IMPACT OF COVID-19 PANDEMIC ON CARE HOME PATHWAYS, OUTCOMES AND SAFETY OF CARE

The COVID-19 pandemic seriously affected care home residents leading to a doubling in the number of deaths with the North East being particularly badly affected. This research will seek to understand how residents who fell ill (with COVID-19 or non-COVID-19 conditions) during the pandemic were managed and whether this was different from 'normal' circumstances. Were more residents cared for within homes and not taken to Emergency Departments? Were residents transferred back from hospital with COVID-19 symptoms? Did COVID-19 change how decisions were made by care home staff?
First we will gather data for individuals in the North East which includes data collected while in care homes, Emergency Department visits and other hospital admission data. This unique dataset will allow us to examine changes and outcomes of care for residents from before, during and after the easing of lockdown. Subsequently we will interview care home staff and community clinical staff to understand how their decision making changed during the pandemic and how this affected care home residents. We will collate the findings to develop recommendations for future guidance and policy on how care homes react in pandemic outbreaks and on broader strategies for health provision for the care home population.

Deaths in care homes from all causes more than doubled at the April peak of the COVID-19 pandemic. Our objective is to evaluate the impact of the pandemic on health service provision and outcomes and provide evidence required to inform the future effective, safe management of care home residents. This novel research is possible because of our unique dataset that links digital information on care home residents with their health service record. We will analyse linked care home, community, Emergency Department and hospital admissions data from the North East (n=68 homes, >2500 residents) from before, during and after easing the lockdown period. The North East has the highest proportion of affected care homes. We will analyse and describe the changes for all care homes on a range of outcomes, including hospital admissions, discharge, readmission, mortality and infection levels. We will undertake a series of interviews with staff from a range of care homes and community clinical teams to understand changes in decision making and referral patterns, specifically exploring how different management strategies between care homes may have led to differing outcomes. The research will address research priority gaps reported to SAGE, and deliver an in-depth understanding of pathways of care between care homes and secondary care settings, leading to policy recommendations for future outbreaks and health service provision. Feasibility is underpinned by a rich dataset, an existing team with appropriate expertise, close connections to key stakeholders, and connections and a platform for dissemination.