Regulation 14: Meeting nutritional and hydration needs

“The nutritional and hydration needs of service users must be met.” (Regulation 14(1))

Reg 14(2) sets when the duty applies: where the provider gives accommodation, or where the service user stays overnight on the premises, or where meeting nutritional or hydration needs is part of the arrangements for care or treatment. A care home is squarely in scope; so is any service where feeding, fluids or eating and drinking support are part of the care given.

Reg 14(4) defines what meeting those needs means: suitable and nutritious food and hydration adequate to sustain life and good health; parenteral nutrition and dietary supplements where a health professional has prescribed them; reasonable requirements arising from a person’s preferences or their religious or cultural background; and, if necessary, support for the person to eat or drink. Where a person aged 16 or over lacks capacity, best interests under the Mental Capacity Act 2005 apply (Reg 14(5)).

For an in-scope service, CQC looks for nutrition and hydration to be assessed on admission and kept under review, with a recognised malnutrition screening tool where the risk warrants it, weights monitored, and food and fluid records that are not just kept but totalled and acted on. Where a person is losing weight or not drinking, the inspector follows the trail to the escalation: a referral to a dietitian or speech and language therapist, a changed plan, evidence the change held.

Preferences and cultural and religious requirements are part of the standard, not an extra. So is support to eat and drink for the people who need it. The record that satisfies Reg 14 shows the need was seen, met, and reviewed, for that person.

The most common gap is the food and fluid chart that is started but never totalled, so a low intake sits in the record unnoticed and unactioned. Next is weight loss that is recorded but not escalated, the numbers trending down with no referral behind them. Then there are preferences and cultural or religious requirements left off the plan, and the wrong assumption that a service is out of scope when eating and drinking support is in fact part of the care it gives. Each is a Reg 14 finding because the duty is tested on whether the need was met and the record can show it.

Verivius keeps the nutrition and hydration evidence in the care record and connects it to the risk and action trail: screening and review at the points the regulation expects, and an escalation that links a falling weight or intake to the referral and the change that followed.

Sample policy template: Nutrition and hydration. Further reading: Regulation 14 nutrition and hydration, what CQC-ready evidence looks like.