A mixed method cross-sectional approach was adopted consisting of a questionnaire, interviews and observations. 
  
This research comprised of 2 interconnected work phases: 
  
1.	Questionnaire sent to all Barnsley Council Commissioned Care Homes 
  
A simple online questionnaire (using Qualtrics platform) to explore what care homes are currently doing to consider protein intake. Also, to understand where any best practice is taking place and whether any nutritional guidelines are being implemented and followed. 
  
2.	Semi-structured interviews with care home managers and catering staff with follow-up care home mealtime observations. 
  
  
The interviews were conducted with care home managers and catering staff and were used to help identify the wide range of complex factors associated with meal planning and food fortification needs. Guided by a semi-structured interview tool consisting of 9 questions (Appendix 1), interviews were conducted face to face and audio recorded. The recordings were then transcribed and analysed.  
  
In addition to the interviews, researchers observed one mealtime at each care home to understand the practical aspects of protein delivery to residents such as; the provision of protein rich foods, the impact of resident choice/preferences and those who need assistance with eating and feeding. To maintain consistency, lunch time was selected as the mealtime to be observed in all care homes for all mealtime observations. A mealtime observational guide developed by researchers at Sheffield Hallam University (Appendix 2) was also used to capture areas of interest, and evaluate practices. The aim was to identify any best practices that were observed, and where barriers to protein intake remained.  
  
In total, 42 care homes were sent the simple online questionnaire via an email from Barnsley Metropolitan Borough Council (BMBC). One week after the initial contact, BMBC made reminder phone calls to care homes to prompt questionnaire completion. Since the questionnaires were completed anonymously, it was not known who had yet to fill out the questionnaire, so phone calls were made to all care homes to prompt completion.  
  
At the end of the online questionnaire, participants were asked if they would be willing to be contacted for the next stage of the research which would involve a researcher attending their care home to do a short interview with the care home manager and a staff member who participated in meal time preparation, followed by a mealtime observation. In total, 10 participants answered ‘yes’ and provided the name of their care home and their contact email address. Following this, the care homes who agreed to be interviewed were contacted by BMBC. Of the 10 participants who initially agreed to be contacted, 3 later declined to take part and 2 were unable to arrange a suitable date/time due to staff shortages and holidays. In total, 5 care home visits were arranged, where 10 interviews were conducted, and five mealtime observations were carried out.