NHS East Lancashire Clinical Commissioning Group supports the use of home made milkshakes and food fortification to ensure that individuals receive a nutritionally balanced diet consisting of adequate calories. We do not endorse the prescribing of Oral Nutritional Supplements for residents in care homes, unless specific exclusion criteria apply as outlined in the policy below. We are proud to support Food First. Residents with a poor nutritional intake should be encouraged to eat fortified meals and offered homemade milkshakes, high energy snacks etc instead of Oral Nutritional Supplements. A number of useful documents have been drawn up to assist care home staff with implementing the changes.