Minimising the impact of infectious outbreaks on resident quality of life: A qualitative proof of concept study using the Adult Social Care Outcomes Toolkit (ASCOT)

Diane Bunn; Wenjing  Zhang; Nick Smith; Oluseyi  Jimoh; Jane  Greenstock; Mohammud  Edoo; Ann-Marie Towers

doi:10.1371/journal.pone.0316424

Minimising the impact of infectious outbreaks on resident quality of life: A qualitative proof of concept study using the Adult Social Care Outcomes Toolkit (ASCOT)

Diane Bunn, Wenjing Zhang, Nick Smith, Oluseyi Jimoh, Jane Greenstock, Mohammud Edoo, Ann-Marie Towers (Lead Author)

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Infection control measures (ICMs) used to mitigate the effects of infectious outbreaks in care homes impact on resident quality of life (QoL). This qualitative proof-of-concept study explored whether the Adult Social Care Outcomes Toolkit (ASCOT) could feasibly support care home staff in recognising and minimising these impacts.

Methods: There were two phases involving online interviews with six care home managers/deputies from five homes who had managed notifiable outbreak(s) in the previous six months in two regions of England. Phase 1, using an incident analysis approach, explored the impact of outbreaks and ICMs on resident QoL, mapping data to the eight ASCOT domains. Phase 2 assessed the usefulness of using ASCOT to identify, monitor and minimise impacts on resident QoL during infectious outbreaks. Follow-up interviews were conducted with four care homes from phase 1 and six healthcare professionals with ICM responsibilities. Online interviews were analysed using framework analysis.

Findings: Phase 1: three types of outbreaks (COVID-19, norovirus, chest infections) were discussed. All were managed using standard ICMs: isolation, increased cleaning, and staff wearing personal protection equipment. The impacts of these measures on resident QoL were described. Phase 2: two overarching themes identified: (i) ICMs as a personal cost for the greater good and (ii) the potential of ASCOT in minimising impacts of infectious outbreaks on resident QoL as a tool to support care planning and mitigating impacts.

Conclusion: ASCOT can support planning to mitigate the effects of ICMs for infectious outbreaks on resident QoL.

Original language	English
Article number	e0316424
Journal	PLoS One
Volume	20
Issue number	9
DOIs	https://doi.org/10.1371/journal.pone.0316424
Publication status	Published - 25 Sept 2025

Keywords

long-term care
quality of life
infection control
aged
qualitative research

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@article{fde70f5c2ae84ca9af23adbbb00eb050,

title = "Minimising the impact of infectious outbreaks on resident quality of life: A qualitative proof of concept study using the Adult Social Care Outcomes Toolkit (ASCOT)",

abstract = "Introduction: Infection control measures (ICMs) used to mitigate the effects of infectious outbreaks in care homes impact on resident quality of life (QoL). This qualitative proof-of-concept study explored whether the Adult Social Care Outcomes Toolkit (ASCOT) could feasibly support care home staff in recognising and minimising these impacts. Methods: There were two phases involving online interviews with six care home managers/deputies from five homes who had managed notifiable outbreak(s) in the previous six months in two regions of England. Phase 1, using an incident analysis approach, explored the impact of outbreaks and ICMs on resident QoL, mapping data to the eight ASCOT domains. Phase 2 assessed the usefulness of using ASCOT to identify, monitor and minimise impacts on resident QoL during infectious outbreaks. Follow-up interviews were conducted with four care homes from phase 1 and six healthcare professionals with ICM responsibilities. Online interviews were analysed using framework analysis. Findings: Phase 1: three types of outbreaks (COVID-19, norovirus, chest infections) were discussed. All were managed using standard ICMs: isolation, increased cleaning, and staff wearing personal protection equipment. The impacts of these measures on resident QoL were described. Phase 2: two overarching themes identified: (i) ICMs as a personal cost for the greater good and (ii) the potential of ASCOT in minimising impacts of infectious outbreaks on resident QoL as a tool to support care planning and mitigating impacts. Conclusion: ASCOT can support planning to mitigate the effects of ICMs for infectious outbreaks on resident QoL. ",

keywords = "long-term care, quality of life, infection control, aged, qualitative research",

author = "Diane Bunn and Wenjing Zhang and Nick Smith and Oluseyi Jimoh and Jane Greenstock and Mohammud Edoo and Ann-Marie Towers",

note = "Data Availability: Due to ethical restrictions, the interview data from this study cannot be publicly shared, as it contains potentially identifiable and sensitive information. Participants did not consent for their transcripts to be made public; therefore, the data remain confidential in accordance with the approval granted by the University of East Anglia Ethics Research Committee. Anonymised verbatim quotes are included in the manuscript to illustrate the findings. Requests for access to the data can be submitted to University of East Anglia FMH S-REC (Faculty of Medicine and Health Sciences Research Ethics Subcommittee) [email protected] (ref: ETH2324-1074), for researchers who meet the criteria for access to confidential data. Funding: This research was funded by the UK Health Security Agency (UKHSA). We also received support from the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East of England (NIHR ARC EoE). The views expressed are those of the author[s] and not necessarily those of the NIHR, the Department of Health and Social Care or UKHSA. There was no additional external funding received for this study.",

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doi = "10.1371/journal.pone.0316424",

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volume = "20",

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T1 - Minimising the impact of infectious outbreaks on resident quality of life: A qualitative proof of concept study using the Adult Social Care Outcomes Toolkit (ASCOT)

AU - Bunn, Diane

AU - Zhang, Wenjing

AU - Smith, Nick

AU - Jimoh, Oluseyi

AU - Greenstock, Jane

AU - Edoo, Mohammud

AU - Towers, Ann-Marie

N1 - Data Availability: Due to ethical restrictions, the interview data from this study cannot be publicly shared, as it contains potentially identifiable and sensitive information. Participants did not consent for their transcripts to be made public; therefore, the data remain confidential in accordance with the approval granted by the University of East Anglia Ethics Research Committee. Anonymised verbatim quotes are included in the manuscript to illustrate the findings. Requests for access to the data can be submitted to University of East Anglia FMH S-REC (Faculty of Medicine and Health Sciences Research Ethics Subcommittee) [email protected] (ref: ETH2324-1074), for researchers who meet the criteria for access to confidential data. Funding: This research was funded by the UK Health Security Agency (UKHSA). We also received support from the National Institute for Health and Care Research (NIHR) Applied Research Collaboration East of England (NIHR ARC EoE). The views expressed are those of the author[s] and not necessarily those of the NIHR, the Department of Health and Social Care or UKHSA. There was no additional external funding received for this study.

PY - 2025/9/25

Y1 - 2025/9/25

N2 - Introduction: Infection control measures (ICMs) used to mitigate the effects of infectious outbreaks in care homes impact on resident quality of life (QoL). This qualitative proof-of-concept study explored whether the Adult Social Care Outcomes Toolkit (ASCOT) could feasibly support care home staff in recognising and minimising these impacts. Methods: There were two phases involving online interviews with six care home managers/deputies from five homes who had managed notifiable outbreak(s) in the previous six months in two regions of England. Phase 1, using an incident analysis approach, explored the impact of outbreaks and ICMs on resident QoL, mapping data to the eight ASCOT domains. Phase 2 assessed the usefulness of using ASCOT to identify, monitor and minimise impacts on resident QoL during infectious outbreaks. Follow-up interviews were conducted with four care homes from phase 1 and six healthcare professionals with ICM responsibilities. Online interviews were analysed using framework analysis. Findings: Phase 1: three types of outbreaks (COVID-19, norovirus, chest infections) were discussed. All were managed using standard ICMs: isolation, increased cleaning, and staff wearing personal protection equipment. The impacts of these measures on resident QoL were described. Phase 2: two overarching themes identified: (i) ICMs as a personal cost for the greater good and (ii) the potential of ASCOT in minimising impacts of infectious outbreaks on resident QoL as a tool to support care planning and mitigating impacts. Conclusion: ASCOT can support planning to mitigate the effects of ICMs for infectious outbreaks on resident QoL.

AB - Introduction: Infection control measures (ICMs) used to mitigate the effects of infectious outbreaks in care homes impact on resident quality of life (QoL). This qualitative proof-of-concept study explored whether the Adult Social Care Outcomes Toolkit (ASCOT) could feasibly support care home staff in recognising and minimising these impacts. Methods: There were two phases involving online interviews with six care home managers/deputies from five homes who had managed notifiable outbreak(s) in the previous six months in two regions of England. Phase 1, using an incident analysis approach, explored the impact of outbreaks and ICMs on resident QoL, mapping data to the eight ASCOT domains. Phase 2 assessed the usefulness of using ASCOT to identify, monitor and minimise impacts on resident QoL during infectious outbreaks. Follow-up interviews were conducted with four care homes from phase 1 and six healthcare professionals with ICM responsibilities. Online interviews were analysed using framework analysis. Findings: Phase 1: three types of outbreaks (COVID-19, norovirus, chest infections) were discussed. All were managed using standard ICMs: isolation, increased cleaning, and staff wearing personal protection equipment. The impacts of these measures on resident QoL were described. Phase 2: two overarching themes identified: (i) ICMs as a personal cost for the greater good and (ii) the potential of ASCOT in minimising impacts of infectious outbreaks on resident QoL as a tool to support care planning and mitigating impacts. Conclusion: ASCOT can support planning to mitigate the effects of ICMs for infectious outbreaks on resident QoL.

KW - long-term care

KW - quality of life

KW - infection control

KW - aged

KW - qualitative research

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DO - 10.1371/journal.pone.0316424

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ER -

Minimising the impact of infectious outbreaks on resident quality of life: A qualitative proof of concept study using the Adult Social Care Outcomes Toolkit (ASCOT)

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Keywords

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