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Alan Armer  
#1 Posted : 16 June 2017 17:13:35(UTC)
Rank: Forum user
Alan Armer

I assess Care Homes in terms of OHS and safety of residents I need to meet both OHS standards ad legislation and those required by the Care Quality Commission (CQC)

HSG220  say that hot water temperature should be a minimum of 50 deg C to reduce the risk of legionella infection for which the elderly are more susceptible. No issues there.

HSG 220 (H&S in Care Homes) and the one my CQC assessor likes says that to reduce the risk of scalding the maximum water temp should be 44 deg C. I'm sure that you can easily identify the anomaly.

It’s not the first time that I've seen HSE anomalies but in current times when there seems to be issues with Care Homes this needs to be right. My view is aim for the 55 and mix with cold at the tap. That's OK for the nursing staff but no so good for the mobile who may have dementia.

Please, no endless discussions on the rights and wrongs of any - and, yes, I know that some legionella bacteria strains can remain viable up to 60 deg - I just need a sensible solution.

 

Thanks

 

Edited by user 17 June 2017 09:52:29(UTC)  | Reason: Incorrect HSG referenced

aud  
#2 Posted : 17 June 2017 20:02:35(UTC)
Rank: Super forum user
aud

See guidance for NHS which discusses how to manage this. Not read it myself, so hope it helps.

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/524882/DH_HTM_0401_PART_B_acc.pdf

Jane Blunt  
#3 Posted : 17 June 2017 21:25:23(UTC)
Rank: Super forum user
Jane Blunt

You can get mixing devices that will mix hot and cold water at the outlet to give the required safe water temperature. You then ensure that you test the water temperature just upstream of the mixing device. If the pipes are copper you can do this from outside the pipe as copper is a very good conductor of heat.

We had a new building which had these devices throughout and we had to strip away a small patch of insulation to do this.

Phil.miers  
#4 Posted : 18 June 2017 12:31:27(UTC)
Rank: New forum user
Phil.miers

Hi Jane

Both these temperatures are correct, but relate to different parts of the water system. The water circulation should be above 50 degrees to minimise the chance of legionella growth (it's also worth noting that the cold water should be below 20 degrees for the same reason). 

Water at the outlet should be at 44 degrees for a bath (this may be different for a shower or a hand basin) and this is achieved by using a TMV or thermostatic mixing valve, which will automatically blend the hot and cold water to achieve the set temperature. I would recommend a Type 3 TMV as these have the correct safety feature (no water flow if the cold supply fails to prevent scalding).

It is also important that any TMV is services annually minimum (6 months ideally), and that the function of the TMV is tested (using a temperature probe at the outlet) to ensure everything is working. Naturally to show due diligence you would have to make records of testing and servicing for each TMV.

My advice is based on hospital healthcare, but should be sound for your situation too.

I would recommend seeking the advice for a qualified company who are registered with the LCA (Legionella Control Association)

thanks 1 user thanked Phil.miers for this useful post.
jwk on 19/06/2017(UTC)
Xavier123  
#5 Posted : 19 June 2017 07:53:33(UTC)
Rank: Super forum user
Xavier123

Yup, agree with above post.  No contradiction.  L8 etc. does not require water temperature to be anything - it requires that you undertake an assessment of the risk and then put in place a scheme of controls.

Most of the time, the best control measure is temperature but there are occasions when this will not be possible e.g. care home outlets.  In that case, you minimise the length of pipework at a lower temperature, keep it in regular use and maintain/clean the TMV regularly.

As an aside, TMV's are being installed all over the place these days, often inappropriately so, since whilst they can deliver 'comfortable' temperatures there isn't necessarily a scalding risk....and rarely is the need for maintenance of the TMV itself a. planned for or b. undertaken.

chris.packham  
#6 Posted : 19 June 2017 10:14:57(UTC)
Rank: Super forum user
chris.packham

Actually, the temperature for use is not correct. Any water temperature above 38 deg C will have an adverse effect on the skin's barrier properties. There is no benefit in terms of hygiene of having a higher water temperature. Most skin cleansers are designed to work most effectively at 35 deg C. If anyone wants the evidence on this drop me an e-mail at chris@enviroderm.co.uk and I will send you a document with the relevant references.

Chris

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