COVID-19: Burden and impact in care homes - a mixed methods study

Lead Research Organisation: University College London
Department Name: Institute of Health Informatics


The COVID-19 pandemic poses a substantial risk to elderly and vulnerable care home residents and COVID-19 can spread rapidly in care homes.
We have national, daily data on people with COVID-19 and deaths, but there is no similar data for care homes. This makes it difficult to know the scale of the problem, and plan how to keep care home residents safe. We also want to understand the impact of COVID-19 on care home staff and residents.

Researchers from University College London (UCL) will measure the number of cases of COVID-19 in care homes, using data from Four Seasons Healthcare, a large care home chain. FSHC remove residents' names and addresses before sending the dataset to UCL, protecting resident's confidentiality.
Since we cannot visit care homes during the pandemic, we will hold virtual (online) discussion meetings with care home stakeholders (staff, residents, relatives, General Practice teams) every 6-8 weeks, to learn rapid lessons about managing COVID-19 in care homes and identify pragmatic solutions.
Our findings will be shared with FHSC, GPs and Public Health England, patients and the public, and support the national response to COVID-19. Patients and the public will be involved in all stages of the research.
Description Estimates of the burden of COVID-19 infection and mortality in the first wave of the pandemic using data from a large UK chain of care homes
Evidence on attitudes to vaccination derived from interviews with staff
Exploitation Route The study provides a method of estimating excess mortality in care homes and demonstrates the feasibility of using electronic health records from care homes for research.
The award has catalysed a programme of COVID-19 research in care homes that was subsequently funded by the Department of Health and Social Care.
Sectors Healthcare

Description Findings on the burden of infection evidenced the severe impact of COVID-19 in care homes following the first wave of the pandemic.
First Year Of Impact 2020
Sector Healthcare
Description Understanding SARS-CoV-2 infection, immunity and its duration in care home staff and residents in the UK (COVID-19 in care homes - VIVALDI)
Amount £6,898,313 (GBP)
Organisation Department of Health (DH) 
Sector Public
Country United Kingdom
Start 06/2020 
End 04/2022
Title COVID-19: Burden and Impact in care homes 
Description COVID-19 causes significant mortality in elderly and vulnerable people and spreads easily in care homes where one in seven individuals aged > 85 years live. However, there is no surveillance for infection in care homes, nor are there systems (or research studies) monitoring the impact of the pandemic on individuals or systems. Usual practices are disrupted during the pandemic, and care home staff are taking on new and unfamiliar roles, such as advanced care planning. Understanding the nature of these changes is critical to mitigate the impact of COVID-19 on residents, relatives and staff. 20 care homes staff members were interviewed using semi-structured interviews. 
Type Of Material Database/Collection of data 
Year Produced 2021 
Provided To Others? Yes  
Impact Analysis of interviews currently in process. Preliminary findings submitted to DHSC consultation on mandatory COVID-19 vaccination in care homes 
Description Collaboration with Four Seasons Healthcare Group (care home chain) 
Organisation Four Seasons Health Care
Country United Kingdom 
Sector Private 
PI Contribution We have provided information on the incidence of COVID-19 infections and mortality across the care home chain. We have also generated insights into factors that facilitate transmission of infection
Collaborator Contribution Four Seasons have provided UCL with pseudonymised electronic health records on their residents
Impact Publication
Start Year 2020