IDDSI Framework
Practical guidance for safe swallowing in care kitchens — levels 0–7, quick texture tests, and service checks your team can use today.
What is IDDSI?
The International Dysphagia Diet Standardisation Initiative (IDDSI) provides a common language for food and drink textures to support individuals with swallowing difficulties. Levels run from 0 (Thin) liquids to 7 (Regular) foods.
- Improves safety and clarity between kitchen, care staff and clinicians.
- Simple texture checks help teams verify consistency at the point of service.
- Menus and labels should clearly show the IDDSI level for each item.
IDDSI Levels (quick reference)
| Level | Name | Typical examples | Key characteristics |
|---|---|---|---|
| 0 | Thin (drink) | Water, tea, coffee | Flows like water. |
| 1 | Slightly Thick | Fortified drinks | Thicker than water, still sippable through a straw. |
| 2 | Mildly Thick | Milkshakes, smoothies | Drips slowly off a spoon; sips through a wide straw. |
| 3 | Moderately Thick / Liquidised | Thickened soups | Cannot be drunk with a straw; pours from spoon. |
| 4 | Extremely Thick / Pureed | Smooth purees | Holds shape; no lumps; sits on spoon; not pourable. |
| 5 | Minced & Moist | Finely minced meats, moist mash | Very small, soft pieces; can be mashed with fork. |
| 6 | Soft & Bite-Sized | Soft casseroles, tender veg | Bite-size pieces (approx. 1.5 cm); easily broken with fork. |
| 7 | Regular / Easy to Chew | Everyday meals (soft options) | Normal texture; consider softer choices as needed. |
Always follow the resident’s assessed level and any speech & language therapy guidance.
Quick texture checks (service side)
10-second test (Level 4)
Place puree on a spoon; when tilted for 10 seconds, it should remain mound-like and not pour off.
Fork-drip test (Levels 2–3)
Liquid should drip slowly through the prongs; for L3 it sits briefly then falls in dollops.
Fork-pressure (Levels 5–6)
Food should break apart with gentle fork pressure and not require significant chewing.
Document any failed check and correct before service (e.g., further blending, adding thickener, or moisture).
Menu planning & plating cues
Menu pointers
- Offer at least one **assessed level** option at each meal time.
- Use sauces/gravies to keep foods moist and cohesive.
- Avoid mixed consistencies (e.g., soup with lumps) for Levels 3–4.
- Label clearly on menu boards and plated tickets (L0–L7).
Presentation & dignity
- Use piping/moulds for purees to keep components distinct.
- Serve correct portion sizes; check temperature and moisture.
- Provide suitable cutlery, seating, and unhurried mealtimes.
- Record intake notes where required by the care plan.
Service checks & audit
Daily service checks
- Correct resident level noted on ticket / board.
- Texture verified at point of service (quick test as needed).
- Allergen controls and cross-contamination avoided.
- Hot holding / chilling within safe limits.
Weekly audit prompts
- Menu/recipes match IDDSI levels and are achievable.
- Staff refreshed on checks; records completed.
- Blenders/thermometers in working order and cleaned.
- Feedback from residents recorded and actioned.
We can supply simple **IDDSI check sheets** and **label templates** on request.
Training & handovers
Our chefs are briefed on local policies, IDDSI levels in use, and any resident-specific needs before service. We leave concise handover notes with any texture adjustments made.
Typical briefing list
- Resident levels & high-risk alerts (allergies, choking risk).
- Menu for the day and feasible texture modifications.
- Available thickeners/equipment and label system.
- Service times, assistance, and documentation required.
Need IDDSI-aware cover?
Book an experienced care-sector chef — safe textures, clear documentation, calm service.