Scott Jones is curious about just how much money and effort goes into the meals made for his father, who lives in a Hobart-based aged care facility.
"They're feeding him rubbish," Mr Jones said, after seeing his father being offered party pies for breakfast.
"It's sad these old people have put up with meals that are substandard," he said.
Mr Jones travels to Tasmania to see his father when he can, and each time, he has been shocked by the food being served up in the home.
One meal he saw — a plain bakery scroll and a few bits of lettuce — prompted him to complain.
"That was just absolutely ridiculous. I was gobsmacked, to be honest," Mr Jones said.
Revelations about poor quality food and malnutrition were among the disturbing issues that kicked off the Royal Commission into Aged Care in 2018.
In July 2021, the former Morrison government announced a $350 million taxpayer funded package to change that.
The Basic Daily Fee (BDF) supplement meant eligible aged care providers received an additional $10 per day per resident specifically to improve the quality of their food.
As of October 1, the 2021 BDF supplement was rolled into general funding for the sector, known as AN-ACC, and the change has many advocates concerned.
"This money was supposed to be directed towards improving the quality of meals in aged care," Dr Sarah Russell from advocacy group Aged Care Matters said.
"But now that it's going into general funding, we have even less idea how they're spending it."
Dietitians Australia was already sounding the alarm about the food quality before the funding change.
President Tara Diversi said dietitians working in aged care haven't seen a consistent improvement in food quality since the Royal Commission and supplement announcement.
"We still have 800 aged care facilities that are not spending the minimum of $10 on food per person per day," Ms Diversi said.
"That's something that we need to see if malnutrition is going to be improved across aged care facilities."
She wants to ensure the $10 supplement is spent on food, and is calling for regular monitoring by dietitians. She said they should visit every aged care home "once a year".
"[It's so] they can do that nutrition assessment, provide recommendations and guidance about how you can spend that $10 per person per day," Ms Diversi said.
But Tim Hicks from the Aged and Community Care Providers Association wasn't convinced the extra assessment was required.
He said homes already sought specialist support for their menus, and the focus should be on "nutritionally adequate food" that was "also attractive for people to eat".
"That's probably the bigger innovation that the sector needs to focus on to address things like malnutrition," Mr Hicks said.
Concerns about 'substandard quality'
Flinders University, which is surveying families of aged care residents across Australia, has identified similar concerns.
Of the 260 responses so far, 85 per cent of families said there was "room for improvement when it comes to the food and dining experience of their loved one" and they were concerned about the "substandard quality of meals".
Those concerns were based on the "appearance, taste and temperature of the food", a lack of fresh produce and reliance on frozen or packaged food.
The survey also found that dietary requirements like coeliac disease are often overlooked and that residents who need help to eat, don't always receive assistance because of poor staffing.
The latest available health department figures also show only about two thirds of nursing homes report spending $10 per resident per day or more on food.
And 2 per cent of homes spent $6 or less on food.
Latest available data from the Australian Institute of Health and Welfare showed about 10 per cent of aged care residents suffered unplanned weight loss.
'There is an improvement'
But some aged care homes have found solutions to malnourishment and unappetising meals.
The not-for-profit Adventist Aged Care spends $100,000 a year on a consultancy designed to improve food for its 330 Queensland residents.
Its Caloundra Manager, Manpreet Gill said there had been measurable benefits from it.
"Our severe malnutrition rates have decreased from 11 per cent to zero. And, positive engagement with the dining room experience has improved by 37 per cent for residents with dementia," she said.
The program was developed through the Lantern Alliance, a social enterprise, and involves education, higher-protein meals and changes to the dining environment.
"That needs to be a calm and relaxing environment, with no distractions and soothing music. And, for residents with dementia, staff need to stay there one-on-one until they finish their meal," Ms Gill said.
Margaret Manson moved into Adventist Aged Care earlier this year.
"I enjoy the meals, I think they're pretty good. It's quite a big organisation but they cope well, we get quite a bit of variety," she said.
In a statement to the ABC, the Department of Health and Aged Care said the Government was consulting on a new nutrition standard for the whole industry.
It also said there was now greater transparency and monitoring of food in aged care.
Mr Hicks supports greater accountability.
"There is an improvement that is ongoing and has been for some time," Mr Hicks said.
He also hit back at claims that some providers have pocketed the government supplement and said that two thirds of providers are operating in a deficit.
"The industry is actually spending its own money to make up for the current inadequacies in funding," Mr Hicks said.
