COVID-19 and Policies for Care Homes in European Welfare States: Too little, too late?

This article examines COVID-19 and residential care for older people, comparing countries drawn from different welfare state models - Denmark, England, Germany, Italy and Spain - to identify the policy approaches taken to the virus in care homes and set these in institutional and policy systemic context. Pandemic policies towards care homes across the countries are compared in terms of lockdown, testing and the supply of personal protective equipment (PPE). The comparative analysis shows a clear cross-national clustering: Denmark and Germany group together by virtue of their relatively proactive approach whereas England, Italy and Spain had major weaknesses which resulted in delayed or inadequate responses. The paper goes on to show that these outcomes and country clustering are embedded in particular LTC policy systems. The factors that we highlight as especially important in differentiating the countries are the resourcing of the sector, the extent to which LTC and care homes are regulated, and the degree of vertical (and to a lesser extent horizontal) integration of coordination in the LTC sector and between it and the health sector.