Health and safety in care homes
This guidance is intended to help those providing and managing care homes – to give them a better understanding of the real risks and how to manage them effectively.
Legionnaires’ disease is a potentially fatal form of pneumonia. It is normally contracted by inhaling tiny, airborne droplets containing viable legionella bacteria.
Although everyone is susceptible to infection, the risk increases with age and some people are at a higher risk, such as people over 45, smokers, heavy drinkers,
people suffering from chronic respiratory or kidney disease, diabetes, lung and heart disease and anyone with an impaired immune system. Water systems in care homes, with residents likely to be particularly vulnerable, need particular consideration.
Although legionella bacteria are widespread in natural water sources, outbreaks of the illness occur from exposure to legionella growing in purpose-built systems where water is maintained at a temperature high enough to encourage growth (between 20–45 °C) and where there are nutrients that support bacterial growth such as rust, sludge, scale, organic matter and biofilms. The bacteria are dormant below 20 °C and do not survive above 60 °C. Airborne water droplets are created by water systems such as hot and cold water services, atomisers, wet airconditioning plant, spa baths and hydrotherapy baths.
When managing water temperatures to control legionella in care homes, you should consider potential scald risks.
For Legionella please see Chapter 9 Page 45.
HSG220 Health and safety in care homes
This new edition was published during a period of change. At the time of publication (June 2014), HSE and local authorities investigate serious worker and resident incidents. Under the Enforcing Authority Regulations, HSE regulates homes with nursing and local authority owned or run care homes. Other homes are regulated by local authorities. However, from 1st April 2015 the Care Quality Commission (CQC) in England became the lead investigator of incidents where residents have been harmed because of unsafe or poor quality care.