Table 6 Reflexive monitoring: supporting data

24. “I think there was ownership for her [the stroke survivor], this is my goal, here’s what I want to set out and do, you guys [rehabilitation staff] help me achieve it.” (Support Worker; Team A)

25. “I can think of one particular woman who wanted to work on a computer [to do online shopping], and we sat down, we talked through what was the best way to break down this goal so that she was able to get the focus and see what she needed to do to work this computer. And it was amazing. Over the period of a few weeks, she went from not really knowing what to do, to being competent totally!” (Support Worker; Team B)

26. “It’s a really good tool [the G-AP record] to record the journey that somebody is going through, especially if they’ve got any sort of memory problems. You’ve got proper evidence of where they came from. You can say, ‘Oh a couple of weeks ago you couldn’t do that, but now look!’ So, yes, it definitely added value.” (Support Worker; Team A)

27. “Well before [G-AP] the goals would be fairly uni-professional or they would be highlighted as certain professional goals, so that would be a sort of physio [therapy] type of goal, or an OT [Occupational Therapy] type of goal. [Now] we’d think a bit more about the patient’s goal and how they’re going to achieve that and how we would fit into that, rather than how they would do their physio goal, if that makes sense.” (Physiotherapist; Team B)

28. “As someone who’s done goal setting for years, it’s quite helpful to think through, ‘Right, negotiating the goals, setting them, then how are we going to achieve them, what are the barriers etc.’, I think the structure has been quite helpful. It’s very easy to skip steps, and you’ve not talked about what the barriers could be or you forget that ‘Right, we’ll come back and review this’.” (Physiotherapist; Team B)

29. “When I was actually doing it [G-AP] with a client, I asked one of the support workers if they wanted to come and sit with me because I knew that that worker would probably spend more time with that person than me or anybody else. And that seemed to work quite well. I knew that support worker then taught another support worker. So I don’t think it has to be a therapist, it could be a champion or - I don’t know what the right word is, a mentor.” (Occupational Therapist; Team B)

30. “I mean, if I’d had a stroke, and I’m in a terrible mess, and I’m upset and somebody sits down ‘Right now what are your goals?’ you know. It can be very patronising to make a goal, you know, as well and it can diminish, their experience... if they’re in the middle of telling you about these experiences that are hugely traumatic, you can’t suddenly say ‘Right, what are you going to do for next week then just before you go?’ It’s like I’ve not listened to them if I go in and do that.” (Psychologist 1; Team C)

31. “When it was more working at a sort of emotional level, or at level of thoughts, it was difficult to set meaningful goals in relation to that.” (Psychologist 2, Team C)

32. “Perhaps if there had been some encouragement of ‘Right, you’ve got the process now, you know the principles, this is the [G-AP] folder, now sit down as a team and then think about it’ - that was maybe the one bit that was missing [in the G-AP training].” (Physiotherapist; Team B)

33. “It’d be worthwhile almost to have some sort of like supervision type group that you could go along to; otherwise you’re sort of using it [G-AP] in isolation. You’re not really getting a chance to speak to people about how it’s going and what’s trouble, what’s difficult, what’s going right, what’s going wrong.” (Psychologist; Team C)

34. “This [the G-AP record] could be something that worked really well electronically; but in paper you’re just duplicating more work and it just kind of made it more time. This could be an App; it would be a perfect App.” (Support worker; Team A)