Abstract This qualitative study investigates how care homes in South-West England managed and responded to the everyday challenges of the COVID-19 pandemic. While many studies explore the impact of the pandemic on care home staff, residents, and families, limited research addresses care homes’ experiences with filtering top-down rules and guidelines during ‘uncertain times’. Drawing on the concept of street-level bureaucracy, this study examines how professionalism operates under crisis conditions and how it impacts discretion and organizational response within care homes. Based on fourteen semi-structured interviews with care home staff, including managers, analysis highlights care homes engaged in effective response mechanisms and developed innovative practices in response to the needs of staff, residents and their families by moving beyond the scope of established guidelines. The mobilization of professional discretion under crisis conditions by both care workers and managers centre around four key categories: strengthening infection control and prevention, promoting socialisation, enhanced communication and fostering intra- and inter-professional teamwork. Pioneering, which emerges as a common element across these categories, shapes care home workers and managers professional discretionary responses in relation to policy mediation and implementation during the pandemic. This study, thus, emphasises the ability of care home staff to take action and their resilience in facing pandemic-induced challenges.
Siviş et al. (Thu,) studied this question.