Research has found that COVID infection rates were markedly lower in smaller, detached residential units when compared to rates of transmission in larger, single-site facilities.

The meta-analysis – led by UNSW Sydney – found aged care facilities with a cottage model design had an infection rate almost half that (26 per cent) of a more traditional institutional-style facility (50 per cent).

Researchers studied pre-Omicron data documenting the COVID-19 experience of 757 aged care facilities worldwide, covering 11 countries, 90,657 residents and 6,521 staff.

When it comes to infectious diseases such as the coronavirus “the design of aged care facilities should be smaller in size, with adequate space for social distancing,” the researchers concluded.

Professor Chris Poulos

Infection control policies in future should address factors such as the number of beds per facility and staff-to-bed ratios while also considering modifications to homes with multiple-occupancy rooms, the research found.

Professor Chris Poulos – director of HammondCare’s Centre for Positive Ageing and one of the authors of the study – said: “What this research shows is that better infection control is just another benefit of the small cottage model.”

This latest study follows previous research showing residents with dementia living in smaller, domestic care settings have fewer hospitalisations, less inappropriate medications and a better quality of life.

The Australian analysis supports other studies that also found smaller aged care facilities superior for infection control. A US study released last year showed infection rates were less in the Green House aged care model and other small nursing homes that feature 10-12 beds and home-like settings.

When the aged care royal commission released its final report last year, it recommended smaller, lower density living arrangements – especially for people living with dementia – for future aged care design.

In March, dementia care specialists HammondCare opened two additional cottages at its aged care home in the Wollongong suburb of Horsley as part of a $6.9 million expansion project.

Factors Associated With SARS-CoV-2 Attack Rates in Aged Care—A Meta-analysis is published in the March edition of Open Forum Infectious Diseases.

Main image: one of HammondCare’s new Horsley cottages

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