As a result of global climate change, the UK is expected to experience hotter and drier summers, and heatwaves are expected to occur with greater frequency, intensity and duration. In 2003 and 2018, 2,091 and 863 heat-related deaths, respectively, were reported in England alone as a result of heatwaves, meaning future temperature increases could lead to a parallel rise in heat-related mortality. The UK also currently has a rapidly ageing population, with people aged 75 or over expected to account for 13% of the total population by 2035. Older populations are more vulnerable to climate-induced effects as they are more likely to have underlying, chronic health complications, making them more vulnerable to heat stress. The indoor environment is a principle moderator of heat exposure in older populations, who tend to spend the majority of their time indoors. Poor building design, the lack of effective heat management and diverging needs and preferences between staff and residents in care settings may contribute to increased indoor heat exposure with detrimental health impacts falling on the most vulnerable residents. Maladaptation to a warming climate, such as the uptake of air conditioning, could increase fuel bills in care homes, increase operational costs for businesses in the already financially stretched care sector, and increase building carbon emissions, thus undermining government efforts to reduce greenhouse gas emissions. The one-year pilot project 'Climate Resilience of Care Settings' and previous small-scale studies led by our research team have shown that UK care homes are already overheating even under non-extreme summers. A key target for climate adaptation in care settings is to limit such risks by introducing passive cooling strategies via building design. However, preliminary modelling as part of the pilot project also demonstrated that common passive cooling strategies may not adequately mitigate overheating risk in the 2050s and 2080s. Further research into advanced passive cooling strategies, combined with human behaviour and organisational change is required to identify optimum climate adaptation pathways for UK's care provision. The main aim of the project is to quantify climate related heat risks in care settings nationwide and enhance understanding of human behaviour, organisational capacity and governance to enable the UK's care provision to develop equitable adaptation pathways to rising heat stress under climate change. Building on the foundations of the pilot project, this novel, interdisciplinary project will collect, for the first time in the UK, longitudinal temperature and humidity data in a panel of 50 care settings in order to quantify the recurring risk of summertime overheating. We will also identify and assess social, institutional and cultural barriers and opportunities underpinning the governance of adaptation to a warmer climate in care and extra-care homes through surveys with residents, frontline care staff, managers and policy stakeholders. Within sub-samples of this panel, we will use innovative measurement techniques to collect residents' physiological data and study their relation with heat exposure and health impacts. Also for the first time in the UK, we will create a building stock model of the UK's care provision able to predict future overheating risks in care settings under a range of future climate change scenarios. This will help evaluate the effectiveness of near, medium and long term future overheating mitigation strategies and policies on thermal comfort and health outcomes. Throughout the project, we will continue to develop and expand the stakeholder community that was created during the pilot project. Through ongoing dialogue with our diverse network of stakeholders, we will explore organisational capacity and structures, and how these influence action and policy, in order to generate best practice guidance for practitioners, businesses and policymakers.

As a result of global climate change, the UK is expected to experience hotter and drier summers and heatwaves are expected to occur with greater frequency, intensity and duration. According to recent climate change projections by the MetOffice, increases in mean daily temperatures could be up to 5.4 deg. C during the summer months and 4.2 deg. C during winter by 2070 under a High emissions scenario. In 2003, 2,091 heat-related deaths were reported in the UK alone as a result of the European heatwave, meaning future temperature increases could lead to a parallel rise in heat-related mortality. The UK also currently has a rapidly growing number of old people, with people aged 75 or over expected to account for 13% of the total population by 2035, compared with 8% in 2012. Older populations are more vulnerable to climate-induced effects as they are more likely to have underlying, chronic health complications, making them more vulnerable to heat stress. The 2003 heatwave demonstrated that older people in care settings are at the highest risk of heat-related mortality. People aged over 65 years spend more than 80% of their time in residential environments or care settings, and people aged over 85 years more than 90%. Therefore, the indoor environment is a huge moderator of heat exposure in older populations: Poor building design and the lack of effective heat management in care settings may contribute to increased indoor heat exposure with detrimental health impacts falling on the most vulnerable residents. Care facilities function as both a home for residents and a workplace for staff, meaning that the people sharing those spaces can have diverging needs and preferences making overheating prevention measures difficult to enforce. Interactions between staff and residents play an important role in preventing overheating in care settings and it has previously been noted that staff are often made to prioritise warmth due to wide recognition of the detrimental effect cold weather can have on old-age health, leading to overheating risks being overlooked. Understanding factors that contribute to indoor summertime overheating in care homes is crucial in developing methods to prevent overheating and the subsequent negative health impacts. Previous research by the applicants has indicated that care facilities are already overheating even under non-extreme summers, highlighting the need to develop timely prevention measures given the way temperatures are expected to rise in the UK over the next century. A key target for climate adaptation in care settings is to limit such risks by introducing passive cooling strategies via building design and occupant behaviour. Development of passive cooling strategies will reduce the likelihood of uptake of mechanical cooling, which would undermine government efforts to reduce greenhouse gas emissions. Therefore, the principal aim of the project is to undertake preliminary work to develop methods that will support a system of care provision in the UK that is adequately prepared for rising heat stress under climate change. The project will undertake pilot work in five care settings in the UK to monitor the thermal environment and conduct surveys with residents, frontline care staff and care home managers. Within these buildings, it will test novel approaches for understanding the comfort levels of the residents and relating this to the thermal environment. It will also test novel measurement techniques for assessing impact of heat on the health of the residents. Via detailed modelling work, it will then test methods to assess future overheating risks and to evaluate the effectiveness of overheating mitigation strategies. Throughout the project the work will bring together multidisciplinary research perspectives with those of care home practitioners and other stakeholders. Via these packages of work, plans for the large-scale project that is so urgently needed in this area will be developed.

The Centre for Care is a collaboration between the universities of Sheffield, Birmingham, Kent and Oxford, the London School of Hygiene & Tropical Medicine, the Office for National Statistics, Carers UK, the National Children's Bureau and the Social Care Institute for Excellence. Working with care sector partners and leading international teams, it addresses the urgent need for new, accessible evidence on care. Arrangements for care, and people who need or provide care, are under unprecedented pressure. Quality, cost, unmet need and the situation of carers and care workers are central concerns. Care interacts with other systems in the NHS, jobs market and in policy on migration, welfare and housing. The cultures, values and public policies that determine eligibility for support and funding rules are also crucial, and 'shocks' like Covid-19 have profound and multiple effects. Together, these factors have led to fragmented care provision and unfair outcomes, and the need for reform is now widely accepted. The Centre for Care provides new evidence and thinking for policymakers, care sector organisations and for people who need or provide care. Its objectives are to: - work with people who need care, carers, care workers and others to produce studies that improve understanding of care and promote wellbeing; - publish robust findings on care systems, on paid and unpaid care, and on diversity, inequalities and sustainability in care; - exploit existing data and develop new studies, producing findings that policymakers and other researchers can use; - work with PhD students and emerging scholars, establishing a new generation of care specialists; - stimulate and inform public discussion of care and translate research into practice; and - collaborate with other care research teams, within and beyond the UK. In studying care, we focus on support, services and protections to promote the wellbeing of vulnerable or disabled people of all ages, and the networks, communities and systems that affect them. Our work will generate new knowledge on three major topics: 'Care trajectories and constraints: requiring, receiving and giving care' explores experiences of care at different life stages and as people transition between different parts of the care system. It also studies how giving or receiving care is affected when families are geographically dispersed. 'Inequalities in care: consequences, planning and place' uses latest statistical and data linkage techniques to learn how socio-economic, health and other inequalities shape experience of care, and the consequences of these for groups and individuals in different places and over time. 'Care workforce change: organisation, delivery and development' focuses on care worker recruitment and conditions; regulation and organisation of care work, including the introduction of new technologies; and efforts to improve job and service quality in care. Cross-cutting these studies, the Centre will also examine 'Care as a complex, adaptive ecosystem', 'Digital care' and Care data infrastructure', supporting the integration of all our research. This helps us develop new thinking on care inequalities, how care ecosystems operate and change, and the drivers and implications of digitalisation and other developments. It also enables us to exploit the UK's finest statistical datasets to produce compelling new insights on care and caring. Our multidisciplinary research team builds on a strong portfolio of care studies and is supported by researchers in nine other countries, all equally passionate about doing impactful research that can drive positive change in experience of care and caring. Our work is undertaken in partnership with care sector organisations and groups advocating on behalf of people who need care, carers and care workers. The Centre for Care is vibrant, innovative, and determined to make a positive difference through impactful, accessible research for all to use.