Preventing winter deaths and illnesses associated with cold homes

Featured article - 16 January 2020
Martin Hodges, Health and Housing Research Associate, Care & Repair England

Head-shot of the author, Martin Hodges, Health and Housing Research Associate, Care & Repair England

Care & Repair England is a small national charitable organisation set up to improve the homes and living conditions of older people. Whilst not directly delivering services it promotes examples of good practice and works to influence evidence led policy at national and local level.

Why are cold homes important to the NHS and social care?

Excess cold is known to be a significant hazard in homes occupied by older people and its presence undermines an individual’s ability to sustain good health and wellbeing.

What are the causes and what can be done?

Cold homes can be caused by characteristics of the property itself and/or the inability of the occupier to afford to use the heating system. Addressing these problems can involve repairing, improving or replacing the heating system, upgrading insulation and giving advice on how best to address fuel poverty. The solution is dependent on individual circumstances. Unfortunately, occupiers of cold homes are sometimes isolated, do not know what assistance may be available to them and who to contact for advice. Home care staff are ideally placed to identify where vulnerable people are experiencing cold homes but sometimes do not know which organisations may be able to assist. Housing organisations such as home improvement agencies have a strong interest in reducing the number of vulnerable people living in cold homes and are experienced in this area of work.

Case Study – St Helens Home Improvement agency

A referral was received from local care colleagues regarding a 68-year-old man struggling to heat his home and keep it warm. He is a left leg amputee and suffers with severe COPD. An affordable warmth advice visit identified and resolved several issues:

  • Inadequate front door on the property so draughty and insecure - quotes obtained for a replacement front door (funded via a local lottery funded project).
  • Back door draughty - draught proofing provided by agency’s handyperson service.
  • Gas boiler broken - gas engineer visit arranged, confirming current boiler irreparable. The householder qualified for a replacement boiler under an Energy Company Obligation scheme. The affordable warmth team oversaw the application process.
  • Oil filled radiators provided by the agency whilst waiting for original boiler to be assessed.
  • The agency contacted the householder’s energy provider and applied for the warm home discount, resulting in an additional £140 credited to his electric account.

Additional issues identified/resolved by the agency:

  • Toilet leaking, not flushing and mains water stop tap leaking - A replacement tap and toilet repair were provided by the agency using the Council’s emergency fund.
  • Finance - agency’s welfare advice team completed a benefit check to maximise the householder’s income.
  • Bathing difficulties - referral made for occupational therapy assessment with improvements being arranged.


The householder reports improved physical and mental health following the interventions arising from the affordable warmth visit. Specifically, the new front door has resulted in reduced anxiety and the new efficient boiler has improved the thermal comfort of the property resulting in reduced COPD symptoms and allowing him to better manage his long-term health condition.

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