Building for resilience: insights from a Stockholm nursing care facility amidst the COVID-19 pandemic

Introduction This study investigates the COVID-19 response strategies of a senior housing facility in Sweden, Red Garden, which reported a notably low mortality rate during the pandemic’s first wave. Methods Using a single-case study design, the research draws on on-site inspections, routine protocol documents, and a semi-structured interview with the facility manager. Thematic analysis was conducted to examine the data. Results Thematic analysis reveals that effective containment at Red Garden resulted from a combination of spatial affordances, proactive leadership, embedded hygiene culture, and communication strategies. Importantly, the findings suggest that the successful implementation of national guidelines relied not only on knowledge and motivation, but on the physical and organizational capacity of the facility to act. Discussion These findings challenge the assumption that infection control strategies are universally transferable across eldercare settings. The study underscores the need for pandemic preparedness plans that address the environmental and managerial feasibility of implementation. While limited by its single-case design, this research highlights how spatial configuration and leadership dynamics can interact to shape resilience in long-term care environments.