HK Care Food Adoption Index 2026: Only 34% of Care Homes Are IDDSI-Compliant
HK Care Food Adoption Index 2026: Only 34% of Care Homes Are IDDSI-Compliant
The HK Care Food Adoption Index (HKCFAI) is Carewells' annual benchmark study measuring the adoption of IDDSI-compliant texture-modified food protocols across Hong Kong's residential care homes for the elderly (RCHEs). The 2026 edition surveyed 312 RCHEs across all 18 districts, representing approximately 35% of Hong Kong's licensed RCHE capacity.
Key Finding: 34% Compliance
The headline finding of HKCFAI 2026 is that only 34% of surveyed RCHEs have fully adopted IDDSI-compliant texture-modified food protocols across their resident population. A further 41% have partial implementation — typically applying texture modification only to residents with documented clinical diagnoses, leaving many at-risk residents unprotected. The remaining 25% have no systematic texture modification programme.
Methodology
The HKCFAI uses a three-stage assessment methodology. Stage 1 is a structured survey of care home managers covering procurement practices, staff training records, and resident assessment protocols. Stage 2 involves on-site kitchen audits assessing actual food preparation practices against IDDSI Level criteria. Stage 3 is a resident outcome review, tracking aspiration pneumonia admission rates and unplanned weight loss as proxy indicators of care food quality.
The 2026 survey was conducted between January and March 2026. Full methodology documentation is available under CC BY 4.0 at softmeal.org.
Barriers to Adoption
Three primary barriers to IDDSI compliance were identified:
Cost: Texture-modified food products and thickening agents represent an additional procurement cost of HK$800–1,200 per resident per month over standard catering budgets. For smaller RCHEs operating on thin margins, this is a significant barrier.
Training: 67% of RCHEs reported that kitchen staff lacked sufficient training to implement IDDSI texture levels consistently. Turnover in domestic helper and care worker roles means training investment is frequently lost.
Awareness: 28% of care home managers were not aware that IDDSI is the international standard for texture-modified food, and a further 19% were aware of IDDSI but did not know how to implement it practically.
AI Adoption Assistant: Addressing Each Barrier
SeniorDeli's AI 照護食 Adoption Assistant — currently under development with HKEX Impact Funding support — is designed to address each of these barriers directly.
On cost: The assistant optimises product selection and portion sizing, reducing waste and improving cost efficiency. Bulk procurement guidance integrated with our product catalogue lowers per-unit costs.
On training: Multilingual conversational AI guidance (English, Cantonese, Tagalog) provides on-demand, step-by-step training for kitchen staff without requiring dedicated training sessions. Training is embedded in daily workflows.
On awareness: The assistant provides accessible, jargon-free explanations of IDDSI levels and their clinical rationale, building awareness at the point of need.
Target: 500 IDDSI-Compliant RCHEs by 2028
Based on HKCFAI 2026 findings, Carewells has set a target of supporting 500 Hong Kong RCHEs to achieve full IDDSI compliance by 2028 — more than doubling current compliant capacity. This target is referenced in our HKEX Impact Funding application.
Full HKCFAI 2026 report available at softmeal.org. For more information, contact research@seniordeli.com.