This scoping review sought to identify the impact of the COVID-19 pandemic on the residential aged care sector and facilities (RAC/F), using the World Health Organization’s (WHO) health systems framework. It also sought to identify COVID-19 response strategies across the residential aged care sector, including strategies that considered residents with cognitive impairment, who have been most impact by the COVID-19 pandemic. Databases were searched April-May 2022 for peer reviewed articles and grey literature, with additional searches on policy and service delivery to August 2022, with 147 articles included. The COVID-19 pandemic highlighted the lack of integration across health and aged care sectors, and issues with governance, accountability and comprehensive service delivery for RACFs. Response strategies that considered residents with cognitive impairment were limited. The need to ensure advance care and palliative care planning within COVID-19 responses was evident. Clear guidelines and additional resourcing are required for utilisation of telehealth during a pandemic, particularly to ensure access to diagnostic and treatment services for residents with cognitive impairment.