Introduction Climate change is increasing the frequency and intensity of heatwaves, creating critical challenges for social care settings where both staff and residents face heightened heat⍰related vulnerability. This study examined the impact of heatwaves on UK care homes using a national survey of staff experiences, challenges, and adaptation strategies.

Methods Care home staff (N = 225) in managerial (N = 88) and caregiving roles (N = 137) completed an online survey investigating staff perceptions of heatwaves impact on thermal comfort, health and vulnerability of themselves and residents, alongside current heat resilience strategies and the barriers to their implementation.

Results Two thirds (66%) of the surveyed staff complained of being too hot three or more times per day resulting in a perceived impact on their ability to perform tasks (90%) and on residents’ comfort and health (92%). Staff demonstrated strong awareness of older adults’ heightened heat vulnerability (95%) and signs of heat illness (87%). Thematic analysis identified five key barriers to providing effective cooling: funding limitations, inadequate equipment, building constraints, staffing pressures, and individual resident needs; and four priority improvement areas: increased access to cooling equipment, improved temperature control, strengthened strategy and policy, and support for staff needs.

Conclusions Heatwaves place considerable strain on care homes, challenging staff capacity to maintain comfortable thermal conditions, despite good knowledge of heat risks. Financial, infrastructural, and staffing constraints limit effective heat⍰resilience practices. Evaluating and implementing affordable, accessible, and context⍰appropriate cooling strategies will be essential to protect both residents and staff as extreme heat events become more frequent.

WHAT IS ALREADY KNOWN ON THIS TOPIC

Older adults in care homes experience elevated mortality during heatwaves, and these events increase the workload and strain on care staff.

Most social care practitioners demonstrate a reactive approach when responding to extreme high temperatures.

WHAT THIS STUDY ADDS

This study provides UK⍰wide evidence that care home staff possess strong knowledge of heat risks, resident vulnerability, and how to recognise signs of heat illness.

It reveals that despite this knowledge, staff face substantial barriers—most notably inadequate cooling equipment, restricted ventilation, ageing buildings, and heavy workloads—that prevent effective heat⍰resilience practice.

Care home staff clearly identified the sector’s priority challenges: limited funding, insufficient or ineffective cooling systems, building constraints, staffing pressures, and the diverse thermal needs of residents.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

Findings demonstrate that current heat⍰resilience measures in UK care homes are insufficient, with staff reporting routine thermal discomfort and compromised working conditions during heatwaves. Evaluating and implementing low⍰cost, effective cooling strategies, and embedding them into policy and practice, will be essential to safeguard both residents and staff as extreme heat events become more frequent.

The authors have declared no competing interest.

This work was supported by the Institute for Life Sciences at the University of Southampton, UK through a Pilot Project Funding call.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Research Ethics Committee of University of Southampton gave ethical approval for this work. Approval number: 103283.

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Data will be made available upon publication at the University of Southampton data repository (PURE; URL to be activated upon publication).