Quality statement 5: Identifying people vulnerable to health problems associated with cold homes on admission

Quality statement

Hospitals, mental health services and social care services identify people who are vulnerable to health problems associated with a cold home as part of the admission process.

Rationale

Identifying people vulnerable to health problems associated with cold homes at the earliest opportunity (for example soon after admission or when planning a booked admission) based on their socioeconomic, demographic or clinical circumstances, allows care providers the opportunity to then carry out a more detailed assessment of needs that will inform discharge planning. This will help people in care settings who are vulnerable to health problems associated with cold homes to avoid the risks of discharge to a cold home.

Quality measures

Structure

Evidence that care settings (hospitals, mental health services and social care services) have arrangements to identify people who are vulnerable to the health problems associated with a cold home as part of the admission process.

Data source: Local data collection.

Outcome

The number of people vulnerable to the health problems associated with a cold home who are identified on admission.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers (such as hospitals, mental health inpatient services and social care residential services) ensure that they have systems in place to identify people who are vulnerable to the health problems associated with a cold home at the earliest opportunity (for example soon after admission or when planning a booked admission) as part of the admission process. Subsequent discharge planning should take account of any issues identified.

Health and social care practitioners (such as occupational therapists, nurses and residential care managers) identify people who are vulnerable to the health problems associated with a cold home at the earliest opportunity (for example soon after admission or when planning a booked admission) as part of the admission process to hospital, a mental health service or social care service. Subsequent discharge planning should take account of any issues identified.

Commissioners (such as clinical commissioning groups, local authorities and NHS England) ensure that they commission hospital, mental health inpatient and residential social care services that identify people who are vulnerable to the health problems associated with a cold home as part of the admission process.

What the quality statement means for patients, people using services and carers

People admitted to hospital, a mental health service or a social care service (for example a residential care home) are checked when they are being admitted to identify if they are vulnerable to health problems associated with a cold home.

Source guidance

Definitions of terms used in this quality statement

People who are vulnerable to the health problems associated with a cold home

People living in cold homes who are vulnerable to the associated health problems include:

  • people with cardiovascular conditions

  • people with respiratory conditions (in particular, chronic obstructive pulmonary disease and childhood asthma)

  • people with mental health conditions

  • people with disabilities

  • older people (65 and older)

  • young children (under 5)

  • pregnant women

  • people on a low income

  • people who move in and out of homelessness

  • people with addictions

  • people who have attended hospital due to a fall

  • recent immigrants and asylum seekers.

[Adapted from Excess winter deaths and illness and the health risks associated with cold homes (NICE guideline NG6) and expert opinion]

Health problems associated with a cold home

Cold homes and poor housing conditions have been linked with a range of health problems in children and young people, including respiratory health, growth and long‑term health. In older people, cold temperatures increase the risk of heart attack, stroke and circulatory problems, respiratory disease, flu and hospital admission. They also lower strength and dexterity, leading to an increase in the likelihood of falls and accidental injuries. Home temperatures also have implications for mental health because cold is linked with increased risk of depression and anxiety.

[Adapted from Local action on health inequalities evidence review 7: fuel poverty and cold home-related health problems (2014) Public Health England]

Equality and diversity considerations

Good communication between health and social care practitioners and people who may be vulnerable to the health problems associated with a cold home is essential. Those at risk are likely to include people with communication needs, people who are frail or confused, and people who have difficulty understanding when asked about their home heating needs.