200mls whole milk
1 scoop of ice cream
2 tbsp skimmed milk powder
3 tsp vitamin fortified milkshake powder, such as Nesquik or Tesco Milkshake Mix
Method:
1. Add all the ingredients together and whisk
2. Serve chilled or warmed
Fruit Smoothie
351kcals and 9g protein per serving
Serves 1
Ingredients:
200mls full fat milk
4 tsps dried milk powder
50mls double cream
1 small pot (125mls) full cream yogurt
1 banana - mashed (or other fruit)
1 scoop ice cream (optional)
Method:
1. Mix all ingredients together either with a whisk or in a blender
2. Serve chilled
Fruit Juice
192kcals and 2.3g protein per serving
Serves 1
Ingredients:
100mls fresh fruit juice
100mls lemonade
1 scoop ice cream
1 tbsp sugar
Method:
1. Mix all the ingredients together.
2. Serve chilled.
Fruit Yogurt Drink
234kcals and 9g protein per serving
Serves 1
Ingredients:
200mls fresh fruit juice or pureed fruit
1 small pot (125mls) full fat yogurt
Method:
1. Whisk all ingredients together
2. Serve chilled
Fortified recipes - desserts
Creamy Fruit Whip
360kcals and 6g protein per serving
Serves 4
Ingredients:
60g Instant Whip
170mls Evaporated Milk
130mls Fortified Milk
2 Bananas
125mls Whipped Cream
Method:
1. Line dishes with sliced banana (or other soft fruit)
2. Whisk instant whip with milk and gradually stir in the evaporated milk
3. Pour the mixture over the fruit and place in fridge to set
4. Top with whipped cream.
Fortified Milk Pudding
400kcals and 11g protein per serving
Serves 4
Ingredients:
850g prepared milk pudding
60g (4 tbsps) milk powder
120mls double cream
2 tsps jam to serve
Method:
1. Stir in milk powder and cream to ready prepared milk pudding
2. Serve each portion with a dollop of jam on top.
Mousse
308kcals and 5g protein per serving
Serves 4
Ingredients:
140mls full fat milk
3 tbsps dried milk powder
140mls double cream
60g Instant Mousse Packet
Method:
1. Make the mousse with the milk and milk powder
2. Blend in the cream
3. Leave to set
Fortified recipes - Savoury options
Quick and Easy Soup
350kcals and 19g protein per serving
Serves 1
Ingredients:
1 instant soup sachet
200ml full fat milk
2 tbsps skimmed milk powder
Method:
1. Warm the milk.
2. Gradually add the soup sachet and milk powder, stirring well.
Bubble and Squeak
370kcals per portion
Serves 8
Ingredients:
900g mashed potato
50g butter
100g grated cheese
8 rashers bacon - fried and chopped into pieces
8 tbsps double cream
Leftover vegetables, e.g. cabbage, peas, spring greens, carrots, swede
Salt and pepper
Method:
1. Stir the grated cheese, bacon pieces and cream into the mashed potatoes
2. Melt the butter in a pan and add the mashed potato mixture and vegetables
3. Fry for 10 mins turning over in the melted butter two or three times ensuring the potato and vegetables are thoroughly reheated
4. Season with salt and pepper as needed.
Serving suggestion: as a side dish as part of a main meal or with baked beans or extra cheese as a lighter meal.
Macaroni and Smoked Haddock
480kcals per portion
Serves 10
Ingredients:
875g macaroni
950g Smoked Haddock, skin removed
700mls fish stock
700mls Fortified milk
125g butter
100g plain flour
225mls double cream
Method:
1. Cook pasta until tender, drain & rinse in cold water
2. Put haddock in a pan with stock & milk, gently simmer for 10 mins
3. Melt butter in a large saucepan, add flour & cook whilst stirring for 2 mins
4. Gradually blend in the cooking juices, whisking until smooth
5. Simmer for 10 mins
6. To serve, flake fish into the sauce, add the cream & pasta then heat through.
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First Community (Head Office)
Call: 01737 775450 Email: fchc.enquiries@nhs.net Text: 07814 639034
Address: First Community Health and Care, Consort House, 5-7 Queensway, Redhill, Surrey, RH1 1YB.
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For office use only: Version 6 HPD_TS025 Publication date: May 2026