The process and outcomes of six-month reviews in care home settings: are we meeting the needs of stroke survivors in care homes?

Background: The Greater Manchester Stroke Assessment Tool (GM-SAT) is a structured evidence-based needs assessment, developed to support post-stroke reviews. Following UK-wide implementation of GM-SAT, expert consultation helped revise the tool and enhance suitability for use with care home residents. This work investigated the feasibility and usefulness of the revised Greater Manchester Stroke Assessment Tool (rGM-SAT) in care homes and its acceptability to stroke survivors. Method: (1) Quantitative study of unmet needs identified during reviews across eight Greater Manchester services; (2) qualitative interviews with reviewees and reviewers. Results/Findings: A total of 74 stroke survivors in care homes were reviewed, mean age = 83. A wide range of unmet needs were identified, for example, medicines related (N =16), cognition/communication (N = 12), extended activities of daily living. Thirteen reviewees were interviewed (eight stroke survivors, three family, and two care home staff). Reviewees valued the review but recall issues affected detailed exploration of rGM-SAT. Twelve professional reviewers were interviewed. rGM-SAT was deemed a useful, comprehensive tool for this population, helping legitimize and normalize needs. Layout and formatting improvements were suggested. Barriers to implementation were identified by reviewers including locating reviewees and arranging reviews, communicating planned actions to general practitioner (GP) and other agencies. Discussion: The rGM-SAT proved feasible and useful as a means of reviewing a variety of needs of care home residents with stroke. Improvements will include merging with GM-SAT and updating guidance for follow-up. Staff training is also advocated. Conclusion: Post-stroke reviews are an important 'safety-net' for this vulnerable population of care home residents. Further work is planned to ensure implementation into practice. GM-SAT tools are freely available online. [ABSTRACT FROM AUTHOR]