Qualitative data
 Qualitative data were collected from a subset of intervention group participants (n=13) by the study research nurse (JJ) via telephone interviews at the end of the study. Feedback from the two ANPs was also taken in meeting sessions with researchers during and after the intervention period. The interview schedule was designed to explore the older adult’s perception and experience of being part of the research project. Participants were asked about their perceived challenges, strength and benefits of the assessment, care and support plan (see Additional file 