Objectives: Explore the feasibility of using a stroke-specific toolkit for six month post-stroke reviews in care homes to identify unmet needs and actions.
Design: Observational study including qualitative interviews to explore the process and outcome of reviews.
Setting: UK care homes
Participants: Stroke survivors, family members, care home staff (review participants) and external staff visiting to conduct reviews (assessors)
Interventions: modified Greater Manchester Stroke Assessment Tool (GM-SAT)
Results: The observational study provided data on 74 stroke survivors across 51 care homes. 45/74 (61%) had unmet needs identified. Common unmet needs related to: blood pressure; mobility; medicine management and mood. We conducted 25 qualitative interviews: 13 review participants; 12 assessors. Three overarching qualitative themes covered: acceptability of conducting reviews in care homes; process and outcomes of reviews; acceptability of modified
GM-SAT review toolkit. The modified GM-SAT review was positively valued, but stroke survivors had poor recall of the review event including the actions agreed. Care home staff sometimes assisted with reviews and highlighted their need for training to support day-to-day needs of stroke survivors. Assessors highlighted a need for clearer guidance on use of the toolkit and suggested further modifications to enhance it. They also identified organisational barriers and facilitators to implementing reviews and communicating planned actions to GPs and other agencies.
Conclusion: The modified GM-SAT provides a feasible means of conducting six month reviews for stroke survivors in care homes and helps identify important needs. Further modifications would enhance acceptability. Full implementation into practice requires staff training and organisational changes.