1203 SUPPORTING SAFE SWALLOWING OF CARE HOME RESIDENTS WITH DYSPHAGIA: HOW DOES CARE COMPARE WITH GUIDANCE?

Abstract Introduction Dysphagia affects up to 70% of nursing home residents, causes significant morbidity and increased hospital admissions. Speech language therapists (SLT) make recommendations reduce the risk aspiration support safe eating drinking but have limited capacity offer ongoing guidance care staff. This study aimed measure mealtime experience residents with dysphagia, how this compared SLT advice what factors influenced care. Methods The safety nutrition/hydration dysphagia in 2 homes was observed using a structured tool capturing 12 elements expected practice. Observed practice SLT/care-plans. Interviews staff understand that contributed delivered. Results for 18 were predominantly focused on food/fluid modification, other swallowing strategies mentioned less frequently. 66 episodes 11 observed. Adherence SLT/care-plan food texture, posture alertness resident 90% occasions, than 60% occasions alternating drink, prompting during feeding, ensuring swallow completed throat/mouth clear. Compliance recommended fluid thickness 68%; thickening frequently not aligned required IDDSI level. Nutrition when fed dining room multiple present. found care-plans rarely consulted, needs communicated verbally handover, training targeted at modification safer strategies. Limited knowledge about coughing whilst eating/drinking drove inappropriate referrals. Conclusions A culture addresses system workforce issues would improve their aspiration.