FC&A Magazine - Future Constructor & Architect
Building Care Homes for a Changing World

With more than 1.9 million requests for support and 841,000 people receiving state-funded long-term care showing in the most recent statistics, social care is in significant demand. Combine that with the ongoing financial crisis and the ambitious national targets for carbon emission reduction, and you have a perfect storm for public sector care homes to weather. Simon Briggs, Energy Lead at complete construction partner Stepnell, believes the key to addressing this daunting series of challenges is to ensure care and health projects are designed and built with sustainability in mind.


With nearly 500,000 residents currently in care homes across the country and a rapidly-ageing population, there is rightfully an ever-increasing focus on residential care for older people. On top of this, better diagnosis of developmental challenges and childhood traumas have seen a significant rise in those under 18 requiring social care.

This increase of pressures on the system have seen the value of the care sector overall increase to more than £16bn, and – with the rise in the cost of utilities like energy and the ongoing cost-of-living crisis showing little sign of easing – more and more responsibility falls on the public sector care providers to scrutinise the efficiency of their existing facilities and planned builds.

If care homes are going to invest in new or refurbished buildings, they must ensure that it will be able to provide the best environment for often vulnerable members of society that must be well looked after.

Along with this duty of care, the high energy expenditure that often comes with providing it must also be carefully managed to ensure that the building remains efficient and won’t cost unnecessary amounts to keep warm or cool.

An engaged supply chain

An important element of executing these design ideals is having the contractor involved at the earliest possible stage. In its simplest sense, early engagement means that conversations about buildability can be had while the project is still in the design stage, and a contractor can lend its expertise to the process to aid the client’s decision making.

Another major benefit of this is that the supply chain and key material suppliers are also brought to the table early, which helps maximise efficiencies and allows for early purchasing of materials. This is something that has become increasingly important in the past year in particular, with significant material shortages caused by a combination of Brexit regulations, the long tail of the COVID-19 pandemic and the war in Ukraine.

One of the ways the public sector is able to achieve early engagement is by procuring projects through frameworks. Frameworks help to ensure quality and cost effectiveness and can support the public sector by providing a faster route to project delivery.

Through our work procured through several framework agreements, including specifically for the public sector, Stepnell has found that they provide a collaborative platform for all parties with shared success factors, bringing greater efficiencies at project and programme level while safely delivering innovation, on time and to budget.

While this is the case for new buildings, there is still a significant challenge with the existing public estate and retrofitting its respective infrastructure. Again, early engagement here is key to finding the right solution, and any actions taken need to be based on the particular energy usage profile. This can only properly happen when there are open and honest conversations between clients, contractors, consultants and end users. Bringing these stakeholders together will allow informed decisions to be made, generating realistic and achievable decarbonisation plans.

The energy question

It’s no secret that care home running costs can be astronomical. With the essential heating and lighting – not to mention any medical equipment required – there is a real need for efficiencies to be found wherever possible.

The elimination of wasted energy should be the priority in the first instance, and this can be achieved at the design stage by ensuring the building fabric is as energy efficient as possible, with high levels of insulation and airtightness, high-quality windows and doors, as well as smart controls for lighting and heating systems.

While this approach is best practice, it isn’t always practical or possible, meaning that the focus shifts to energy efficiency, achieved through installing appliances that have a beneficial effect on the building and its individual usage. For care settings, this approach is especially relevant when it comes to heat recovery, making sure the building remains heated by recirculating the warm air that would be extracted under more conventional systems.

Looking longer term, there is a real need in the care sector for a concerted push to use more renewable and sustainable energy solutions. With the current high energy costs showing no sign of abating, some of the most common renewable plant and machinery solutions have significantly reduced payback periods for the initial expenditure of installing them compared to traditional methods.

The design answer

This push towards more energy-efficient approaches to building fabric is reflected in some of the changes in design we’re seeing from our work in both the public and private sectors. Heating solutions are now leaning more towards the use of air-source heat pumps, and incorporating systems powered by solar PV, rather than traditional gas central heating.

At Stepnell, we have committed to supporting projects early on with the right energy-efficient design and installation solutions through ‘Step Energy’. This is an in-house offering providing commercially-sound, bespoke energy-saving and carbon-reduction strategies throughout the lifecycle of projects.

As well as carefully factoring in low-carbon heating solutions, material choices are key in this equation – whether that’s getting the right amount of glass to provide natural light without leaking heat, or looking at more sustainable material solutions for buildings such as the timber and zinc Stepnell used at The Forge (pictured) – a residential care home for children in Warwickshire.

Functionality is naturally the priority when it comes to health and care facilities, but it’s important to remember that they need to be living spaces that inspire residents and staff alike.

A better way

The priority for construction partners needs to be on ensuring not just that the right technologies are being offered to suit client requirements, but that they are installed, commissioned and monitored to make sure they are continuing to perform.

In fact, the public sector is in a prime position to be the client of best practice and, with the right engagement and support, can debunk the ‘lowest price wins’ mindset, which doesn’t factor in the longer-term savings associated with creating schemes that consider the embodied carbon of a building long after the initial build.

The ultimate key to doing this effectively is understanding the whole scheme and how each element aligns with the other – something that can only truly be achieved by engaging early and working with suppliers that have a true understanding of energy usage.

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