CQC Advice For Care Homes When the Hot Weather Returns

The CQC has issued advice to those caring for the elderly, vulnerable and disabled during the hot weather.

Making sure patients and clients are properly cared for during hot weather falls under the umbrella of making sure services are ‘safe’ and having processes and procedures in place to manage the effects of hot weather is critical

Andrea Sutcliffe CBE, Chief Inspector of Adult Social Care, said: “While many of us are enjoying the heatwave, the risks of overheating and not getting enough to drink are much greater for older people and people in vulnerable circumstances.

“That is why it is so important that those living in care homes and other health and care settings, particularly people living with long-term illnesses and complex conditions, are appropriately monitored and supported to maintain their usual health and wellbeing.

“Most of this is common sense – thinking about the environment and having person-centred care plans will help you to identify people at greatest risk and make sure they have the support they need.

“There’s also lots of good advice available from Public Health England and NHS England in the Heatwave Plan for England including specific advice for care homes as well as hospital services. Information published by the Care and Support Alliance has a useful section on extreme weather conditions too.

“So, let’s enjoy the summer sunshine but let’s prepare and be #TempAware too.”

Excerpts from the Public Health England’s Heatwave Plan for England are below, but we urge all those involved in providing services for the elderly, disabled and vulnerable to take a look at the full document.

Heatwave Plan For England  – Advanced Preparations

Buildings and surroundings:

  • check that windows can be shaded, preferably by curtains with pale, reflective linings rather than by metal venetian blinds and curtains with dark linings, which can make conditions worse – if these are fitted, check that they can be raised
  • check that there are no problems opening windows while acknowledging security considerations
  • increase outside shading, in the form of shutters, shades, trees or leafy plants; reflective paint can also assist in keeping the building cool. Increase outside greenery, especially in concreted areas, as it increases moisture content and aids cooling as a natural air conditioner
  • cavity wall and loft insulation help to keep the building warm in winter and cooler in the summer – contact your local authority’s energy efficiency officer or your energy company to see what grants are available
  • create cool rooms or cool areas. High risk groups that are vulnerable to the effects of heat, physiologically find it hard to cool themselves efficiently once temperatures rise above 26ºC. Therefore, every care, nursing and residential home should be able to provide a room or area that maintains a temperature at 26ºC or below
  • cool areas can be developed with appropriate indoor and outdoor shading, ventilation, the use of indoor and outdoor plants and, if necessary, air conditioning
  • ensure that staff know which rooms are the easiest to keep cool and which are the most difficult, and review the distribution of residents according to those most at risk Heatwave plan for England – supporting vulnerable people before and during a heatwave – advice for care home managers and staff 7
  • indoor thermometers should be installed in each room in which vulnerable individuals spend substantial time (bedrooms and living and eating areas) – during a heatwave, indoor temperatures should be monitored regularly
  • electric fans may provide some relief, if temperatures are below 35ºC (note, use of fans: at temperatures above 35ºC fans may not prevent heat-related illness. Additionally fans can cause excess dehydration; the advice is to place the fan at an appropriate distance from people, not aiming it directly on the body and to have regular drinks – this is especially important in the case of sick people confined to bed)

Working arrangements:

  • ensure business continuity plans are in place and implement as required (sufficient staff must be available so that appropriate action can be taken in the event of a heatwave)
  • get extra help from relatives of residents and volunteers
  • provide an email address to local authority/NHS emergency planning officers, to facilitate the transfer of emergency information
  • identify cool areas in the care home
  • increase awareness of staff to heat-related illness and health protection measures

Facilities:

  • check that you have an adequate supply of fans and water sprays – install thermometers
  • check that water and ice are widely available – ensure that you have a supply of oral rehydration salts, orange juice and bananas to help maintain electrolyte balance for those on diuretics
  • arrange for cold drinks to be distributed regularly in the event of a heatwave
  • plan to adapt menus to cold meals (preferably with a high water content, such as fruit and salads) in consultation with residents

Residents:

  • make sure you know who is most at risk – ask primary care staff if you are unsure and record it in their individual care plans
  • ensure that you have protocols to monitor residents most at risk and to provide additional care and support (room temperature, body temperature, pulse rate, blood pressure and dehydration will need to be monitored)
  • ask the GPs of at-risk residents about possible changes in treatment or medication in the event of a heatwave and review residents on multiple medications
  • check that residents have light, loose-fitting cotton clothing to wear
  • be aware that plastic pads and mattresses can be particularly hot during a heatwave

What To Do When You Know A Heatwave Is Coming

  • identify high-risk residents/patients
  • if temperatures exceed 26ºC, high-risk individuals should be moved to a cool area that is 26ºC or below – for patients who can’t be moved, or for whom a move might be too disorienting, take actions to cool them down (eg liquids, cool wipes) and enhance surveillance
  • check local weather forecasts on the radio, news, websites (eg www.metoffice.gov.uk) or paper
  • check that staff, and others such as volunteers, know what to do during a heatwave
  • suggest that all residents consult their GP about possible changes to their treatment and/or medication; consider prescribing oral rehydration salts for those on high doses of diuretics
  • check indoor temperatures are recorded regularly during hottest periods in all areas where patients reside
  • communicate alerts to staff and make sure they are aware of heatwave plans
  • prepare cool areas and provide regular wet towels and cool foot baths
  • ensure sufficient staffing

 

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