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What are the risks of legionella in care homes?


You don’t have to look far on the internet to find information on the importance of legionella control in care homes. It features prominently in the HSE’s HSG220 document, in guidance from the Department of Health, and countless other resources from regulators and key industry figures.

There’s also no shortage of evidence that legionella control failings in British care homes can and do occur. As recently as January 2016, Reading Borough Council was made to pay £120,000 after a fatal incidence of Legionnaires ’ disease at a council-run care facility; many other homes have been fined by the HSE and CQC simply for failing to carry out compliant legionella risk assessments.

But are the risks of legionella really significantly higher in social care than in other sectors? Or should facilities managers apply no greater precautions than they would elsewhere?

Here’s what we think are the risk factors care homes ought to consider when it comes to legionella control.

(Recommended reading: A guide to water safety in care homes)

The elderly are a high-risk demographic

Firstly, and perhaps most importantly, the elderly are a high-risk demographic for legionella. This is a commonly repeated statement, but it’s also well-documented: according to the latest figures from Public Health England, more than eight in ten confirmed cases of legionnaires’ disease in 2014 (84.9%) affected over-50s. In just under a third (32%) of cases, the patient was 70-plus.

A care home setting presents other demographic risk factors, too. A weakened immune system, for example, increases a person’s risk of Legionnaires’ disease, and can be caused by common ailments like arthritis. Other health problems and a history of smoking can also contribute to a higher risk.

Altogether, Public Health England found that around three-quarters (73.4%) of 2014 cases affected a person with a pre-existing medical condition.

Other legionella risks in a care home setting

Another significant risk factor for legionella in a care home setting is the nature of the building, or buildings, themselves.

Care homes are often large buildings with complex water systems that supply bedrooms, bathrooms, laundry rooms, kitchens and a host of other on-site facilities. They may also be old buildings that have been adapted from another use, involving changes to their pipework along the way. As such, legionella risks like disused lengths of pipe and neglected water tanks are commonplace.

Infrequently used outlets are also a potential issue, and may crop up in a care home setting as a result of rooms left unoccupied for weeks or months at a time.

How can I control the risks?

So, then, the answer is yes – care homes are often at higher risk of legionella and legionnaires’ disease than other properties, and their facilities managers need to be proactive in managing and controlling this risk. While you can’t easily change factors like the age of your residents or the size of your building, you can take steps to ensure your water supply is clean, safe and compliant.

The first step is to get a legionella risk assessment. This will help you fully understand the risks on your premises and how to address them, whether that means monitoring water temperatures, removing dead legs from pipework, delivering training to staff, or even undertaking chemical treatment of you water supply.

To learn more, why not read our new free guide?

Free download: A guide to water safety in care homes >

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