"We Do the Best We Can with What We Have": Reflections from Residential Care Stakeholders on the Impacts of COVID-19

COVID-19 mandates required residential youth care providers to quickly adapt services while adhering to state and local mandates, impacting family visitation, stress, and potential disruption to reunification efforts. This mixed-methods study utilized data from a larger study of residential group homes in one southeastern state, utilizing the Quality Standards Assessment (QSA). First, utilizing open-ended responses on the QSA, a content analysis was used to explore residential care providers' challenges and responses during COVID-19. Next, descriptive statistics and trend charts were utilized to explore quality differences in programs pre-, during, and post-COVID-19. The qualitative data reflected that COVID-19 presented significant challenges to residential care providers, including impacts on family and community engagement, programmatic procedures, education, and the residential care workforce. Responses to challenges included creating activities on-campus, conducting family visits virtually, shifting to on-campus schooling, and conducting re-licensing inspections virtually. The quantitative analysis showed mean quality rating trends dropping during the pandemic, with some quality ratings improving post-pandemic. Moreover, trends in mean incident reports increased during and post-pandemic years. Residential programs adapted to challenges, while some gaps remained. Issues with school and being isolated from family and community, as well as an increase in incident reports, were experienced among youth within residential care during COVID-19. Post-pandemic incident reports underscore the potential long-term impacts of COVID-19 on residential group care.