Lay summary Question/Rationale What did you do? Method step 1 here… Name Susan Guthrie Affiliation Lancashire Care FT; Calderstones FP Trust Lay summary Adults with intellectual disabilities and/or mental illness often have difficulties at mealtimes. This can be overlooked by caregivers. Many choking incidents occur at evening mealtime. This study investigated what influences were identified by caregivers in a long stay residential unit. Question/Rationale What mealtime difficulties do caregivers perceive at mealtimes, what social and environmental problems are identified? What did you do? Method step 1 here… Method step 2 here… Method step 3 here… Collected reports of choking incidents written by caregivers Interviewed 5 staff who had reported a choking incident at evening meal Qualitative analysis of themes What did you find out? Caregivers identified influencing factors in environment, social aspects and in staffing. Individual service user characteristics were mentioned less. Next steps: Dissemination to service users, multidisciplinary team, & SLT fora. Need for service user led follow up. Implications: Protected mealtimes would appear relevant to this population, staff and service user training in dysphagia awareness.