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Registration Number: {{org_field_registration_no}}

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Managing Heatwaves and Heat-Health Alerts Policy

1. Introduction

A heat wave is defined as a prolonged period of excessively high temperatures, which can pose serious health risks, particularly to older adults, people with chronic health conditions, individuals with mobility issues, and those on certain medications. Given the increasing frequency of extreme weather conditions in the UK, supported living providers must be prepared to mitigate risks and protect tenants’ health and well-being.

This policy outlines the procedures and responsibilities required to prevent heat-related illnesses, provide emergency response actions, and ensure that {{org_field_name}} workers are adequately trained and equipped to support tenants during heat waves.

{{org_field_name}} will follow current UK Health Security Agency (UKHSA), NHS and Met Office guidance, including the Adverse Weather and Health Plan and the Heat-Health Alerting system. The service will use UKHSA/Met Office Heat-Health Alerts as part of its planning and response arrangements. The core Heat-Health Alert season runs from 1 June to 30 September each year, although extraordinary alerts may be issued outside this period where hot weather presents a risk to health.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and CQC Fundamental Standards, including Regulation 9 (Person-centred care), Regulation 10 (Dignity and respect), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 14 (Meeting nutritional and hydration needs), Regulation 15 (Premises and equipment, where equipment is supplied or used by the provider), Regulation 17 (Good governance), Regulation 18 (Staffing), Regulation 19 (Fit and proper persons employed), Regulation 20 (Duty of candour), and the Care Quality Commission (Registration) Regulations 2009, including notification requirements where applicable.

2. Purpose

The purpose of this policy is to ensure that all tenants remain safe, comfortable, and hydrated during periods of extreme heat. This includes:

• Recognising heat waves and their associated health risks.
• Taking preventive measures to avoid heat exhaustion and heat stroke.
• Providing emergency interventions if a service user shows signs of heat-related illness.
• Ensuring {{org_field_name}} staff are adequately trained and equipped to manage tenants’ needs during a heat wave.

This policy applies to all {{org_field_name}} staff, agency workers, volunteers, managers, tenants, and relevant stakeholders involved in the delivery, planning, monitoring or review of regulated care and support. In supported living, tenants usually live in their own homes; therefore, staff must respect tenancy rights, privacy, dignity, consent and choice while taking reasonable steps to prevent avoidable harm and escalate risks appropriately.

2.1 Legal and Regulatory Framework

This policy must be read alongside {{org_field_name}}’s policies on risk assessment, safeguarding, medication, mental capacity and consent, nutrition and hydration, infection prevention and control, business continuity, accidents and incidents, complaints, duty of candour, record keeping, staff training, lone working, and health and safety.

The registered manager is responsible for ensuring that the service can evidence compliance with relevant CQC Fundamental Standards. This includes ensuring that heat-related risks are assessed, monitored, reviewed and mitigated; that staff are competent to recognise and respond to heat-related illness; that people receive support to maintain hydration and wellbeing; that records are accurate and contemporaneous; and that lessons are learned following incidents, near misses, complaints or feedback.

Where a heat-related incident results in serious injury, avoidable harm, death, abuse or neglect concerns, police involvement, safeguarding referral, or any other notifiable event, the registered manager must consider whether a CQC statutory notification, safeguarding referral, commissioner notification, RIDDOR report, or duty of candour response is required.

3. Understanding the Risks of Heat Waves

Heat waves can have serious health consequences. Some service users may be vulnerable because they may be less able to regulate body temperature, may not always drink enough fluids, or may be taking medications that affect hydration levels. Staff must not assume that all tenants are affected in the same way. Each tenant’s level of risk must be considered individually and reviewed before and during periods of hot weather. Higher-risk factors may include older age, learning disability, autism, dementia, mental health needs, limited communication, reduced mobility, respiratory disease, cardiovascular disease, diabetes, kidney disease, obesity, pregnancy, substance or alcohol dependence, previous heat-related illness, inability to access cool areas, living in top-floor or south-facing accommodation, social isolation, and medicines that may affect temperature regulation, blood pressure, hydration, sweating, alertness or kidney function.

Common Heat-Related Conditions:

1. Dehydration
   • Can cause dizziness, confusion, fainting, and increased risk of falls.
   • Service users may not always recognise they are dehydrated or may forget to drink fluids.
2. Heat Exhaustion
   • Symptoms include heavy sweating, weakness, nausea, and rapid pulse.
   • If left untreated, it can progress to heat stroke, which is life-threatening.
3. Heat Stroke (Medical Emergency)
   • Symptoms may include confusion, agitation, lack of coordination, hot skin, reduced or absent sweating, fast breathing, rapid heartbeat, a very high temperature, seizure, collapse or loss of consciousness. Changes in skin colour may be harder to identify on brown or black skin, so staff must consider the whole presentation and not rely on skin colour alone.
   • Requires immediate medical attention—call 999 or 112.

By understanding these risks, support workers can prevent and respond appropriately to heat-related illnesses.

3.1 Heat-Health Alert Levels

{{org_field_name}} will monitor UKHSA/Met Office Heat-Health Alerts and respond proportionately to the level of risk.

Green / preparedness: No alert is in place, but summer preparedness must be maintained. Managers must ensure that this policy is current, staff know how to access guidance, high-risk tenants are identified, and hydration/cooling measures are available.

Yellow alert: Staff must increase awareness, check high-risk tenants more frequently, remind tenants and representatives about hydration and cooling measures, review planned activities, and consider whether any tenant requires additional welfare checks.

Amber alert: Managers must actively coordinate the heatwave response. This includes reviewing staffing levels, prioritising high-risk tenants, increasing welfare checks, checking indoor temperatures where this is part of the care and support plan, reviewing medication and hydration risks, and escalating concerns to health professionals, commissioners or emergency services as needed.

Red alert: This is an emergency response level. Managers must activate business continuity arrangements, prioritise life, health and wellbeing, maintain close oversight of high-risk tenants, liaise with emergency services and local system partners where required, and ensure all actions, decisions and escalations are recorded.

4. Preventive Measures for Heat Waves

4.1 Hydration & Nutrition

Maintaining hydration is a key control measure during hot weather. Staff must support tenants in a person-centred way, taking account of preferences, communication needs, cultural needs, health conditions, swallowing difficulties, prescribed fluid restrictions and any advice from healthcare professionals.

Staff must:

• Encourage regular drinks throughout the day, rather than waiting until the person feels thirsty.
• Offer preferred drinks and hydrating foods where appropriate, such as water, diluted squash, milk, fruit, salads, ice lollies or other suitable options.
• Support the person to keep drinks within reach where this forms part of their care and support plan.
• Monitor and record fluid intake where the person is identified as being at risk of dehydration, where this is included in the care plan, or where a healthcare professional has advised monitoring.
• Escalate concerns promptly if the person is drinking significantly less than usual, has reduced urine output, appears confused, dizzy, weak, drowsy, unwell, or shows signs of dehydration.
• Follow any Speech and Language Therapy, dietetic, GP, nursing or other clinical guidance about thickened fluids, swallowing risks, diabetes, kidney disease, heart failure or fluid restriction.
• Avoid blanket instructions such as ‘everyone must drink more water’ where this may be unsafe for people on fluid restriction or with specific clinical needs.

Where a tenant declines drinks or cooling support, staff must respect their decision if they have capacity to make that decision, while providing accessible information about the risks, offering alternatives, recording the decision, and escalating where refusal creates a serious risk of harm.

4.2 Maintaining a Cool Environment

• Support tenants to keep indoor spaces as cool as reasonably possible, including closing curtains or blinds on windows exposed to direct sunlight, opening windows when the outside temperature is cooler than inside, using cooler rooms where available, and avoiding unnecessary heat-generating activities during the hottest parts of the day.
• Use fans or air conditioning where available, ensuring they do not blow directly onto tenants to prevent chills.
• Encourage tenants to stay in shaded areas when outdoors and avoid exposure to direct sunlight.
• Avoid cooking large meals that generate heat indoors.

Support workers must regularly assess the temperature in supported living accommodations and take necessary steps to keep it comfortable.

Where {{org_field_name}} provides or uses equipment as part of regulated care and support, such as fans, cooling aids, thermometers, air-conditioning units, pressure-relieving equipment or mobility equipment, staff must ensure that the equipment is safe, clean, suitable, used correctly and reported for repair or replacement if faulty. Where accommodation or equipment is not provided by {{org_field_name}}, staff must still report concerns that may place the tenant at risk, seek consent to liaise with the landlord, housing provider, family, representative or commissioner where appropriate, and escalate serious risks in line with safeguarding and health and safety procedures.

4.3 Clothing & Sun Protection

• Encourage light, loose-fitting, and breathable clothing (cotton is preferable).
• Apply sunscreen (SPF 30+) to any exposed skin if a service user must go outside.
• Use sun hats and sunglasses for added protection against direct sun exposure.

4.4 Individual Heat Risk Assessment and Care Planning

Before and during the Heat-Health Alert season, staff must identify tenants who may be at increased risk from hot weather. Where a tenant is identified as higher risk, their care and support plan must include proportionate heat-related controls. These may include increased welfare checks, hydration prompts, support with appropriate clothing, support to access cooler areas, monitoring of symptoms, support with prescribed creams or sun protection where this is part of the care plan, communication aids, involvement of representatives, and escalation arrangements.

Risk assessments must be reviewed when:

• A Heat-Health Alert is issued.
• The tenant’s health, medication, mobility, cognition or communication changes.
• The tenant has a heat-related illness, near miss or hospital admission.
• The tenant moves room, flat or accommodation.
• Concerns are raised by staff, family, representatives, neighbours, commissioners or health professionals.

All actions must be proportionate, person-centred and the least restrictive option available.

4.5 Medicines and Clinical Risk

Some medicines and health conditions can increase the risk of dehydration, overheating, falls, confusion or deterioration during hot weather. Staff must not stop, change or withhold prescribed medicines unless instructed by an appropriate healthcare professional. Where staff are concerned that hot weather may be affecting a tenant’s health or medication safety, they must seek advice from the GP, pharmacist, community nurse, NHS 111 or emergency services, depending on urgency.

Staff must monitor and escalate concerns where a tenant appears unusually drowsy, confused, dizzy, weak, breathless, unsteady, has reduced urine output, has vomiting or diarrhoea, refuses fluids, or shows signs of acute deterioration.

4.6 Mental Capacity, Consent and Best Interests

Tenants must be supported to make their own decisions about hydration, clothing, room ventilation, outdoor activities and cooling measures wherever possible. Staff must provide information in a way the person can understand, including easy-read, pictures, objects of reference, communication aids or involvement of a trusted person where appropriate.

Where there is reason to believe that a tenant may lack capacity to make a specific heat-related decision at the relevant time, staff must follow the Mental Capacity Act 2005 and {{org_field_name}}’s Mental Capacity and Best Interests Policy. Any best-interests decision must be decision-specific, proportionate, least restrictive, recorded, and involve relevant people where appropriate. Staff must not impose restrictions simply for convenience.

5. Identifying and Responding to Heat-Related Illnesses

If a service user displays symptoms of heat-related illness, the following steps should be taken immediately:

5.1 Response to Dehydration

• Encourage the service user to drink small, frequent sips of water.
• Move them to a cooler room.
• Observe for worsening symptoms and call NHS 111 if necessary.

5.2 Response to Heat Exhaustion

• Move the service user to a cool, shaded area.
• Loosen or remove unnecessary clothing.
• Provide cool fluids (but avoid very cold drinks as they may cause stomach cramps).
• Use cold compresses on the neck, wrists, and underarms to lower body temperature.
• If symptoms do not improve after 30 minutes of active cooling, or if the person becomes confused, has a seizure, collapses, loses consciousness, becomes very drowsy, has fast breathing, chest pain, severe breathlessness, or staff suspect heatstroke, call 999 immediately.

5.3 Response to Suspected Heatstroke — Medical Emergency: Call 999

If heatstroke is suspected, staff must call 999 immediately. Do not wait to see whether the person improves.

While waiting for emergency services, staff must:

• Move the person to a cooler area if it is safe to do so.
• Remove excess outer clothing where this can be done safely and respectfully.
• Cool the person using cool water, cool damp cloths, wrapped cold packs to the neck/armpits/groin, or fanning.
• Place the person in the recovery position if unconscious and breathing normally.
• Not give anything to drink if the person is unconscious, very drowsy, fitting, or unable to swallow safely.
• Continue to monitor breathing, responsiveness and temperature-related symptoms.
• Stay with the person until emergency help arrives.
• Inform the registered manager or senior on call as soon as possible.
• Record the incident, actions taken, advice received and outcome.

5.4 Escalation, Recording and Notifications

All heat-related concerns, incidents, near misses and refusals of support that create risk must be recorded in the tenant’s daily notes and, where applicable, on the incident reporting system. Records must include symptoms observed, temperature/environmental concerns where known, fluids offered or taken where monitored, action taken, advice sought, people informed, decisions made, and the outcome.

The registered manager or delegated senior must review heat-related incidents to identify whether further action is required, including care plan review, risk assessment update, staff debrief, safeguarding referral, commissioner notification, family/representative update, CQC notification, RIDDOR report, or duty of candour response. Any serious incident must be escalated without delay in line with {{org_field_name}}’s incident management and safeguarding procedures.

6. Staff Training & Preparedness

All staff must receive information, instruction, supervision and training appropriate to their role so that they can prevent, recognise and respond to heat-related risks. Training and competency checks must cover:

• The current heatwave/Heat-Health Alert procedure.
• The signs and symptoms of dehydration, heat exhaustion and heatstroke.
• Hydration support and escalation.
• Person-centred care, consent, mental capacity and best-interests decision-making.
• How to support tenants with communication needs, learning disability, autism, dementia or mental health needs during hot weather.
• Safe use of cooling equipment supplied or used by the service.
• Recording requirements, incident reporting and escalation.
• Safeguarding concerns linked to neglect, self-neglect, unsafe accommodation or failure to act on heat-related risk.
• Business continuity arrangements during extreme heat, including staffing shortages, transport disruption, power failure, water supply disruption or increased demand.

Where {{org_field_name}} is a CQC-registered provider, staff must also receive learning disability and autism training appropriate to their role in line with the statutory requirement and the Oliver McGowan code of practice.

7. Communication & Coordination

{{org_field_name}} will maintain clear communication arrangements before, during and after hot weather.

Internal alerts: The registered manager or delegated person will monitor UKHSA/Met Office Heat-Health Alerts and ensure that relevant staff are informed of the alert level, expected risks, priority tenants and required actions.

Tenant communication: Staff will provide tenants with accessible information about staying safe in hot weather, including hydration, cooling, avoiding excessive heat exposure, recognising symptoms and how to ask for help. Information must be provided in a format suitable for the person.

Families, representatives and advocates: With the tenant’s consent, or where there is lawful authority or a best-interests reason to do so, staff will involve families, representatives or advocates in heat-related planning and escalation.

Health and social care partners: Where risks increase, staff must liaise promptly with relevant professionals, which may include GPs, pharmacists, community nurses, mental health teams, learning disability teams, occupational therapists, commissioners, housing providers, local authorities, NHS 111, ambulance services, safeguarding teams or emergency services.

Housing and environmental concerns: Where a tenant’s accommodation becomes unsafe due to excessive heat, lack of ventilation, faulty cooling equipment, inability to access water, power failure or other environmental concern, staff must escalate to the landlord, housing provider, commissioner, local authority or emergency services as appropriate, while respecting consent and tenancy rights unless there is an immediate risk of serious harm.

7.1 Business Continuity During Extreme Heat

The registered manager must consider whether extreme heat may affect the safe running of the service. Business continuity planning must include arrangements for staff absence, travel disruption, increased welfare checks, prioritisation of high-risk tenants, failure of water or electricity supply, failure of cooling equipment, safe storage of medicines, communication failures, and access to emergency support.

Where staffing capacity is reduced, managers must prioritise support according to risk and must document decisions, actions taken, and any communication with commissioners, families, representatives or professionals.

7.2 Safeguarding

Heat-related risks may become safeguarding concerns where a tenant is experiencing neglect, self-neglect, organisational abuse, unsafe accommodation, refusal or inability to access essential fluids, or failure by any person or organisation to act on known serious risks. Staff must follow {{org_field_name}}’s Safeguarding Adults Policy and escalate concerns promptly to the registered manager or safeguarding lead. Immediate risks to life or serious harm must be escalated to emergency services without delay.

8. Review, Audit and Continuous Improvement
This policy will be reviewed at least annually, following any significant heat-related incident, following any relevant change in legislation or national guidance, or where audit, feedback, safeguarding, complaints or incident analysis identifies that improvement is required.

The registered manager will ensure that heat-related preparedness is audited before or during the Heat-Health Alert season. The audit should include:

• Identification of tenants at increased risk.
• Completion and review of heat-related risk assessments and care plans.
• Staff awareness of Heat-Health Alert actions.
• Availability and safe use of equipment supplied or used by the service.
• Hydration monitoring where required.
• Incident and near-miss trends.
• Feedback from tenants, staff, families, representatives and professionals.
• Actions taken and evidence of learning.

Findings must be recorded, actioned and monitored through the service’s governance system.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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