Objectives To explore nutrition in local day care settings in order to develop a package of interventions that will promote healthy eating in Liverpool across deprived communities.

Design Qualitative—participant observation, direct observation, interviews.

Setting Community—preschool nurseries.

Participants Nursery managers, cooks, staff, parents, children (total=36).

Main Outcome Measures Up to date assessments of food policy and provision in a range of nursery settings highlighting inequalities in good practice and gaps in existing evidence. Identification of specific needs and barriers in nurseries serving areas of deprivation.

Results Nurseries have a potentially important role in supporting parents in their children's and their own healthy eating. Level and depth of communication between the nursery and parents is important regarding what children have eaten both at home and at the nursery. Private nurseries have minimal access to information and guidelines compared to those based in Sure Start children's centres. Most nurseries do not have a specific healthy eating policy but use their menu planning as the way to maintain a focus on healthy eating. Most nurseries have an appropriately balanced 4-week menu plan. Use of gravy and pre-prepared sauces is problematic and needs attention. Cooks' level of knowledge, experience and motivation is important. None had been trained in healthy eating for under fives. Meal times can be an important means of developing social skills and achieving Early Years Foundation Stage competencies. Making meal times fun and appropriate-sized cutlery and crockery are important to encourage children to eat. Communication between different levels of government and departments needs strengthening. Additional funding for training will be, essential to promote menu planning and cooking, but also for encouraging healthy eating and learning through food.

Conclusions Nurseries are genuinely interested in implementing healthy eating policies and need further support to achieve this. Support should include: improved mechanisms for effective communication between all government levels as well as with nurseries; funded training for cooks and managers in menu planning, cost effective food sourcing, and food preparation. Classroom staff should receive training in strategies to encourage healthy eating habits and how to facilitate food related learning and social skills development. Nurseries appear to have a key role in working with parents to encourage healthy eating at home. Further research is needed to understand the ways in which nurseries can be supported to achieve this.