Care Homes during the Covid-19 pandemic: Report

Between October and December 2020, we spoke to care home staff and managers, along with members of the public with a loved one living in a care home, to learn more about experiences in Liverpool care homes during the Covid-19 pandemic.
A close up of and older woman, with short white hair, smiling at a mobile phone. The phone is being held up by a younger women, wearing a surgical-style face mask.

In Summer 2020, Healthwatch Liverpool staff met with staff from Liverpool City Council to discuss how we could learn more about the impact of COVID-19 on local care homes.

Due to the closure of care homes to visitors during the pandemic, we were unable to visit care homes. We were therefore keen to explore new ways to find out how care homes were operating during the pandemic, and how they were looking after residents’ physical and mental health as well as their general wellbeing. 

We agreed to conduct a series of interviews with staff members from different care homes across Liverpool. Liverpool City Council provided us with information about six care homes across the city, which represented a range of different experiences. In addition to interviewing staff, we also decided we would also conduct some outreach with people with relatives or other loved ones living in care homes, to ensure we could include their experiences in our final report.

This report shares our key findings from this piece of work. A full version of the report is available, along with an 11 page summary, and a 2-page overview of our findings and recommendations. All versions of the report are available to download below.

Sometimes it feels like something out of a movie … it’s been a hard year, a very hard year.
— Staff member at a Liverpool care home

We asked care home staff and managers a number of questions, including what they felt worked well, what they found difficult, PPE, testing for staff and residents, the impact on residents, communication with residents’ families, staff morale, guidance, and support from external agencies.

We asked family members about their experiences with visiting care homes, staying in touch with their relative, and receiving updates from their relatives' care home.

Our report outlines a number of recommendations and learning points relating to:

  • funding and finance for care homes, including funding for homes to improve internet connectivity, and to improve activities for residents;
  • guidance issued for care homes during the pandemic;
  • processes around the verification of deaths in care homes experiencing a Covid-19 outbreak, to ensure care home staff are not  pressured to verify deaths themselves;
  • psychological support for care home staff;
  • timeliness of support provided to care homes by external agencies; and
  • provisions for family visits.

We would like to thank all staff, managers, and members of the public we spoke to in interviews and focus groups for their time, and also for their openness in sharing their experiences with us.

We received the following response from Liverpool City Council:

“Liverpool City Council sincerely thanks colleagues from Healthwatch Liverpool for producing this report and so many colleagues and families of residents from across Liverpool care homes for generously sharing their lived experiences of managing in this pandemic.  

It is clear that the toll of managing care homes as services throughout the pandemic has been physically and mentally exhausting for everybody and it has tested logistics management to its extremes. Staff and family members have also shared some very personal reflections too. Care homes are not just services. They are homes in which individuals live their lives, loved and cared for by staff and relatives alike. The impact of more deaths, particularly earlier on in the course of the pandemic, was traumatising and the impact of restrictions on visiting, though now largely lifted, will have been permanent for some, in terms of how it has affected the mental health of residents.

Pulling together in the caring professions is, perhaps, what we do best. There is no doubt that, despite extreme adversity, people have worked together incredibly well. Those of us working in the commissioning agencies would like to pay tribute to the flexibility and adaptability of care homes managers and staff, particularly in adopting a wide range of infection control procedures, testing regimes, vaccination regimes and supporting safe hospital discharges. Your actions have demonstrably saved lives.

We know that the organisation around some of these things was initially slow and clunky and we know that messages were at times unclear, or so constantly changing as to be confusing, or so frequent it was overwhelming. It took too long for national organisation to catch up around PPE and testing and initially we were all feeling our way through. This report adds some real colour to how that felt on the ground.

Thank you for your feedback to us about what we did get right too. It is also helpful that the Healthwatch report has highlighted the impact of national decisions as opposed to those matters agreed locally. Generally it was appreciated that local government was often not responsible for the things that didn’t go so well. Thank you again to care homes and relatives for your patience and care when things obviously became frustrating. Thank you to Healthwatch Liverpool for allowing all of us, including care homes themselves, to have so much information to reflect on and to inform how we can support the system and our most vulnerable residents in the future. We have a range of learning points to respond to and will certainly use it both in our emergency and general planning.”


If you need this report in a different format, please email or call 0300 77 77 007.

2 page overview - Care Homes during Covid 19
11 page summary - Care Homes during Covid-19
Full Report - Care Homes during Covid-19

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