Internal Environment

Comfortable temperatures have been shown to be associated with good quality of life amongst RLTC residents. Specifically, high temperatures in the resident’s bedroom was associated with lower quality of life (Garre-Olmo, López-Pousa et al. 2012 as cited in Fleming & Bennett 2017).  

A large amount of data and studies have found that the spread of pathogens and viruses could be facilitated in cold and dry conditions. The indoor relative humidity between 50 and 60% is suggested to reduce the risk of spreading airborne-infectious diseases. 

Ventilation and air quality are critical to the wellbeing of older people in nursing homes.

(Mendes et al., 2015)

Openable windows should be used to provide natural ventilation and fresh air can improve well-being. The overall building and the design of the windows should be carefully considered where high noise level, pollution or dust levels may be a potential problem (Department of Health (UK), 2015). 

Allen and Marr (2020), point to emerging evidence indicating that COVID-19 can be transmitted via inhalation of aerosols.  

Rooms often too warm due to heating system, temperature the same in summer and winter.

- Staff

Ventilation can be challenging as provided via windows in bedrooms. Residents do not like the cold when windows are open. Underfloor heating in a large portion of home can sometimes be challenging to regulate quickly.

- Staff

There can be noise from other residents at times, especially evening time.

- Staff

High levels of natural light with views to the garden and fountain.

- Resident

Key Findings


Family members note the poor sound proofing and high noise levels of settings. 


Staff in one setting note that the setting’s temperature is too hot, impacting on staff and service users. 


Temperature and Humidity

  • The virus (SARS-CoV-2) that causes COVID-19, survives longer in cold and excessively dry conditions. These conditions may be problematic in terms of encouraging the spread of COVID-19; therefore, it is advisable to have warm indoor temperatures (e.g., 18-21 degrees Celsius, depending on the room and the occupant’s preference/health), and an indoor relative humidity at approximately 50%. (See also below for findings and recommendations around ventilation).

Ventilation and Air Quality

  • Perform purge ventilation at regular intervals to air out the rooms by opening windows and doors to replace any stale air in the room with fresh air. Ensure windows are capable of being easily operated and fully opened when required (while considering safety and security). Ensure window design provides good views to the outside from both a seated and standing position.
  • Monitor poor ventilation and low humidity with CO2 (carbon dioxide monitors) to keep CO2 below 600ppm (parts per million).
  • Use portable air filters in the bedrooms of residents with COVID-19, (portable high-efficiency particulate air (HEPA) filters) to help remove aerosols from the air. Many domestic type filters are equipped with H13 HEPA filters capable of filtering 99.97% of particles at a clean air delivery rate of 467 m3 per hour on the highest fan speed setting.
  • See –

Acoustic Environment

  • Residential long-term care settings should consider noise insulation or sound proofing, to allow for private visiting and peaceful rest times.
  • Smaller, private visiting spaces allow for improved privacy and lower noise levels.

Download the report on Internal Environment here.