Extremely hot weather can be uncomfortable for everyone, even for those who usually like the sun. However, for vulnerable people, such as older people or those with chronic or severe illnesses, very high temperatures can be dangerous.
The hottest weather takes the form of a heatwave – an extended period of abnormally high temperatures. These extreme weather conditions can even be fatal.
Here are seven things that adult social care providers can do to help service users stay safe during hot weather.
1. Follow local and regional planning guidance
All health and adult social care organisations should have policies in place for coping with hot weather and heatwaves. These should be informed by relevant public health planning guidance. See template policies for Heatwaves in Residential Care and Heatwaves in Domiciliary Care.
Inspectors will usually want to check that appropriate plans are in place as part of regulatory activity.
In England the Heatwave Plan applies. The plan is a good practice guide regularly updated by Public Health England. It includes arrangements for the Met Office to monitor temperatures through the summer each year. Under the “heat-health watch” system a heatwave alert is issued whenever a location records a period of at least three consecutive days with daily maximum temperatures meeting or exceeding a set threshold.
A level 2 “readiness” alert is issued when a heatwave is forecast. A level 3 warning requires organisations such as social care providers to take action to protect “at-risk” people. Level 4 signals a major incident or national emergency where there is a serious threat to life.
Similar public health planning is in place for Scotland, Wales and Northern Ireland.
As well as being aware of regional plans and alert systems, care providers should also work with local authorities and local emergency planning and resilience partnerships as appropriate.
2. Help service users to prepare
Make sure that service users in both residential care and domiciliary care are prepared and aware of the dangers of very hot or prolonged hot weather.
In both residential and domiciliary care, providers should review individual care plans to assess which service users are at particular risk and to check on their care arrangements. Where additional support is needed this should be arranged.
To reduce heatwave risks in residential settings, care home managers and staff should try to keep buildings as cool as possible. This might include measures such as:
checking that south-facing windows, which let in most sunlight, can be shaded, preferably with curtains with pale, reflective linings
installing outside shutters or awnings
checking that rooms can be properly ventilated without causing security problems
considering setting up a “cool room” where people can be moved to if necessary.
Care home managers should ensure that enough fans or air conditioning units are available, particularly if premises are difficult to keep cool. Shady areas should be available in gardens. Chilled drinking water should be readily available and cold food choices served.
In domiciliary care, managers and staff should review the homes of at-risk service users. They should provide advice and can help in simple ways, such as helping to obtain fans if premises are difficult to keep cool. Check that people’s fridges and freezers work properly and that cold water is available.
3. Keep an eye on forecasts
Providers should monitor the Met Office website or local and national news during hot weather and watch out for alerts. Warnings should be disseminated to relevant staff who should follow set policies and protocols informed by the Heatwave Plan or other relevant regional plans.
Managers and staff should always take heatwave alerts seriously and act on them to help people stay safe.
4. Take reasonable steps to keep people cool in the heat
Staff in both care homes and in domiciliary care should know what to do to help service users keep cool in the event of a heatwave or a spell of very hot weather.
Certain core messages should be delivered to service users during a heatwave. People who may be vulnerable to the heat should be advised to stay out of the sun if possible. They should be encouraged to:
wear light coloured, loose, cotton clothes
wear hats outside
drink plenty of water or other cold drinks
avoid drinking alcohol and caffeine
While the temperature outside is higher than it is inside people should be advised to keep curtains and blinds closed at windows exposed to the sun. They should open the curtains and windows once the temperature outside has dropped.
If people do go out they should do so when it is cooler, in early mornings or in the evening, and always use sunscreen.
Managers should also act to help their staff stay cool too. Encourage them to wear cool clothes and to drink provide plenty of water and keep the workplace as cool as possible.
5. Keep an eye on vulnerable service users
In the event of a heatwave both care home and domiciliary care staff should monitor the condition of at-risk service users such as those over 75, those with chronic illness and those on certain types of medication (eg diuretics). Managers should ensure that suitable care plans are in place that provide them with adequate support.
During a heatwave, at-risk service users may need additional help from care staff. They may require additional visits to ensure they are keeping cool and are drinking sufficient amounts of water. Some may require their fluid intake to be monitored and recorded, particularly if they are unable to drink unaided.
In the community anyone in a high-risk category who is living alone is likely to need at least daily contact during a heatwave, whether by care workers, volunteers, neighbours or informal carers.
6. Have business continuity plans in place
Serious heatwaves can be very disruptive. They may affect transport networks and schools, affecting how staff get to work and disrupting healthcare services and emergency services. Adult social care providers should therefore have emergency contingency plans in place to ensure that they can continue to provide appropriate care. Plans may need to be coordinated with other agencies, such as primary care, and with carers and voluntary services. See a template Emergency Planning Policy.
7. Know what to do if someone feels ill or gets heatstroke
During a heatwave, staff should be alert to the specific symptoms of illness caused by the heat. See a useful Employee Factsheet on Heatstroke.
Heat exhaustion and dehydration are often seen as the first signs that someone is feeling ill due to excessive exposure to heat. Symptoms are usually caused by a loss of body fluids and salts. They might include:
hot skin that feels “flushed”
fatigue (extreme tiredness) as a result of a decrease in blood pressure and blood volume
rapid heartbeat (tachycardia)
urinating less often and producing much darker urine than usual.
Symptoms can appear rapidly. The person should be moved promptly to somewhere cool and given fluids, preferably water, to drink. They should start to feel better within half an hour. If they do not improve an ambulance should be called.
Where a person has existing health conditions, such as diabetes, kidney or heart conditions, emergency first aid or medical advice should be sought immediately.
Heatstroke is a more serious condition. Symptoms include:
high temperature (40°C (104°F) or above)
heavy sweating that suddenly stops (the skin becoming dry is a warning sign that the body has become over-heated and dehydrated)
rapid breathing (hyperventilation)
nervous system impairment, such as confusion, lack of co-ordination, fits (seizures), headache, etc.
Heatstroke is a potentially fatal condition and should always be treated as a medical emergency. An ambulance should be called immediately.