1. BACKGROUND, JUSTIFICATION, HYPOTHESIS AND OBJECTIVES 

 1.1 Background  

The sector where the COVID-19 pandemic has probably had the most devastating impact has been in the care homes one, especially care homes for older people. Beyond the death toll, it is likely that there have been many and very significant the effects on the psychological and social well-being of residents, their families and professionals. Furthermore, there have been important ethical, political and economic implications that have guided the actions of service providers and the social and health care system.  

1.2 Justification  

 To our knowledge, there has been no systematic and in-depth evaluation of this reality in Catalonia, which would be crucial for planning better present and future responses:  

• This project is centred on what has unfortunately become the face of the COVID-19 pandemic (care homes), a historically neglected and stigmatised setting, where people who are particularly vulnerable to COVID-19 live.  

•  This project explores particularly sensitive and essential areas (impact on physical, emotional, social and spiritual needs of residents, family members and professionals) from a gender perspective. This project has been validated by organisations of older people in a participatory process.  

1.3 Hypothesis  

•  The COVID pandemic has had a high impact on residents, professionals and organisations in the residential sector in Catalonia.   

•  The causes of this impact are multifactorial, and related to the characteristics of the pandemic, but also due to previous structural deficits.  

•  There are specific responses to each of the causes identified, and the impacts caused, which can constitute a systematic plan for the improvement of the residential sector.  

 1.4 Objectives  

 The ResiCOVID-19 project has two main objectives:   

•  To evaluate the impact of the pandemic on people living in old age, dependency and mental health care homes in Catalonia, as well as on their families, workers and organisations.  

•  On the basis of the lessons learnt, to build proposals for improving care and the care model.  

2. METHODOLOGICAL DESIGN 

A research strategy has been designed that combines different methodologies:  

For the first objective: Description of COVID-19’s impact in the long-term care home sector 

1. Literature review for international contextualization: Systematic mapping of the literature published from the beginning of the pandemic to the present time.
2. Analysis of Big data from the Catalan Health Service’s Register of Morbidity and Use of Healthcare Resources: Retrospective population-based study (March 2020) of the population of Catalonia living in long-term care homes. 
3. Fieldwork in a multicentric cohort of people and representative residences: A mixed quantitative/qualitative study to describe the basic characteristics of people who live in care homes, based on a randomized representative sample of long-term care homes in Catalonia. 

For the second objective: Proposals to improve the care model 

1. Consensus on improvement proposals with the stakeholders involved: Construction: focus groups + SWOT by dimensions, with professionals and residents/families 
2. International benchmarking of improvement proposals: Structured interviews and review of documentation and national and international literature to identify and describe good practices.

•  Mapping of the literature on the COVID-19 pandemic in care homes

• Big data analysis of the morbidity and use of health resources  of the population living in care homes in Catalonia 

• Mixed quantitative/qualitative study describing the impact and experiences of people living in care homes during the COVID-19 pandemic 

• Recommendations derived from focus groups and SWOT analysis 

• International benchmarking of proposals for improvement