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Residential rest and care homes

In September 2006, a survey of private and local authority-managed residential care and rest homes found that 20% were not aware of HSE guidelines on preventing Legionnaires' disease through effective water quality management - and 23% were not sure of the most appropriate professional to manage the risks.

The survey also found that many such homes failed to maintain a water management logbook, despite HSE agreed practice. Should a resident contract Legionnaires' disease due to control shortcomings, establishments would have difficulty defending against an HSE prosecution.

Rest and care home residents are particularly vulnerable due to age, existing respiratory disorders or post-operative and hence immunocompromised.

As many residential homes are old, large buildings that have been converted, there is a probability of infrequently maintained or poorly insulated cold water tanks - which may be in a warm part of the building. Plumbing may have been adapted, with dead legs where lukewarm water may remain for long periods of time. Ideal areas for Legionella bacterial growth.

Helping residential rest and care homes comply with ACoP L8 for the control of Legionella bacteria in water systems is AquaCare Water Hygiene Services’ primary objective.

Useful documents:

HSE Guide: Legionnaire's disease - Essential information for providers of residential accommodation - HERE
HSE Guide: Controlling Legionella in nursing and residential care homes - HERE

Ideally, bath or shower water should be between 40-45°C. This is also the optimum temperature range for Legionella growth. Previous recommendations suggested raising the temperature to 60°C - which will kill Legionella bacteria in around 30 minutes - introducing a risk of scalding.

However, the elderly or disabled pose a greater risk of scalding than the average population. The solution is to fit thermostatic control valves (TMVs) as close to the outlet (tap, shower, etc) as possible to minimise opportunities for Legionella to grow. However, remember that your TMVs will still require regular monitoring and maintenance, at least twice a year.

Water temperatures	Normal	Max*
Bath	44°C	46°C
Bidet	38°C	40°C
Shower	41°C	43°C
Wash basin	41°C	43°C
[* maximum permitted in the event of a cold water failure]

This new, easy-to-install shower head offers instant protection against Legionella and other pathogens in the water system. Ideal for patients vulnerable to infection following clinical procedures that suppress their immune system. Contact AquaCare for more information.