Over the last two years, the Aged Care Quality and Safety Commission has reminded aged care providers of the importance of preparing for summer and the increased risks extreme heat conditions pose to the health and safety of older people. In the NDIS space, the Commission has highlighted some key points about summer safety for people with disabilities that continues to be relevant each year.
This year, preparation for extreme heat conditions is particularly important, with the Bureau of Meteorology monitoring an El Niño weather system predicted to impact the summer months, and long-range forecasting indicating higher than average temperatures over both day and night during summer.
Whether you deliver services to older people, children, people with a disability, or others, the needs of people receiving care and services may vary in hot weather, and the heat may change the way services are delivered to them. In addition, people receiving services may be at greater risk of heat-related illnesses due to a range of risk factors, including:
- Cognitive impairment including dementia and intellectual disability;
- Physical disabilities and limited mobility;
- People taking certain medications; and
- Medical conditions (or symptoms of conditions) such as diabetes or dysphagia.
Preparing for extreme heat is an extended process that leans on key elements of your organisation. Strong risk management and planning processes can set you up for the best chance of success, and the best preparation for extreme heat starts well before summer begins.
Identifying areas of risk
One of the most important parts of preparing for periods of extreme heat is risk identification and management. Providers should assess the risks that exist, or that are likely to occur, in the course of service delivery and with regard to the characteristics unique to their organisation. Some examples of risks include:
- Bushfire risks, particularly if you are in regional areas or have bushland close by;
- The demographics of the service user base;
- The layout and design of the service environment, including areas with limited shade cover, high sun exposure both indoors and outdoors, or that are prone to retaining heat; and
- Health and safety risks to workers during extreme heat.
When providers recognise areas of risk for their operations, they’re able to plan and prepare for these risks in order to mitigate their effect. You can’t change the weather, but you can ensure that you’re in the best position to minimise the impact of the weather on your service users and workers.
Planning, assessment and evaluation
In addition to organisation-level risks, each service user should be assessed for unique risks that heat might pose to their health and safety, and planning should be undertaken in partnership with each person to develop heat management strategies and alternatives for regular care activities where this may be required.
Providers best prepared to manage extreme heat events are aware of the risk factors for heat-related illnesses that impact each service user in their care. These risks are documented in their care plans so that workers can respond to them appropriately. Strong planning, assessment and record-keeping systems help identify service users who may need additional support during extreme heat events. They also assist workers to monitor for signs of dehydration, heat stress and heat stroke. In addition, experiencing extreme heat may affect or trigger behaviours of concern. Documenting the risks of these behaviours and planning for if they occur helps to ensure the safety of the service users and others in the service environment.
Summer-ready service environments
Providers should actively check their service environment now to ensure that it’s suitable and safe for extreme heat conditions and make any necessary changes before summer begins. Safe service environments not only ensure the comfort and health of service users. They also contribute to safe working environments for your workers, helping to prevent heat-related illnesses in the workforce and mitigate the risk of mistakes caused by heat exhaustion or heat stroke.
A great place to start is with areas identified as high risk during the risk assessment process, as these should form the highest priority. Examples of things to check include:
- Functionality of air-conditioning/cooling systems and alternatives including portable fans;
- Availability of shaded outdoor areas, and how this changes throughout the day;
- Efficacy of ventilation;
- Temperature fluctuation indoors from sun shining through windows or glass doors; and
- Preparedness of the service environment for bushfire conditions, including gutter clearage, water availability and up-to-date evacuation plans.
Where services are delivered in a person’s home, it’s also important to provide information and assistance to service users, their family and supporters about actions they can take to minimise the effects of heat and keep their homes cool.
Service delivery - focusing on food and drink
During periods of extreme heat, some aspects of service delivery may need changing or adapting to minimise the risks of heat-related illnesses. For example, outdoor activities such as gardening could be scheduled for early morning or evening timeslots to avoid periods where sun exposure, temperature and UV are at their highest. One key area of focus for providers during summer is nutrition and hydration.
Monitoring hydration in service users is critically important, particularly during extreme heat where fluid can be lost through sweat. In June, the Aged Care Quality and Safety Commission released a clinical alert focusing on the importance of hydration. The alert highlighted environmental factors including high temperatures and sun exposure as risk factors for dehydration in older people. These principles are equally relevant for other groups at risk for heat-related illnesses.
Food and nutrition can significantly impact hydration and can help to maintain healthy hydration levels. Where they deliver services on-premises, providers should be reviewing their menus and food and nutrition processes to provide services that promote hydration, and budgeting and planning during the spring months to ensure readiness for summer. Some examples of actions providers might take include:
- Adjusting menus to include foods with high water content, e.g. soups, melons and cucumbers; and
- Planning for increased fluid delivery, e.g. additional water stations, staff bringing drinks, frozen treats etc to service users more regularly.
Where services are delivered irregularly or in the person’s home, workers can still play a part in ensuring hydration levels through education, including:
- Providing information on the importance of hydration during summer; and
- Encouraging service users to make beneficial food and drink choices when shopping or cooking.
Informed choices
Providers should inform service users about extreme heat and the risks of heat exposure, both generally, and in relation to their specific risk factors, to allow them to make informed choices about the activities they do during summer.
Some service users may insist on participating in activities that put them at higher risk of heat-related illness. They might want to stick to an established routine by taking daily outdoor walks, or consume drinks with high levels of caffeine or alcohol that can contribute to dehydration. In these cases, workers should take extra caution to monitor the person for signs of dehydration, heat stress and heat stroke and know how to take action if required.
What next?
If you need to get on top of your summer preparation, we have you covered with a range of resources. Start off with our risk management and service user risk assessment policy templates. Consider using our risk register to identify and mitigate key areas of risk for your organisation. And take a look at some of our other resources, such as Policy: Extreme Heat or our food and nutrition resources.
Not sure where to start?
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