Eoin McQuone, business director at washroom specialist Rada, discusses how a modern water system sits at the heart of running high quality care facilities.
Maintaining a high quality and safe care facility is a complex challenge with water management and infection control one consideration in a very long list
Many care home providers are doing a good job managing water controls, but outbreaks of Legionella do happen. Last year, Reading Borough Council was fined £120,000 after a fatal incidence of Legionnaires at a care facility. We’ve also seen other facilities fined by the Health and Safety Executive (HSE) and Care Quality Commission (CQC) for failing to complete Legionella risk assessments.
Care facilities often have large water systems supplying en-suites, bathrooms, kitchens and other on-site facilities through which bacteria can easily spread, which can lead to a higher Legionella risk.
The good news is there is guidance on control measures. It features prominently in the HSE’s Health and Safety in Care Homes HSG220, HSE’s The control of legionella bacteria in hot and cold water systems L8, HSE’s HSG274 Legionnaires’ disease technical guidance, and in guidance from the Department of Health’s Health Technical Memorandum HTM 04-01.
Since it’s almost impossible to prevent Legionella from entering water systems, good offence is the best defence. Legionella proliferates in water stored at temperatures between 20°C and 45°C but is killed at higher temperatures. The risk of an outbreak is reduced by storing water at at least 60°C and distributing to reach outlets at 55°C within one minute.
Storing water at high temperatures can present a scalding risk, however, and this is typically more acute with the elderly due to decreased sensitivity and slower reaction times.
HTM 04-01 recommends additional measures may also be required such as thermal disinfection and duty flushing. It says duty flushing ‘should form part of the daily cleaning process’ and that this ‘should be fully documented and covered by written instructions’. Additionally, HSE’s L8 states that duty flushing ‘has to be sustained and logged, as lapses can result in a critical increase in Legionella’.
However, this can introduce inadvertent human error, is labour intensive, and can result in staff resources being directed away from other valuable forms of patient care.
So how can we ensure user safety and adhere to the exacting requirements for infection control while being cost and resource efficient?
The most effective means to achieve these objectives is to store and distribute water at high temperatures and use thermostatic mixing valves (TMVs) to reduce discharge temperatures to appropriate levels. Such is the value TMVs bring HTM 04-01 and HSG274 make specific reference to their use. TMVs reduce the discharge temperature of stored hot water to an appropriate level by blending it with cold water before it reaches the outlet – ensuring a constant and safe temperature even if the system experiences variations in supply pressures or temperatures.
Digital TMVs are the latest innovation in this area and offer care home facilities managers further levels of functionality, control and efficiency. Digital TMVs offers precise temperature control and the ability to set a range of additional hygiene measures such as thermal disinfection and duty flushing. They are capable of recording and creating a log to demonstrate compliance with guidance requirements. Couple this with a quality product that is aesthetically pleasing and easy to use and you have taps and showers that provide comfort for residents and care providers alike.
In recent years, here at Rada we’ve been pioneering the use of digital technology in water controls and by doing so we’re providing greater levels of bacterial control, safety and efficiency. The opportunity to better utilise technology to provide a more effective and efficient way of safe water management has never been greater.
Eoin McQuone, Commercial Business Director at Rada
Eoin has been in the washroom controls industry for over 15 years. He is involved in a wide range of industry forums and organisations and is passionate about promoting user safety and the sustainability of washroom products.
