Environmental health Residential care homes
The main hazards associated with residential care homes include:
Injuries arising from lifting
In order to prevent such injuries employers are required to avoid hazardous manual handling operations and use lifting, handling and assisting aids wherever practicable. Employers must carry out a sufficient assessment of manual handling operations.
Biological hazards
All staff should be trained in safe working practices and hygiene standards, as well as being provided with appropriate protective equipment in order to prevent hazards arising from the handling of clinical waste and soiled laundry. There should be adequate procedures laid down for the safe handling, segregation, storage, spillage control and disposal to reduce the risk from such hazards to a minimum.
Electrical safety
All equipment should be installed and maintained by a competent person. It is recommended (IEE Wiring Regs BS7671) that the fixed system is inspected/tested at least every five years (or more frequently as recommended by a qualified electrician), and that all electrical appliances are examined/checked ('PAT' tested) at a frequency appropriate to the risk. Regular maintenance should include visual checks for general wear and tear ensuring that plugs, leads and sockets are in good condition and that there is no exposed wiring. Any corrective actions must be carried out immediately.
For further information on electrical safety, please view HSE online publication
Gas safety
All premises - any place of work that has a gas installation and/or gas appliances installed must be maintained in such a way so as to prevent risk of injury to any person. The definition of what is an appropriate maintenance programme will be determined by the installation's age, condition and usage. If an inspector is of the opinion that the installation is not being properly maintained and may give rise to danger, enforcement action may be taken.
In any room where there is a gas appliance (boiler/heater etc.), and the room is, or can be, used for sleeping or dining/lounging, then that appliance must be checked for safety at intervals not exceeding 12 months by a CORGI-registered engineer.
A record book must be kept in respect of the appliances including: date of the inspection, any defect identified and any remedial action taken.
Floors, corridors and stairs
In order to prevent slips and trips, these areas should be kept free from obstructions at all times. Floor coverings and route ways should be maintained, and all areas should be well lit. Stairs should have handrails on both sides. Kitchen floors need to have enough grip and should be kept dry as far as is practicable. Spillages should be cleared up immediately. Warning signs should be displayed during cleaning to warn residents of potentially slippery surfaces. Ensure that any change in floor level is clearly visible.
Windows
To prevent falls from height, windows which are large enough to allow a person to fall through should be modified to reduce the size of the opening. Any large area of glass, eg patio doors, should be marked so that people are aware of its presence.
Drugs
To prevent the accidental taking of drugs, medicines should be safely secured under lock and key. Any clients' medicines should be stored safely in a cupboard in the bedroom.
Water temperatures and legionella control
One way to minimise the growth of legionella is to store hot water above 60C and distribute it at above 50C. Where water comes out of taps and showerheads at above 43C there is a risk of scalding (especially for whole body emersion). In these circumstances it is strongly advised to fit thermostatic mixing valves to prevent water from being discharged at more than 43C. Water systems should be designed to avoid conditions that favour the growth of legionella by ensuring adequate insulation of storage tanks and pipes, using materials that do not encourage growth of legionella and protecting against contamination by fitting tanks with lids. Water systems need to be routinely checked and inspected by a competent person and the risk assessment should be reviewed regularly.
Water stagnation can encourage conditions that favour growth of legionella. It is therefore advisable to remove dead runs in pipe work from the system, flush out seldom used shower heads, taps and remaining dead legs periodically (weekly), and to remove any dirt or limescale.
Additional information
For more guidance, please read the 'Health and Safety in care homes' HSG 220 publication.