BackgroundChildren and young people (CYP) with Cerebral Palsy (CP) are at risk of nutritional problems. Up to 90% experience difficulties in chewing or swallowing, and/or eating or drinking independently.It has been recognised that these children at risk of nutritional problems have an increased risk of bone demineralization and low-impact fractures.Feeding impairment also correlates with the severity of motor deficit (GMFCS level IV – V). Studies show that those within this category were 5.7 times more likely to have lower bone mineral density (LBMD) than GMFCS level I-III.The recent NICE guidelines have made recommendations that CYP with CP have regular reviews of their nutritional status and LBMD should be assessed and adequately managed.AimTo ascertain (as per the NICE guidelines)a. Whether CYP with CP (GMFCS level IV–V) seen in a tertiary neurodisability service are having regular reviews of their nutritional status.b. Whether LBMD is being assessed adequately.MethodRetrospective case note analysis of CYP with CP (level IV-V) attending between March 2015- February 2017Results24 children with GMFCS IV-V, CP, were identified. The male to female ratio was 11:1396% had their weight measured92% had their height measured75% had a nutritional review performed70% were referred to dieticians/for alternative methods of feeding.62.5% of individuals had their dietary intake of vitamin D/calcium assessed at clinic17% had investigations performedDiscussionOur findings showed that we are not achieving optimum results in mandatory areas such as measuring weight and height. Barriers identified were lack of equipment and training in mobilising a wheel chair bound child.Other areas for improvement include the need to perform regular nutritional reviews, with ongoing referrals if deemed necessary.A proforma/checklist for the service is currently being developed in order to aid clinic reviews, and a further audit will be performed in a year.