Warm spaces in England: an evidence review and toolkit for local organisations
Published 23 November 2023
Applies to England
Executive summary
This toolkit provides a framework for organisations seeking to develop or evaluate a warm space for their local population during the winter. Based on a systematic literature review, a small survey of local authorities across England and guidance from an expert network of providers of such spaces, this toolkit has been developed to help increase the effectiveness of warm spaces being set up to provide support to local populations through the winter months. The toolkit includes case studies sharing examples of best and promising practice as well as signposting to resources to support organisations in developing their warm space offer.
Evaluating warm spaces is one of the ways in which the evidence base for these services could be strengthened. This toolkit represents a first step towards supporting organisations to generate evidence of the health and wellbeing effectiveness of their warm space service.
Background
There is a significant body of evidence demonstrating the health risks of exposure to cold weather (1). In countries that routinely experience extreme cold weather, such as Canada and the USA, so-called ‘warming centres’ have been a longstanding approach to sheltering some of the most vulnerable members of society including rough sleepers in particular (2 to 4).
In England, concerns around the increasing costs of living and heating during winter 2022 to 2023 saw the emergence of local interventions to establish warm spaces (5 to 7). Typically, these were established and run by local authorities, communities, and voluntary, community and social enterprise sector organisations to offer a warm space, often with additional resources, for example hot drinks, internet access and support services.
A systematic review of the literature carried out by the UK Health Security Agency (UKHSA) (Appendix A) identified some of the features contributing to the use (or otherwise) of warm spaces, including ease of access, the provision of advice and support, and access to food and drink (Figure 1). The review also showed that the evidence base underpinning the effectiveness of these types of interventions, particularly from a health and wellbeing perspective, is underdeveloped. As such, the contribution that warm spaces can make in addressing societal inequalities is unclear.
Figure 1. Factors contributing to the use (or otherwise) of warm spaces
Facilitators:
- provision of food or drink
- offering social activities and interaction
- welcoming atmosphere
- advice and support services for cold weather
- easy access via public transport
- flexible opening hours
Barriers:
- security concerns
- travel or access issues
- caring or work commitments
- lack of knowledge or understanding about warm spaces
This toolkit provides a framework for organisations to consider when running or developing a warm space and provides an evaluation framework to increase understanding of what does and does not work when setting up and running such services. It is based on evidence from the systematic literature review and a survey of local providers of warm spaces in England (Appendix B), The toolkit includes case studies sharing examples of best and promising practice as well as signposting to resources to support organisations in developing their warm space offer.
Toolkit aim and objectives
This toolkit provides evidence, resources, and a framework of principles to assist organisations in the local delivery and evaluation of warm spaces in England. It should be tailored to the local context.
The objectives of the toolkit are to:
- help build engagement and collaboration between organisations setting up warm spaces, including sharing of evidence, case studies, and examples of what does and does not work, based on local experience in England
- provide practical assistance and knowledge to help organisations undertake high quality evaluations of warm spaces and link to main resources currently available
- help organisations consider the merits of creating warm spaces as an intervention to support their populations during adverse cold weather in line with UKHSA’s Adverse Weather and Health Plan
Toolkit development
To develop this toolkit, several different methods were employed:
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A systematic review of the literature on the public health effectiveness of warm spaces was undertaken. This review identified the paucity of evidence related to the effectiveness of warm spaces but also provided some evidence of barriers and facilitators for the set-up and running of warm spaces. This is described in more detail in Appendix A.
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A network of organisations from across England with experience of running warm spaces in winter 2022 to 2023 was convened. Participants were identified through grey literature searches undertaken as part of the systematic literature review. The network met 3 times during summer 2023 to share learning and case studies covering the setting up, running and evaluation of warm spaces, examples of which are included in this toolkit.
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Commissioners and providers of warm spaces were invited to participate in an online survey in July 2023 via the healthy places knowledge hub and regional networks. This is described in more detail in Appendix B.
The above evidence has been synthesised to provide the basis for the framework of principles within this toolkit.
Toolkit
Setting up and running warm spaces
There are several resources available to support organisations in setting up and running warm spaces. For example, the Chartered Institute of Library and Information Professionals published ‘A Warm Welcome: setting up a warm space in your community’ (5), which is a guide providing practical suggestions for warm spaces to consider, including planning an accessible warm space, training and safeguarding considerations for volunteers and staff. The Warm Welcome Campaign provides support to warm spaces by hosting a community of practice, sharing resources, providing branding and communications as well as offering funding collaborations.
Sections below outline suggested approaches, based on the evidence gathered through the 3 methods described above, for local organisations to consider when setting up and running warm spaces to enable them to begin to evaluate the impact and effectiveness of their warm spaces.
Understand the needs of your local population
Your local population is likely to have unique needs and vulnerabilities to cold weather. It is important to understand the demographic profile of your population, social vulnerabilities, as well as identifying community assets; collectively these will inform how you might design an appropriate warm space service for your population.
Demographic factors to consider in your area could include the number of people over 65 years old, young children (particularly those aged under 5 years), and those from Gypsy, Roma or Traveller communities. You could use the Core20PLUS framework to help you to identify specific populations.
Social factors to consider include people sleeping rough, those who are homeless or at risk of homelessness, areas of deprivation, housing quality (such as homes which are hard to heat, or which rely on traditional heating methods) and new arrivals (such as refugees, asylum seekers and other immigrants).
Consider the findings and recommendations in the Marmot Review 10 Years On report to support the identification of priority areas and populations (8).
Understand your local assets
Assets are things like skills, knowledge, capacity, resources or buildings which communities have. This could include venues, local businesses, places of worship, local people and groups, faith leaders, and parish or town councils.
Your local authority may hold relevant data for you to consider when planning your warm space offer. This information is often published publicly within the local joint strategic needs assessment for your community.
Your warm space should seek to reduce health inequalities; an equality impact assessment may be helpful to identify access needs and potential barriers for people with protected characteristics, in addition to any vulnerable groups you have identified locally.
It is good practice to involve your local community and community organisations in decision-making about their community assets, people at risk, and the services within it as this can improve the effectiveness and the reach of your service to your local population. See A guide to community-centred approaches for health and wellbeing for more detail. This was published by Public Health England (PHE), which has now become UKHSA.
Define your priority groups
Carefully define the groups who would benefit from your warm space service, as this is likely to influence the location, type of service, and activities or support offered. For example, a warm space service tailored to people sleeping rough would be very different to one aimed at older people living in their own homes.
The National Institute for Health and Care Excellence (NICE) guidelines on excess winter deaths and illness and the health risks associated with cold homes may provide useful background evidence to help identify populations that may benefit most from your warm space.
It may be that your service is ‘open to all’ but think carefully about how you can tailor the service to support those most at risk in your community.
Understand what has been tried before, locally, and elsewhere, as relevant to the groups you are looking to support. The case studies in this toolkit may provide some useful suggestions.
Warm space locations
The location and accessibility of your warm space services will be critical to its success. Consider how your audience will reach the service, for example, if it is accessible by foot or public transport, whether secure bicycle or mobility scooter parking is available, and whether it is in an area that may be attractive for other reasons, such as near shops or other services, such as a GP practice.
Aim to narrow health inequalities rather than widen them, for example prioritise locations in more deprived areas with fewer community assets, rather than those that are more affluent and well served by other services.
Our evidence shows that building on existing services and assets, such as a library, is more effective than setting up a bespoke service or emergency shelter, as the community may already know and trust the service, staff, and area.
Consider links to other local organisations such as voluntary, community or social enterprise organisations, food partnerships, libraries, or family hubs. Using established services should also reduce capital and set-up costs.
Consider collaboration with local businesses, such as cafés, that may have good relationships with the audience, and combining spaces as this may also help to minimise costs by capitalising on existing facilities and subsiding running expenses.
Consider the security and accessibility considerations of your chosen site.
Make the offer attractive
Evidence shows that warm spaces providing entertainment and services see a much higher footfall than those solely designed as a place for people to go to be warm. Services could consider providing wifi, books, games, and social interaction.
Provide hot drinks and snacks. Warm or hot food is best as this would help attendees to stay warm.
Consider what timings attendees would benefit from. For instance, warm spaces for those rough sleeping may be needed overnight, whereas older people may prefer a daytime service.
Some warm spaces offer additional support services, (such as debt advice, or social services), which may be helpful to attendees. However, consider carefully if this could be potentially off-putting to people.
Case study: ‘Warm items’ project – Kirklees council
Kirklees Council Public Health team procured a range of warm items that were handed out to identified residents in need via warm spaces based in libraries.
Warm items procured included warm clothing (including base layers, hats, scarves, gloves, socks and fleece jackets), hot water bottles, heated blankets, microwave wheat packs and electric hand warmers.
As a result of this scheme, 234 households received one or more warm item(s) as a result of this scheme, with most receiving more than one item. This included:
- 26 households with children (11%)
- 145 households with pensioners (62%)
- 29 households with a disabled person (12%)
Avoid stigma
Consider how to brand the service. Although commonly called ‘warm spaces’ some evidence suggests that this is potentially stigmatising.
Branding may focus on other benefits or services offered, with a place providing warmth being one of many benefits of using the service. For example, some services have opted for terms like ‘welcoming spaces’ instead of ‘warm spaces’ to focus on the social benefits of the interventions.
Promote the offer
Consider the messaging and choice of communication channels for the service. It is recommended to co-produce communications, where possible. For example, community contributions can ensure messages about service benefits are understood and that communications are culturally appropriate.
Consider how your message will reach your audience. Many services have used social media. However, it is important to note that a digital communications strategy may not be appropriate for all.
Consider aligning your service alongside other health promoting opportunities such as seasonal vaccinations campaigns like flu or COVID-19.
Many areas and organisations have created maps or repositories of warm spaces in their area, in order to make it easy for people to find their local warm spaces. An example is Leeds City Council. The Warm Welcome campaign and Warm Spaces host online directories of warm spaces through which you can register your warm space locations and people can use to search for warm spaces near them.
Evaluating the impact of warm spaces
Evaluation is an essential part of improving the quality of services, informing decision making and building an evidence base. A well-thought-out evaluation can be useful for future commissioning of services and sharing findings can help other providers improve their services.
There is not a strong evidence base for warm spaces, so even a simple evaluation will be useful. While not all the suggested approaches will be appropriate for every warm space, when evaluating your warm space please consider the following steps.
Planning your evaluation
It’s important to consider:
- who will conduct the evaluation
- who will be asked to participate in an evaluation
- what questions will be asked
- who will collect and analyse the data
- how the findings will be used
Anyone can undertake an evaluation; however, you may wish to consider collaborating with your local authority public health team, local academic institutions such as universities for additional advice or support, particularly with regards to conducting your evaluation and analysing your data.
Have clear aims for your service (for example to protect health or alleviate loneliness) and plan to evaluate from the outset of the intervention.
To evaluate your service, it is important to collect information that helps you to assess whether your service has delivered against its objectives. The information you collect should be considered at the beginning.
Consider ways to ensure data collection is simple and straightforward (such as by collecting data at the point attendees register for or arrive at the warm space).
If you decide to conduct a survey, using the same set of questions before and after attendance at a warm space can help you to capture outcomes in a systematic way. Using standardised and validated health and wellbeing measures, such as the Office for National Statistics Personal Wellbeing Indicator (ONS4), which is free, may be useful. The Wellbeing Measures Bank has several suggested measures you could consider.
Consider capturing the inputs for the service, including financial, staffing, and other resources that could be used to help you track the cost effectiveness of the warm space.
Identify the service objectives, which are the impact or changes you hope the service will deliver. These objectives should be specific, measurable, achievable, realistic and time bound (SMART).
Consider how you can bring the community together to reflect on the warm space, for example holding an evaluation workshop or focus group.
Considering the social value of your warm space may be a helpful way to capture outcomes of your service. Social value is defined by the Local Government Association as the wider financial and non-financial value created by an organisation through its day-to-day activities in terms of the wellbeing of individuals and communities, social capital created and the environment. If you have the resources to do so, a social return on investment evaluation is an approach you may want to consider to evaluate your warm space.
You may need to consider seeking consent to allow you to collect and use certain information. Speak to your Data Protection Officer for more information, if your organisation has one. The Information Commissioner’s Office provides helpful advice for small organisations on a range of uses relating to data protection.
Figure 2 provides a simple framework which you may find useful as part of developing service objectives, considering the structure, the process, and the resulting outputs and outcomes from the service.
Figure 2: Adapted Donabedian model providing a framework for evaluating warm spaces
Step 1: Design
Has the warm space reached the priority audience?
For example, has it reached specific neighbourhoods, age groups or populations you aimed to?
Step 2: Process
Has the warm space been efficiently used?
For example, what percentage occupancy have you averaged over the time your warm space has been open?
Step 3: Output/outcome
What are the outcomes following the use of your warm space?
For example, did attendees report improvements in their health and wellbeing?
Consider using a simple questionnaire to see the impacts of attendance on health and wellbeing.
Conducting your evaluation
The following sections provide some further detail following the outline of the framework above.
Design: Has the warm space reached the priority audience?
Aim to collect relevant data to understand if the audience of the service were your intended groups. The Core20PLUS framework may be useful to refer back to here, if you used it to help identify your priority audience.
Consider if the overall number of attendees or attendees from specific groups is more important in terms of defining a successful service.
Consider whether attendees were different to your priority audience, and if so, why? For instance, did the more socially engaged and affluent attend because they had better support and travel arrangements, or were services less accessible to some vulnerable groups? You could consider using postcode data to assess neighbourhood reach and/or undertaking a demographics survey to assess age, sex and ethnicity.
Consider conducting surveys of your population in a different environment (for example outside supermarkets) to find out if they were aware of the warm space, if they used it, and if they would recommend it to their friends and family.
Capturing the views of attendees. A simple survey could ask them what they like and dislike about the service, and if they have any suggestions for improvement.
Process: How was the warm space used?
Some services struggle to attract people, and so detailed information on usage is important to understand how successful the service has been and can be more informative than simply measuring overall footfall.
Consider measuring how long people tend to stay, what times people prefer to arrive and depart, and whether the same people come back for further visits.
Aim to measure how people used the warm spaces and what activities were preferred over others.
Capture the views of stakeholders involved in the setting up or providing of warm spaces to gather information on how they felt the warm space was used.
Case study: stakeholder feedback – Kirklees Council
Kirklees Council collated feedback from organisations that provided warm spaces and associated cost-of-living support for residents during winter 2022 to 2023.
The following questions were posed to organisations:
- Did footfall increase?
- Did it reach the people who were most in need? We took a proportionate universalist approach (9) to this work; as such, while all residents were welcome in our warm spaces, priority groups included people experiencing financial hardship, older people, people with long-term conditions and people with disabilities
- What worked well?
- What would need to be different in future?
- Were there any additional benefits to the organisation or community from having a warm space?
Outcome: what are the outcomes following use of your warm space?
Consider the health and wellbeing impact that the warm space has had on attendees. This could be conducted using a simple questionnaire or validated health and wellbeing measures, described in more detail in the planning your evaluation section.
Consider using financial metrics, for example cost per visit, to demonstrate how effectively resources have been allocated.
Consider measuring secondary effects, for example if the funding allowed another service or community provision to continue running during a period of financial strain.
Case study: Evaluation methods – Sandwell Metropolitan Borough Council and the University of Birmingham
The evaluation of Sandwell Metropolitan Borough Council (SMBC) warm space programme was conducted to assess the effectiveness of their warm spaces in meeting the needs of the community and to identify any areas of improvement. It aimed to understand:
- how people perceive warm spaces
- how to most effectively reach people who would benefit from using warm spaces
- how to maximise use of warm spaces
- the barriers and facilitators to using warm spaces
A mixed-method approach was employed for this evaluation involving a quantitative survey of warm-space users and providers and in-depth qualitative interviews with warm-space users (group 1), providers (group 2), and community leaders (group 3). The evaluation tools can be accessed at Evaluation of Sandwell Metropolitan Borough Council warm space programme – methods and tools or Find a welcoming space in Sandwell and include an example provider survey and interview topic guides.
Following this evaluation, important recommendations were made for the future of warm spaces in Sandwell:
- increase the number of warm spaces available in the borough
- improve accessibility of warm spaces, particularly for people with disabilities
- provide more activities and resources at warm spaces
- work with community partners to promote the warm spaces and to raise awareness of their importance