Research: Smaller, domestic aged care homes had lower infection rates during COVID-19

HammondCare's Horsley cottages

The COVID-19 infection rate in aged care residents was significantly lower, almost half, in facilities with smaller, detached buildings compared to single-site facilities, a recent meta-analysis of research studies has revealed.

The research paper, Factors Associated with SARS-CoV-2 Attack Rates in Aged Care – A Meta-analysis, was published in Open Forum Infectious Diseases on January 28, 2022, and led by Prof Raina MacIntyre of the University of NSW.

A meta-analysis pools the data from a number of like-studies, increasing the size of the data pool and improving the significance of the results. The research examined 41 separate COVID-19 articles on aged care homes in 11 countries reporting on 90,657 residents and 6521 staff in 757 facilities.

The meta-analysis, covering studies prior to the Omicron variant, found aged care facilities with smaller detached buildings had an infection rate of 26 per cent, almost half that of single-site facilities where the infection rate was 50 per cent.

The authors concluded that, when it comes to Covid, “the design of aged care facilities should be smaller in size, with adequate space for social distancing”.

“Infection control policies should address factors such as the total number of beds and staff-to-100 bed ratios and consider appropriate modifications to an institution like single-building facilities with multiple occupancy rooms,” the research found.

The COVID-19 pandemic has resulted in significant morbidity and mortality in aged care facilities worldwide. Since the pandemic began, until March 6, 2022, 1821 aged care residents have died in Australia.

Professor Chris Poulos, Director of HammondCare’s Centre for Positive Ageing and one of the authors of the study, said the results add another benefit to the cottage model which HammondCare has pioneered for more than 25 years.

Prof Poulos said the lower infection rates in the cottage model that has emerged in this study follows other research that has shown residents living with dementia have fewer hospitalisations, less inappropriate medication and better quality of life in smaller, domestic care settings.

“What this research shows is that better infection control is just another benefit of the small cottage model,” Prof Poulos said.

HammondCare Chief Executive Mike Baird, who welcomed the findings, said HammondCare’s cottage model is a combination of small-household design and relationship-based care.

“Each resident receives personalised care from familiar faces while building relationships with other residents who have similar needs, “ Mr Baird said.

The Royal Commission into Aged Care, Quality and Safety final report recommended smaller, lower density congregate living arrangements rather than larger more institutional settings, especially for people living with dementia, for future aged care design.

Read the published study here


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