MSc Dissertation: Impact of COVID-19 on UK Care Homes - ARU London

This dissertation investigates the impact of COVID-19 on UK care homes, focusing on mortality risks and challenges faced by care home authorities. The study uses Caring Health Centre as a case study to examine the negative impacts of the pandemic and explore alternative solutions. It identifies the increased mortality risks, staff shortages, inadequate protective equipment, and disconnection of residents from families. The research employs literature review and research methodology to analyze the situation and propose recommendations for better management of future pandemics. The aim is to provide insights into mitigating the adverse effects of such crises on care home residents and staff.

IMPACT OF COVID-19 ON UK CARE
HOMES

TABLE OF CONTENTS
ABSTRACT.....................................................................................................................................4
ACKNOLWEDGEMENT...............................................................................................................5
CHAPTER 1: INTRODUCTION....................................................................................................6
Background..................................................................................................................................6
Aim and objectives......................................................................................................................6
Rationale......................................................................................................................................6
Significance of the study..............................................................................................................7
Structure of dissertation...............................................................................................................7
CHAPTER 2: LITERATURE REVIEW.........................................................................................9
Introduction..................................................................................................................................9
Theme 1: Impact of the Covid pandemic on mortality risks in care homes................................9
Theme 2: Impediments faced by the authority of the care homes.............................................10
Conclusion.................................................................................................................................14
CHAPTER 3: RESEARCH METHODOLOGY...........................................................................15
Introduction................................................................................................................................15
Research Type............................................................................................................................15
Research Approach....................................................................................................................16
Research Philosophy..................................................................................................................16
Data collection...........................................................................................................................17
Data analysis..............................................................................................................................18
Ethical consideration..................................................................................................................18
Research Limitations.................................................................................................................19
Research validity and reliability................................................................................................19
CHAPTER 4: FINDINGS AND DISCUSSION ..........................................................................21

CHAPTER 5: CONCLUSION AND RECOMMENDATIONS ..................................................27
Conclusion.................................................................................................................................27
Recommendations......................................................................................................................28
REFERENCES..............................................................................................................................30

ABSTRACT
This dissertation investigates and describes the concept of impact of covid-19 on UK care
homes. The study will appropriately examine the impacts in detailed manner as currently there
are few researches had been done over this special and important topic. The topic was chosen as
it highly requires study towards various impacts that has been face by the UK care homes. For
the completion of this research, the Caring health centre has been taken in order to finish the
study. For this the impact of Covid on mortality risks in care home has been identified along with
various challenges that have been faced by the centre. This dissertation will appropriately
examine negative impacts of pandemic over care homes as well as alternative solutions to handle
the situation in fruitful manner.

ACKNOLWEDGEMENT
I would like to acknowledge and give my warmest thanks to all the people who contribute in
completion of my dissertation in appropriate manner. The guidance and information that has
been collected through the journals, books, articles, etc. helped me a lot while conducting my
research over this specific topic through all the stages of writing my project. I would also like to
thank to my friends and family for their continuous support and understanding while I was doing
my research. Finally, I would like to thank god for letting me through all the difficulties and
effectively finish my dissertation.

CHAPTER 1: INTRODUCTION
Background
Covid-19 is an infectious disease that has been newly discovered which has cause
number of death of people in the society. With increase in spread of coronavirus in United
Kingdom, theoperation in care homes has been changed or impacted adversely.Likewise, as per
the statistic of 2020, there are around 490326 people that are living in the care home that is half
million people. Furthermore, this statistic is higher in England as there are 418 thousand people
staying in home care in order to have necessary support to live better lifestyle.So, with increase
in spread of diseases, people wants to have care homes in order to get support and stay healthy
life (Gordon, and et.al., 2020). This dissertation will cover crucial information related to the
impact of covid pandemic on mortality risk in care homes, identification of the impediments
faced by the authority of the care homes. Furthermore, the negative impact of the Covid
pandemic on care homes and alternative solutions that could be used by the care homes to deal
with the issues in pandemic situation.
Aim and objectives
Aim
To investigate on impact of Covid pandemic on care homes those are operating in United
Kingdom. A study on Caring Homes Group.
Objective
 To identify the impact of the Covid pandemic on mortality risks in care homes
 To recognise the impediments faced by the authority of the care homes
 To understand the negative impact of the Covid pandemic on care homes
 To find alternative solutions for care homes to deal with the issues regarding the Covid
pandemic.
Rationale
The topic of “impact of Covid pandemic on care homes of United Kingdom” is
important to study as it with Covid there are number of people that are suffering from diseases
that require care and support in order to be being treated. Furthermore, the scholar is motivated
to select this topic as it has been recently emerged as Covid is uncertain pandemic that has

spread across worldwide since 2019 that have negatively impacted each and every sector of UK.
So, in order to understand the manner corona virus has impact on care homes, the study was
necessary to conduct and derive necessary information (Thompson and et.al., 2020). It will help
in finding what all alternative method that could be used by the care homes to delivered better
services to patient for their health and well-being. At the same time, there has been limited study
conducted on the subject matter of “impact of Covid on care home. Thus it will help in pursing
the study that has not done by any other individuals. Therefore, all these are various factors that
help in understanding that the study or research needs to made on impact of Covid on care homes
of UK.
Significance of the study
Care homes are small institutions that are offering accommodation and care services to
people who are not sufficient to look over themselves. So it is place at where people that have
certain problem are look in order to resolve the key health issue that they are facing. With impact
of covid-19, there are various issue as well as challenges that have to be face by the care homes
so, study will help in identifying and planning strategies to overcome the same (Comas-Herrera,
and et.al., 2020). Moreover, the study is significant to study as it will contribute in gaining ideas
related to positive and negative impact of covid-19. Thus helps in deciding strategies that could
be used by care home to deliver best healthcare services to patient.
Structure of dissertation
This is a section that describe about the manner in which the information will be
presented in the dissertation so that it can be easily understand by the users or interested
individuals. The way dissertation will be organized and structured can be illustrate in detail as
follows:
CHAPTER 1: INTRODUCTION
This will be chapter first of dissertation that will cover introduction of the topic or area to
study such as aim, objective, why it is rationale and background of the study. Along with it, the
introduction also covers the manner in which the dissertation will be structure and organize so
that necessary information can be easily extracted (Bell and et.al., 2020).
CHAPTER 2: LITERATURE REVIEW

This is the second chapter that covered the point of view of well-known author related to
the subject matter or area of study so that it can be evident. Literature review can be defined as
scholarly sources on particular subject area that helps in knowing about the subject matter in
detailed for making study fruitful.
CHAPTER 3: RESEARCH METHODOLOGY
The third chapter of dissertation is related to research methodology i.e, different method
that would be used by the research to collect analysis and interpret necessary information.
Likewise, it explains about the weather primary or secondary method will be used or qualitative
and quantitative to complete the study (Greenhalgh and et.al., 2020).
CHAPTER 4: FINDINGS AND DISCUSSION
The fourth chapter is pertaining to the finding and discussion that covered all crucial
information that has been extracted through conducting the study. In another words, it has
discussed about the impact of Covid on care homes.
CHAPTER 5: CONCLUSION AND RECOMMENDATIONS
The last chapter present in the dissertation is of conclusion and recommendation that
summarize the key points that has been identified or extracted while conducting the study. On
the basis of recognized key issue or negative impact, recommendations are being made thus they
are covered in conclusion and recommendation section.

CHAPTER 2: LITERATURE REVIEW
Introduction
Literature review give chance to be familiar with the subject or topic that is going to be
study so that purpose is to evaluate the current state of research and to have proper understanding
of the subject matter. There are various steps that are taken to proceed with literature review such
as search for literature, evaluate and select sources, identification themes, debates and gap and
finally the literature review is write. It helps in effective reviewing the things that has been
already written by the scholarly author.
Theme 1: Impact of the Covid pandemic on mortality risks in care homes
As per the perspective of Xue and McMunn, (2020), the condition of the care home have
become vulnerable with spread of covid-19 in United Kingdom as it has resulted in causing of lot
of health issue for people living in the society. There are multiple, interconnected issues as well
as challenges that are face by care homes in relation with management and prevention of
outbreaks of covid. Likewise, there are shortage of staff member, inadequate supply of protective
equipment’s and lack of time by staff member to text the patient. Furthermore, the author has
explained that the covid has resulted in adversely impact on people that are living in the care
homes as they have experience more mortality and morbidity. At the same time, it has lead in
disconnection of people from their family and friend and access to the routine healthcare services
so that their health condition might improve to maximum extend.
Another authorGreenhalgh and et.al., (2020), has also supported that there are around
29542 deaths as per august 2020 and maximum of them in care homes. The death of people in
care homes was high in nursing services that are offering services to older people or that are
suffering from dementia. The pandemic does not have only massive impact on care facilities but
also on care workers and visitors as appropriate services are not provided to them for their
overall improvement in health condition. Across United Kingdom or Europe, the government are
adapting more relaxed strategies in order to tackle or manage the pandemic situation. The supply
of testing was also constrained in early pandemic situation that has resulted in increasing the
chance of death that is living in care homes. Therefore, in order to limit the excess of mortality,
the home care needs to make effective policies and procedure so that right of diseases and
subsequent transmission can be limited to more extend.

According to Comas-Herrera and et.al., (2020), there were limited facilities available in
the care home due to number of people admitted so it leads in delay in delivery of services of
patient and many deaths. Such as in England and wales, there is approximately 79% increase in
total number of death in context of 2015-2019. In addition to this, it has been identified that all
the care homes have not equally suffered from the Covid pandemic thus it has different impact
on different care home. Moreover, it has been understand that the infection rate is lower in small
care homes that are around 179 that are having high staff and low bed occupancy rates. On the
other hand, it can be stated that the large care home has experienced high infection rates, all
these consequences were because of limited resources to delivered services to patient.
As illustrate by Ali, Asaria and Stranges (2020),in South east England, the proportion of
care home that has been impacted because of Covid outbreak is 37% that is nearly close to 38%.
So, the total impact of burden of loss of life is majorly in the south- east region. Such as, in April
2020, there are total 15494 care homes with having an capacity of 456862 bed but all these were
not sufficient in comparison to increase in spread of diseases across United Kingdom. So, in
order to cope up with the negative impact of Covid on care home residents they should be
equally distributed across the United Kingdom. The author further states that care homes needs
to find alternative method or strategies to cope up with the current pandemic situation so that
number of death within the society can be reduced to maximum extend.
Theme 2: Impediments faced by the authority of the care homes
From the view of Kennedy and et.al., (2020), the impediments faced by the authority of
the care homes are on-going and had long term impact on companies, staff and patient. The
majority of people that are staying in care homes are over the age of 80, which are suffering from
multiple long term health condition and any other type of physical disability. Limited attention
has been paid towards the social care and older people as there were inadequate funded,
undervalue and are not integrate with British health services. The covid-19 has helped in
understanding that career and support to older people is important in order to effectively
response to the pandemic situation. So, with a motivate to protect the care worker as well as the
patient top priority needs to be given to make investment in social care of people.
The Black and et.al., (2020), explained that there are many issues that the care home of
United Kingdom are facing even prior the Covid such as longstanding financial pressure, narrow

market, limited services and workforce to deliver services to the patient. Along with it, the home
care sector of UK is responsible for employing people around 1.5 million in England thus
contributing in growth of economy by £40.5. Thereby due to covid, 19 all these may have
negative consequence or impact on home care as the staff or career does not have sufficient
income to stay their life in better manner. For example: it has been estimated £6.6 billion extra
costs incurred by the home care with impact of covid-19 in staffing, deep cleaning and PPE.
Moreover, Black and et.al., (2020), states that there has been regularly force by the
people to reduce the fees of care home that resulted in decreasing in disposable income of the
staff member. Quality of services that needs to be provided to each of the patient is also one of
the major in Impediments face by care home authority in context of Covid. Therefore, alternative
solutions need to be finding to overcome the challenges and provide better services to patient.
The nurses share their views that it is essential to establish close collaboration with the patient
and family along with providing them complete emotional support for the family who are highly
in requirement of getting support. The health care staff members states that it is highly beneficial
to do collaborative meetings between the patient as well as their family members, it will
beneficial for both of them to take care of the patient along with understanding the requirements
of the patient who is highly in need of care and support.
Ventura, Molinelli and Barranco, (2021), identifies that providing quality care services
and high level of satisfaction is the basic responsibility of health care organization and this is the
top priority of the firm to provide effectual services to their patients. But apart from this, certain
challenges has been faced by the firm in unintentional manner. Primary is the attracting and
retention of talented staff members as they are main reason for the success and failure of any
healthcare center. It is basically identified that, maintaining sufficient staff within the centre is an
important task for the establishment and thus, the organization is unable to serve various patients.
Turning down patients can also be negatively affecting the relationship with their referral
partners. In the current pandemic situation and health emergency is causing a dramatic loss of
revenue. Poor documentation can also sometimes lead to revenue loss to the firm as well. The
agencies will able to efficiently sync visit documents including certain verification.
Radwan, (2020), illustrates that this helps the firm to reduce documentation errors which
improves the accuracy and saves the time spent on the documentations. The rating of the

enterprise is completely based on the quality care and patient satisfaction. Without this, the
agency reputation could be at high risk which makes referral sources unhappy and causing a
decrease to sample. Thus, in order to retain health care nurses certain steps have been taken by
the health care centre such as providing them effective professional development programs so
that they are able to develop various opportunities for the health care agencies in order to
empower nurses and other staff members to improve their skills and address certain challenges
with complete confidence.
Theme 3: Negative impact of the Covid pandemic on care homes
As per the view of Jones and et.al., (2020) the Covid 19 highly impacted the social care
services within the UK. It has been identified that majority of health care workers died because
of providing their effectual services to the patients who are highly at risk level. Thus, in order to
give efficient services to their patients, the health care centers exclude the staff members who are
above the age of 65 years in order to provide nonstop services to their patients in most
appropriate manner. The impacts that have been faced by the health care centers are that during
the crucial times the patients stay within the hospitals are increased which indicates that the
healthcare association heavily burdened themselves with the huge amount of financial and well
as other services in order to make their management appropriate and provide their patients
efficient services so that they are able to fulfill all the requirements of their patients in most
effectual manner.
As per the view of Greenaway and et.al., (2020), the considerable length of stay among
Covid patients at the time of pandemic suggests that unmitigated transmission of the virus could
able to threaten the hospital staff and management. Measures of social distancing have acted as a
stop gap in reduction of transmission and protecting their health systems but it has been said that
hospitals would do well to ensure the capacity in the upcoming months or years in a manner that
responsive to changes in social distancing measures. The challenges have placed a financial
burden on health care center that cannot be overstated. From the beginning of the situation, the
health care staff members has been shown their complete support and gratitude than ever before
towards the patients or the people who are highly in need of such services.
Guessoum and et.al., (2020), describes that with the introduction of Covid-19, health
system provides immense pressure and stretched others beyond their capacity. As being