Resetting the Table with Confidence and Best Practices

Running Your Business, Senior Living & Healthcare

Healthcare and senior living foodservice moves to a new normal with COVID-19

The COVID-19 pandemic sent shock waves through healthcare and senior living organizations. Food and nutrition services made many changes and will continue to adjust as they provide high-quality, nutritionally sound and delicious meals—all while focusing on the safety of patients, residents and team members. As communities relax COVID-19 precautions, it’s necessary to examine daily operations and service points.

This resource summarizes best practice strategies collected from foodservice operators and industry leaders to help foodservice managers plan for efficient, cost-effective changes. Consider this as you create policies and procedures that comply with your regulations.

An Adaptation Checklist

As healthcare and senior living foodservice adjusts to what’s next during the pandemic, these are four primary areas of focus:

Streamline your menu
Examine back-of-house procedures
Examine front-of-house procedures
- Communal dining
- Self-service areas
- In-room dining
- Retail
Employee safety

Every operation expects front-of-house changes, but many of those changes are dependent on implementing menu and back-of-house procedures. Once those areas are addressed, be sure to:

Plan for new equipment needs
Develop new policies/procedures
Determine appropriate staff levels
Implement staff training
Ongoing evaluation and adjustment

Menu planning

Plan a menu to match staffing levels, while offering the highest level of guest satisfaction.

Streamline variety while still offering a reasonable choice of offerings
Keep the menu flexible to allow for shortages or supply-chain disruptions
If your menu includes delivery, identify offerings best suited for delivery
Consider adding grab-and-go menu options
Remove high-prep menu items if you have labour and/or space constraints
Adjust or eliminate “cook to order” options
Focus on menu items your guests enjoy most
Adjust order quantities, recipe yields and production counts based on updated forecasts

Back-of-house operations

Address operational accommodations to ensure minimal staff contact and social distancing while working.

Increase frequency of cleaning and sanitizing surfaces in your kitchen and employee break rooms
Check dish machine chemicals and wash and rinse temperature gauges more often.
Restrict staff allowed in kitchen (i.e., separate culinary from servers)
Communicate cleaning protocols to staff and assign champions to hold the team accountable. Teach your team to (respectfully) call out one another for safety/sanitation lapses.
Set up a delivery cart disinfecting and sanitizing area
Reinforce personal hygiene and hand-washing policies.
- Consider a mobile hand-washing station or making hand sanitizer available in locations not close to a sink
- Promote hand-washing through campaigns. For example, set a timer to signal hand-washing every 30 minutes, above and beyond normal.
Consider investing in equipment and technology, such as delivery carts and digital pre-order systems, to assist long-term strategies

Front-of-house operations

Follow provincial and local government recommendations when reopening communal dining areas. Plan to address these four areas:

1. Communal dining

Expect residents to be cautious about gathering again for meals. You can reassure them by demonstrating your attention to safety.

Thoroughly clean and sanitize food-contact surfaces, and disinfect non-food contact surfaces. (Be aware of other considerations if the dining area was used for alternative functions while communal dining was closed.)
Have a visible cleaning strategy that instills confidence in your residents. Increase the frequency of regular surface cleaning and sanitizing (i.e., every 1-2 hours, while open)
Adjust front-of-house procedures and job descriptions to match needs created by menu changes (such as no self-service or reduced menu choices)
Redesign seating arrangements
- Remove tables/chairs or mark them as “closed” to comply with social distancing and occupancy rules
- Reduce the number of seats at each table to comply with social distancing rules.
- Arrange chairs at tables so residents are on the outside of rooms and facing the same direction (not face-to-face), in order to increase distance from one another
- Utilize unused space in other areas of your organization for a temporary dining area
Include walking pathways with ample space for social distancing, marking one way traffic, if necessary
Screen guests for symptoms per recommended guidelines
Post signage at the entrance and throughout the dining area about social distancing, frequent hand-washing, and that no one with COVID-19 symptoms can enter.
Provide hand sanitizer at entrance and, if possible, include a staff member to encourage use. Encourage use of sanitizer before and after the meal.
Post a cleanliness commitment/statement for your guests to see
Between seatings:
- Clean and sanitize table tops and chairs
- Replace table coverings (use placemats in place of cloth covering)
- Clean and sanitize condiment caddies (single-use items should be discarded)
- Eliminate table presets, use rolled silverware
- Minimize centrepieces
Develop a serving schedule that allows you to serve the anticipated number of guests.
- Multiple seatings with allotted time for arrival/departure
- Reservations only
- Assure an ample waiting room area to allow 2 metres between guests.
Utilize pre-order systems to reduce time in the dining room
If using menus at the table, use digital ordering, disposable menus or menus that can be disinfected after each use
Offer grab-and-go options from kiosks/carts in other areas to reduce people in dining area
Senior living considerations:
- Screen guests for symptoms prior to allowing them in the dining room. Consider daily screening vs. by meal.
- Start communal dining one or a few times a week to assess operational challenges before expanding
- While occupancy rates are capped at lower capacity, phase in communal dining on alternate days or meals for each resident (eat in the dining room for lunch, in room for dinner, etc.) based on resident preferences
- Collaborate with nursing staff to assure assisted diners receive adequate help

2. Self-service stations (food, drink, condiments, utensils)

These areas may have been closed off for safety or regulatory reasons. If self-service food or beverage stations are to be used, consider:

Schedule frequent cleaning and sanitation
Assure an approved sneeze guard is in place
Provide disposable gloves if guests are dishing their own food
Provide staff to dish out the food items instead of true self-service
Put out smaller batches and replenish often
Provide disposable cups for beverage and hydration stations. Do not allow reusable cups.
Enforce using clean dishes on return visits to self-service areas
Provide wrapped silverware to each guest
Use portion control condiments in place of bulk

3. In-room meals/room service

Offer patients and residents the high level of food and service they enjoyed before COVID-19 changes. Always follow approved infection control/isolation policies. Consider:

Offer choice of food and time to eat to the highest extent possible
Include daily inspirational or comedy cards with meals
Modifying in-room meal delivery in non-COVID care areas or non-isolation rooms
- Use a minimum-contact process (stand at the doorway) to take meal orders
Deliver and retrieve trays following standard precautions
- Portable carts with warming/cooling chambers allow for choice dining and help maintain desirable food quality during delivery
Use regular dinnerware and utensils (vs. disposables)
Process all dinnerware and utensils following approved isolation guidelines policy
Modifying meal service for isolation rooms/units
- Use a minimum-contact process (such as phone) to take meal orders
- Use nursing staff to deliver meals, and align the timing with other room visits (helps conserve personal protection equipment [PPE])
- Allow nursing to retrieve trays and load them into the foodservice cart using standard or transmission based precautions. Sanitize the outside of the cart before returning to a foodservice team member, and return to foodservice following procedure.
- Process all dinnerware and utensils following approved isolation guidelines policy
Avoid cross-contamination while using a tablet to collect orders, such as:
- Only allowing staff to touch it (associate stands in doorway and taps in patient or resident order)
- Sanitize devices between uses by different people
Offer snack and hydration options by using carts down the hallway

4. Retail

Establish protocols to limit capacity. Think about the number of expected visitors during each phase.

Reconfigure front-of house to maximize distance between customers
- Remove tables and chairs or block off seating
- Assure adequate space for walking. Consider posting signs for one-way routes.
Offer mobile ordering for order ahead
Minimize contact at payment
- Offer touchless payment through phone or payroll apps
- Have guests swipe their own cards
- Use plexiglas barriers at registers in addition to PPE
Post social distancing reminders and decals on floor

Employee safety

Promote staff safety to prevent them from risking their health and jeopardizing your ability to provide care to patients/residents.

Screen employees according to your policy.
Send them home if they exhibit or report symptoms while working. Follow policies approved by the Public Health Office and authorities in your province
Train new employees, and retrain existing employees. Post signs to emphasize:
- What signs and symptoms they are required to report to a supervisor
- When to stay at home if sick
- Standard procedures and importance of cleaning, sanitizing, disinfecting
- Standard procedures and importance of hand-washing and hand sanitizer use
- Avoid touching face
- Courtesy statements to use with guests as you work through new policies
Enforce your organization’s policy and local authority for wearing face coverings while working, including guidance on:
- When foodservice workers are permitted to remove face coverings, such as when eating on break.
- How to store a face covering if removed during a shift, such as in a labeled paper bag.
- How to keep coverings clean and laundered daily
Update job descriptions and emergency duties to highlight new procedures. Consider designating employees as leaders in key areas like cleaning, hand-washing and social distancing to influence compliance among peers
Limit the number of employees allowed in break rooms simultaneously
Adjust staff huddles to observe social distancing
Post important information, especially changes, on bulletin boards or digital messaging
Illustrate your cleaning policies in action, via social media