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Food hygiene in care homes – should we be worried?

Elderly people are amongst the most vulnerable to contracting food poisoning, which is why a recent report in The Guardian is so concerning. Having studied data from the Food Standards Agency (FSA), it found that care homes failed food safety inspections more than any other type of care provider. In fact, more than 200 residential, nursing and care homes in the UK received poor scores under the Food Hygiene Rating system.

Why are older people more likely to get food poisoning?

Elderly lady in care home

As we get older, our immune systems become weaker. We produce less stomach acid and our kidneys also function less efficiently. This makes it harder to fight off bacteria, control bacteria in the stomach or filter bacteria from the blood through the kidneys. Older people often have health problems, for example diabetes, arthritis, cardiovascular disease or cancer. some form of medication to control these can also affect their immune systems. All these factors combined make the elderly more likely to be susceptible to food poisoning than, say, a healthy young adult.

How are Food Hygiene Ratings determined?

Food Hygiene Rating

Food safety officers from the local authority inspect businesses to ensure that they comply with food hygiene law. This applies to any type of business which serves food, including restaurants, cafes, take-aways, some retailers, hotels, care homes, nurseries, hospitals, schools etc. During an inspection the following 3 elements are checked – all of which are essential:

Food Handling

i.e. how hygienically the food is prepared, cooked, re-heated, cooled and stored.


The officer will inspect the cleanliness of a building, the layout of a food preparation area, the lighting, ventilation and other facilities.


Also under scrutiny is how the business manages its food hygiene systems. In other words, what it does to make sure the food that it serves is safe and how confident the officer is that the standards will continue to be maintained.

Once the inspection has taken place, the business is given an overall food hygiene rating. The overall rating takes account of the element/s most in need of improvement and the level of risk that these particular issues pose to people’s health. The scale ranges from zero to five – with zero bring ‘poor’ and five being ‘very good.’ Any business receiving a rating of 5 has performed very well in all 3 areas.

Where a score of less than 5 is awarded, the inspector will explain what action needs to be taken to improve the rating. In the case of a zero rating (urgent improvement required) the business has performed poorly in all areas. The premises may be insanitary, the storage, heating, cooling and preparation of food will be of particular concern and management systems will be poor to non-existent.

Can a zero-rated business be shut down?

Zero-rated businesses can be shut down immediately if the risk to health is deemed particularly high. Alternatively, the business in question can be given 28 days to address the most urgent concerns. During this period, they will be revisited on more than one occasion to ensure that the work has been undertaken satisfactorily. If they wish to be re-scored they will need to pay £160. Otherwise they will need to wait until the next scheduled inspection, which will be roughly six months later.

Examples of non-conformance in the zero-rated care homes mentioned earlier included evidence of cross-contamination between raw and cooked foods, mouldy and expired food found in fridges, no facilities for handwashing and unsatisfactory cooking equipment. There was also a lack of food safety management documentation.

How can care homes improve their chances of a good Food Hygiene Rating?

One of the best things they can do is ensure that everyone involved in the preparation of food has the appropriate food safety training. This will ensure that staff are aware of the importance of cleanliness and hygiene, the dangers of cross-contamination, the nature of pathogens which can cause food poisoning, the correct way to store, handle, heat, re-heat, cool and refrigerate food to ensure that it is safe to eat. All staff should hold a Level 2 Food Safety qualification as a minimum, but supervisors and managers would be wise to undertake Level 3 Food Safety training.

Information on our food safety courses. Don’t forget that we can also provide in-house training at your own premises – just ask for details.