Table 3.

Identified themes and subthemes from care home staff regarding their perspectives of nutritional interventions and dietetic care

Theme	Subthemes	Direct quotations
The value of nutritional interventions for malnutrition	Resident preference and personalisation	“We had one person who didn’t like them (ONS), she just did not like the taste” (CH1) ‘The majority of the residents liked them (ONS), there was one female who just completely would not have it’ (CH2) “Would they do as well with snacks as drinks? I’ve been thinking about that- as they don’t always take the snacks—it would depend on what the person preferred” (CH2) “I think the extra homemade things is better, not everyone will drink the supplements” (CH6) ‘Would be a good idea if the kitchen made their own milky drinks—could be a bit more flexible with that’ (CH2) ‘Personalised plans are better aren’t they’ (CH4) ‘Glass of milk, with cream and chocolate powder as a smoothie—they enjoy it’ (CH6)
	Perceived improvements with FB and ONS interventions	‘Improvement in resident’s well-being, including mental well-being’ (ONS) (CH1) ‘Yes, expected weight to increase—usual food regime plus supplements’ (CH1) ‘Yes, would expect the weight to increase’ (ONS) (CH2) “I don’t think they needed anything additional to FB intervention” (CH4) “Yes, I would like to think there would be an increase in weight with FB intervention” (CH4) “I think they would have benefitted by being in one of the other groups—FB or ONS” (CH5) ‘Some of the residents behaviour improved while they were in the trial’ (ONS) (CH1) “I feel it was acceptable for the residents…a lot of them want to continue” (ONS) (CH1)
	Perceived value of interventions from the families of residents	‘A lot of the families have asked if residents could continue supplements’ (CH1) ‘Most of the residents accepted it (the FB intervention) as part of their diet plan—they were pleased to have something extra and the families were as well’ (CH6)
The value of dietetic-led intervention		“It’s useful to be told specific things to do by the dietitian—extra things to add into the diet that you might not have thought of” (CH3) “We could have tried different things on discussion with you (dietitian)” (CH5) ‘Would think they would do better with dietetic intervention’ (CH5) ‘It was a benefit to have the dietitian here more often’ (CH6)

FB, food-based; ONS, oral nutritional supplement; PROM, participant-reported outcome measure; SC, standard care.