Kirstie Jones, Head of Client Services and Environmental Health Expert at Navitas Safety shares her advice on an area of health and safety that’s often overlooked in care homes – temperature monitoring.
When families choose a care home for their loved ones, they expect that person will be well looked after and their health, safety and welfare to be at the forefront of their care. And yet trust in the sector may be at an all-time low, with only 4% of care homes holding an ‘Outstanding’ rating, showing that they are going above and beyond to provide the best quality of care.
The body that carries out inspections of social care provisions, the Care Quality Commission (CQC), has also been condemned recently, with an independent review which highlights a number of failings among the regulator, including a backlog of inspections.
A set of emergency measures were announced following the independent review, with the CQC accepting the findings in full. It says work is now underway to “restore trust with the public”.
When you look at the scope of responsibilities that caregivers face during their day-to-day work, and the requirements for CQC inspections, it’s easy to see why without clear organisation, processes, and a mindset of continuous improvement, care homes may receive poor ratings.
Being slapped with an ‘Inadequate’ rating, or placed in special measures, will do nothing for public confidence – especially if the media get involved.
One area that we know care homes often overlook, but is detrimental to the health and well-being of residents, is temperature monitoring. This was clearly the case at one Huddersfield care home, which hit the headlines after an inspection earlier this year. It was forced to take immediate action after inspectors discovered high risk food – including cheese, yogurt, and cream – stored above 8C, and meat with ‘freezer burn’.
For context, The Food Standards Agency (FSA) states that fridges should be kept at 5C or below. Specifically, for food business operators (FBOs) in England, Wales and Northern Ireland, it is a legal requirement to store cold foods below 8C and freezers should be operating at -18C or below.
Care home managers should be mindful that temperature control is a vast area in itself, covering rooms, baths and basins, medicine storage, and of course, food. Temperature control is one of the most important aspects of hazard analysis. Failures can so easily lead to illness, or at worst, fatalities, particularly amongst vulnerable residents.
It is important to have an understanding of the official recommendations / regulations for each of these aspects, with clear easy-to-follow processes in place, ideally digitised for maximum efficiency and transparency. For example, whilst the temperature of the stored water needs to be above 60C for legionella controls, the water temperature at each outlet should be thermostatically controlled to prevent colds and scalding. For a bath to be considered safe for elderly residents, it should be less than 44C, whilst showers should be at 40C or less.
In regards to medicine, there is also strict guidance on storing medicines below 25C (if allowed to be at room temperature), or kept in a locked fridge which is checked on a daily basis. Temperatures must be checked with a digital thermometer. Alternatively, smart sensors can be used to automate the process, providing real-time data and alerts. For example, caregivers will immediately be notified if a fridge door has been accidentally left open, or the temperature has exceeded 5C.
For rooms, it’s generally recommended to keep temperatures between 18C and 20C. Hypothermia can develop in vulnerable people even after a small drop in room temperature. The risk of hypothermia led to national headlines for a Shropshire-based care home (now closed), where care home residents were ‘knowingly’ left without heating for 72 hours.
While temperature monitoring should be done every day, it’s important to revisit completed records on a weekly basis to verify they are in place and correct. It is also advisable to look at them in more depth during monthly ‘spot checks’ and internal audits. These provide an additional layer of verification and help to identify any discrepancies or patterns that might have been missed during daily monitoring.
In addition, regular audits can help detect malfunctions with temperature monitoring equipment.
How internal audits are carried out will differ from setting to setting. They could require simple ‘yes’ ‘no’ answers, a score from one to five, or a traffic-light warning system. The end goal is to be able to understand which areas need urgent attention, and which need a plan of action putting into place, including refresher training, for example.
