This pilot study aims to assess the feasibility of implementing a plate imaging system for dietary assessment in a stroke rehabilitation ward at University Hospital Southampton. The duration of the study is 12 weeks with an estimated sample size of 50 patients. This is a single centre study.

Accurate dietary intake monitoring is essential to provide appropriate treatment for patients at risk of malnutrition, but collection of food intake data in hospital is a difficult and resource-intensive task. Paper food record charts are often incorrect or incomplete due to competing responsibilities and tasks at mealtimes, inadequate training, or removal of food trays before staff have observed intakes. Malnutrition within the hospital setting therefore continues to be under-identified and under-treated and is estimated to account for around 20% of the health and social care budget in 2023. The causes of malnutrition in hospitals are multifactorial and include acute illness or disease, dislike of food, and psychosocial or environmental factors. Approaches trialled in clinical settings to optimise dietary intakes of patients to date include protected mealtimes, dedicated mealtime assistance, and changes to the presentation and preparation of food. Across the literature, poor food intake and malnutrition was highly correlated with poor patient outcomes. In line with the NHS long-term plan and the UHS digital team's plan for a paperless digital Trust, a digital dietary assessment tool would provide a valid and reliable tool to accurately monitor dietary intakes. Electronic records will enable examination of longitudinal changes in intakes and/or dietary quality, and to identify patterns of intakes associated with positive or negative clinical outcomes.

Inclusion Criteria:

• Patients who eat hospital food
• Patients with a capacity to give consent
• Non-English-speaking patients with interpreters
• Patients who are aged 18 years and above

Exclusion Criteria:

• Patients who receive exclusive parenteral or enteral nutrition
• Patients who do not eat hospital provided meals
• Patients on end-of-life care plan
• Patients who do not give consent

Patients who are admitted to the stroke rehabilitation ward will be proposed to participate in the study