Table 2.

Interview quotes by theme

Theme	Quotes
THEME 1: Delayed and inconsistent offers of face-to-face visits
Varied visitation rights	‘…I didn’t have any visits to see my husband in the care home from that point until I think about the 9th of December…I got 2 visits before Christmas, and on Boxing Day visits stopped and I haven’t had a visit since…I’ve been to a window and waved at him and that’s it…it’s a crazy, crazy times.’ F-Up ID01 Female carer ‘we do video calls but it isn’t the same he doesn’t quite understand well he doesn’t understand full stop what’s happening you know. I mean I suppose in some ways you know it might be a good thing to have dementia because you cannot figure out what’s going on…but for me it’s not good, it’s been horrendous really’ Baseline ID01, Female carer ‘about opening it up completely again they said that they are hoping that once people are vaccinated and everybody’s vaccinated in the home that’s when maybe they can look at letting us have a little bit more freedom of walking around the home with her and doing like normal visits that we used to do.’ F-Up ID10, Female carer
Individual care home decisions	‘we have an essential visitor status and they left it quite open for our interpretation…we actually did have a few people who had essential visitor status and then we increased it because…after lockdown, the second lockdown we could see that people were failing.’ F-UP ID06, female CH manager ‘so it seems to be nice and the visitors the residents now are allowed to sit together in the big lounge whereas they were being kept in the small lounges or in their rooms for so long you know but yes it’s nice to see them smiling when you walk in and they’re all together in the big lounge you know watching the telly or chatting.’ F-Up ID40, care home staff I’m just hoping that they’re not going to rush it and they’re going to take it area by area by area and look at it that way erm yeah ‘cause we haven’t got a lot of residents any more unfortunately F-Up ID04 Female Housekeeper ‘they were intending to allow us to go inside for 30 minute visits in or from the 8th of March but just on an allocated basis, not like every day, so I think they were going to give me 2 a week because it’s just me, I think if other families possibly might just get 1 internal visit and 1 in a pod for another member of the family which is what the Government said should happen.’ F-Up ID01, Family carer
Logistical issues	“there’s a lot more management of relationships, i.e. with relatives in particular. There’s a lot more working with professionals but in a different way as in online or over the phone. It hasn’t made provision of care easy. It’s made it more stressful because, an example would be, might have a GP who would come in, let’s say on a monthly basis, or a link senior nurse from the practice coming in on a weekly basis. They don’t actually physically come in unless it’s absolutely necessary…its increased stress levels and increased our work Baseline ID18, male care home manager ‘last November…visiting had started in the care home so…families were getting reunited …they were able to sort of have that physical contact although it was limited but they were allowed to go into the rooms and spend time…we had to clear a new role for that so that we had somebody who was able to organise all the visiting and help and assist because it was quite a big role.’ F-Up ID06, care home staff
THEME 2: Procedures and facilitation of visits	“I saw my mum for a couple of visits sort of downstairs in her home…just before Christmas and I did one of those lateral flow tests and I was able to sit with her and hold her hand and open her Christmas presents with her and I just thought oh this is how it’s going to be now…it was very very bitter sweet because it was a lovely thing…but then obviously I haven’t actually seen my mum since that time…you could see her behind a screen and with…some sort of microphone…I just thought that would be too confusing for my mum.” F-UP ID14 “a contact visit is I have to have a test half an hour before and so long as that test is negative then I can put the PPE on and we can go in the room, they open the door so you’re still contained in that room but you know at least you can be with her the only thing is, I was a bit worried in case she was going to wander, ‘cause mum does wander.” F-Up Interview ID10, female carer
	“firstly you have to go in a half hour early and do your lateral flow test and then fill everything in for that. So there’s all that but then we actually go into the what they call the pod room but we’re on just the one side of it now together in the same half so and you’re allowed to obviously you’ve got your PPE on you’re allowed to sit and my mum came straight up to hug me and we’re not really supposed to do that but there’s nothing you can do about that and I’m not worried because I’ve not been anywhere and I’m not going to give anything but.” F-Up ID17, female carer, daughter ‘you can have one family member to do contact visits and [the care home] asked which family member, so my brothers don’t talk to me and then I was told that [I] mightn’t be allowed in.’ F-Up ID10 Female carer, daughter ‘we came out of lockdown the home cautiously opened up to garden visits because it was summer…then they said they’ve locked down again …there’s no one to blame because I don’t want COVID to get back into that home…so I can’t blame the home for their decisions and I fully support them because I don’t want that home opening up to everyone and COVID going back in.’ Baseline interview ID14, female carer, daughter
THEME 3: Variable uptake of the COVID-19 vaccine	(I am) 100% in favour of (the vaccine) …if the worst happened and the virus got into the home then it wouldn’t be so bad…it gives you a bit more confidence that when you pass somebody in the street or whatever, if the worst happens it will affect me much less F-Up ID07, male carer, spouse ‘the relatives had asked me how many staff had had the vaccine and I think only was it, was a third only 30% of the staff …we weren’t the only care home that had poor uptake’ F-Up ID06, female manager ‘They’re having weekly tests and their take up rate or sorry they informed us that 90% of staff have had the [vaccine]. What they didn’t explain was whether the other 10% had declined…I need to get to the bottom of that one because I suppose realistically I’m not happy about carers caring for my mum if they haven’t had the vaccination.’ F-Up ID29, male carer, son “I have asked and I have I’ve been given an answer that made me assume that there were some [staff] who haven’t been vaccinated. I don’t know about residents…because they’re all dementia sufferers I can’t believe that relatives would say no. Not given that the care home lost an awful lot of people in the first wave, and I really don’t think that the staff should have an option, don’t get me on that one.” F-Up ID01, female family carer ‘they [staff] won’t tell you anything, they say its data protection but actually I think I’ve got a right to know [the number of staff vaccinated] but they’re not forthcoming with their actual communication generally.’ F-Up ID11, female family carer
THEME 4: Misinformation, education, and free choice	‘they just were really confused but we did all sit down and have a chat, like all the night staff were sat down and we were talking about it and one of my friends had said about the microchip and I was like what it’s not true they wouldn’t do that and so I did kind of get some links up and show her them so she could read and she did actually go and get her vaccine.’ F-UP ID 40, care home staff “it was my choice I was like I don’t I was never educated about it really… there was no like I think some kind of staff meeting would have been helpful or even like a zoom call with some kind of professional, something just to let us know the facts because we didn’t know I didn’t know anything about it really I just know it was the right thing to do but there was all you know on Facebook and stuff and social media like people saying like that it’s going to, yes the fertility one was a big one for me.” F-Up ID13, female, care assistant “I declined it [vaccine] at first and before, because there was all the talk we might be getting vaccines and nearly everyone that I spoke to was like I’m not going to get that vaccine…they don’t know what’s in it and what’s going to how it’s going to affect us… the main reason for me was just because I didn’t really know how it would affect, I think fertility was one of the things they were saying…” F-Up ID13, female, care assistant
	I think it’s because they have to go to the general hospital for the vaccine…there’s a bus service…but if you work 12 hour shifts and you haven’t got a car…it’s a long trip on a bus…the other thing was the staff [were] phoning to get booked in and were told they couldn’t get the vaccine which was a complete and utter lie, so there was a lot of things.” F-Up ID06, female manager ‘they came to the home and all the residents got done and then we literally got a phone call of the manager saying you need to be in in the next half hour your, for your vaccine so we all went down and got our vaccines so.’ F-Up ID40, care home staff ‘then I had a message from my manager which said you need to decide now because we’re booking it [vaccines] and I was like I hadn’t spoken to any of my friends or any other staff and I thought I was going to decline so I declined’ F-Up ID13 female care assistant ‘if you’ve got any concerns, go speak to them [managers] and we’ve got phone lines and websites to visit and the managers are really nice, really supportive making sure everyone’s okay and checking in on everyone’ F-Up ID04, female care home staff
THEME 5: Frustration and anger among family carers	I was going to see [husband/PLWD] in the pod but…2 carers that I spoke to who came in with him…they both declared that they weren’t going to have the vaccine. So I’m sitting on the other side of the pod thinking well actually he’s greater risk on that side of the screen than he is with me. F-Up ID11, female carer, spouse ‘But I’ve got to a point now where I’m thinking why am I bothering because I’ve had my first vaccine I’m so much protected now from being seriously ill at least but this issue with the staff keeping contracting COVID is never going to stop because vaccines don’t stop you catching it. You can still test positive and I can’t see the end of it at the moment you know from a visiting point of view.’ F-Up ID01 my argument all along through this has been that I don’t see myself as the risk to my mum…the staff are the risk because they’re coming and going on a daily basis…they’re getting tested weekly but it’s the staff that are bringing COVID into the home because, because none of the families have been able to get in there so it feels, erm so it’s a little bit frustrating to say the least F-Up ID29, female carer, daughter