Ahmed, a 65-year-old man, is a voluntary inpatient in an Acute Mental Health Unit.  He has been admitted for assessment and treatment of severe depression. Ahmed moved to the UK 20 years ago from Asia.  On admission, Ahmed is found to be underweight and he reports a moderate loss of appetite which has increased during his stay on the unit.  Ahmed enjoys eating his wife's homemade food but dislikes hospital food on the whole.  This seems to have contributed to a steady, continual loss of weight.  

You are the Health Care Support Worker on duty.  You have spoken to Ahmed and encouraged him to fill in his daily menu choice.  Ahmed continues to be unmotivated and seems disinterested but fills the form in anyway.  Ahmed has also been referred to the dietician. 

At mealtime, you notice that Ahmed has not eaten any of the food which has arrived from the kitchens, and despite encouragement, asks you to take his tray away.  You report this to the nurse in charge and document your observation in Ahmed's notes.  At visiting time, you notice that Ahmed is sat with his wife and is eating curry and rice in the day room.

It is evident that Ahmed's wife has, against the hospital policy, brought food in for him.  The policy states that due to legal obligations (Food Safety Act 1990) relatives and patients cannot bring in meals containing cooked meat as they may support the growth of pathogenic bacteria.