Managing the facilities of a care home is a challenging role and one that has many health and safety responsibilities, especially when it comes to hot water and legionella control risks. Consequently there are strict regulations in place that aim to ensure the wellbeing of residents and staff – from the Health and Safety at Work, etc, Act 1974 (HSWA) to the Care Quality Commission (Registration) Regulations 2009.

So what are these water safety risks and where might you be at risk of non-compliance?

Hot water

Residents of care homes are often among the more vulnerable members of society, which makes them more susceptible to health and safety risks. This is especially true with risks of harm from hot water over 44° C, as older people and young children have thinner skin than most and are thus more likely to suffer deeper burns.

Unfortunately, this is evidenced through incidents such as that the one in 2012 where an 88 year-old resident died at a care home in North Wales after she was lowered into a scalding hot bath. Aside from the tragic cost of life, the company that ran the home was fined £5,000 and, not long afterwards, went into liquidation. 

Legionella

Legionella is the bacteria that causes Legionnaires’ disease, a potentially fatal form of pneumonia, as well as other diseases such as Pontiac fever. It occurs in most natural water sources, but thrives in temperatures between 20° and 45° C.

Contracted by breathing in tiny droplets of water in the air that contain the bacteria, Legionnaires’ disease is a greater risk to the elderly and those with health problems than most. This means the residents of a care home can be highly susceptible.

The legal and financial repercussions of an outbreak of this disease can also be very serious indeed – with past fines having reached up to £350,000, such as in the case of Basildon Hospital in 2012.

Risks of water safety non-compliance

Unless you are consistently checking to ensure outlet water temperatures in baths and showers are lower than 44 °C, your residents are at risk of scalding. This means using appropriate thermometers and perhaps even additional engineering controls, along with regular maintenance.

One such control is the use of thermostatic mixing valves (TMVs), now widely considered essential for any care home to prevent health and safety issues from hot water. This is a valve that, once installed, blends hot and cold incoming water to produce a safe and constant water temperature, even taking into account changing water pressures, cold intake shutting off, etc.

However, TMVs can fail, and may come with their own risk of legionella growth. They therefore need expert installation and servicing to ensure compliance. For example, an installation designed to save money by blending the entire supply nearer the source, rather than installed closer to just a couple of outlets, could be found to represent a needlessly high risk of legionella due to warm water (between 20° and 45° C ) left sitting in long lengths of pipework.

Along the same lines, other areas of a care home’s water system that could also be a breeding ground for the bacteria include ‘dead legs’ – sections of pipework that due to infrequent or non-use might pose a risk of stagnation – as well as in the water tanks themselves.

Ensuring compliance – now and in the future

In order to prevent risks to health and safety and ensure compliance with all regulations, an organisation needs to appoint a person competent enough to undertake the tests and maintenance needed.

While the HSE states that this can be handled internally, it is often only one of many jobs that facilities managers are responsible for. Consequently the lack of resources and time means it is often safer to outsource to a water treatment company.

Once you have your skilled and experienced person or company in place, they will need to undertake a hot water and legionella risk assessment and follow-up with any remedial work. However, it should be noted that a one-off cleaning only ensures compliance for so long. So to prevent future risks, your appointed competent person needs an ongoing plan of testing and servicing to ensure water safety compliance.

If you’re concerned about water safety in your care home, and want to ensure you are compliant with all legal regulations both now and in the future, download our comprehensive Guide to Water safety in care homes today.