Legionella testing is more often required in UK care homes to manage the risk of Legionnaires’ disease and ensure a safe environment for residents and staff. Due to the vulnerability of care home residents and the higher risk of legionella bacteria proliferating in water systems, risk assessments, regular monitoring, and sometimes testing for legionella are essential under UK health and safety legislation.
1. Legal Requirements and Guidelines for Legionella Testing in Care Homes
Health and Safety at Work Act 1974:
Under this legislation, care homes have a duty of care to manage health and safety risks, which includes risks from legionella bacteria. Care homes must take appropriate steps to control the risk of Legionnaires’ disease.
Control of Substances Hazardous to Health (COSHH) Regulations 2002:
Legionella bacteria are considered hazardous under COSHH. Care homes must implement measures to control exposure to harmful bacteria, including legionella, particularly in water systems where it may proliferate.
The Health and Safety Executive’s (HSE) Approved Code of Practice L8 (ACoP L8):
ACoP L8 outlines specific duties to manage and control legionella in water systems. This includes carrying out a legionella risk assessment and implementing controls to prevent the bacteria from growing and spreading in the water system.
For care homes, which are considered high-risk environments due to the vulnerability of residents, the water systems must be managed closely, with regular checks, monitoring, and sometimes water testing for legionella.
HSG274 Part 2 – The Control of Legionella Bacteria in Hot & Cold Water Systems:
This HSE guidance provides practical advice on controlling legionella in hot and cold water systems, which is essential in care homes where residents are at higher risk.
It recommends regular temperature monitoring, flushing of infrequently used outlets, cleaning and descaling of showerheads, and testing where necessary as part of a legionella control plan.
2. Key Actions for Legionella Control in Care Homes
Legionella Risk Assessment:
Initial Risk Assessment: Care homes must conduct a legionella risk assessment to identify and assess potential sources of legionella within their water systems. This assessment should be carried out by a competent person and reviewed periodically or when significant changes occur in the water system or building.
Frequency of Review: The risk assessment should be reviewed at least every two years or sooner if there are any changes to the water system, building use, or if an incident (e.g., positive legionella test) occurs.
Regular Temperature Monitoring and Maintenance:
Monthly Temperature Checks: Hot water should be stored at a minimum of 60°C and distributed at 50°C (within 1 minute of running) to outlets. Cold water should be below 20°C (within 2 minutes of running).
Flushing Infrequently Used Outlets: Outlets that are not used regularly should be flushed weekly to prevent stagnation, which increases the risk of legionella.
Cleaning and Descaling: Regularly clean and descale showerheads, taps, and other outlets to reduce biofilm and limescale, which can harbour bacteria.
Legionella Testing (Sampling):
When to Test: Routine water testing (sampling) for legionella is generally recommended in higher-risk settings like care homes, particularly where there is evidence of stagnant water or if the water temperatures are not consistently within safe ranges.
Frequency of Testing: Testing frequency may depend on the risk assessment findings, but testing is typically conducted annually or bi-annually in high-risk environments, or more frequently if required.
Specialist Contractors: Testing should be done by qualified legionella control specialists, and results should be documented and retained for inspection.
Documentation and Compliance:
Maintain records of all risk assessments, monitoring activities, maintenance, flushing schedules, cleaning, and test results as part of your legionella control logbook. This documentation is essential for regulatory compliance and inspections.
Staff Training:
Staff should be trained in legionella awareness, identifying potential risks, and understanding the importance of routine checks and testing.
3. Summary
Legionella risk assessments are required, and regular monitoring, temperature checks, and system maintenance must be carried out.
Testing (sampling) for legionella is recommended, especially where there is increased risk or where controls like temperature are not consistently maintained.
Following HSE guidelines (ACoP L8 and HSG274) and keeping accurate records is essential to ensure compliance and protect the health of residents and staff.
