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Legionella and Care Homes

What is Legionella?

The term Legionella refers to a group of bacteria that are common in natural water supplies such as ponds, but can just as easily be prevalent in domestic water systems. Legionella bacteria normally only become a health problem once they have the opportunity to multiply in an industrial or domestic water system and an individual inhales water droplets that contain the bacteria. However, not everyone that is exposed to the bacteria will become unwell, though there are individuals that are more susceptible:

  • Elderly and Infirm
  • Individuals with Diabetes
  • Individuals with Chronic Heart Disease
  • Individuals with Smoking Related Illnesses
  • Individuals with other underlying health conditions

The symptoms of exposure to Legionella bacteria are very similar to those of flu, with symptoms such as fever and muscle aches, however, a simple urine test can confirm sporadic cases. Due to the potential susceptibility of those in care homes, symptoms should be treated appropriately based on clinical assessment of severity, though, this is a self-limiting illness and usually lasts for a week.

If your residents fit into the categories mentioned above, it is important that they are monitored to ensure that they do not contract Legionnaires Disease. The symptoms of Legionnaires Disease are:

  • Cough
  • Shortness of Breath
  • Fever
  • Muscle Aches
  • Headaches
  • Diarrhea

Once again, Legionnaires Disease is a self-limiting illness but if the individual develops pneumonia symptoms, they should see a doctor immediately and mention potential Legionella bacteria exposure.

On average, there are about 200-250 confirmed cases of Legionnaires Disease each year in England and Wales, with about half of these cases being associated with travelling aboard (HSE). However, it is estimated that there 4,000-10,000 unconfirmed cases each year.

Reducing Legionella Risks

As someone in charge of a care home, there are simple control measures that you can do yourself to reduce Legionella risks. These are:

  • Flushing the system on a regular basis
  • Ensuring that debris cannot get into the system (e.g. cold water tanks, where fitted, have a tight fitting lid)
  • Setting control parameters (e.g. setting the temperature of hot water cylinders to ensure water is stored at 60⁰C)
  • Making sure that any redundant pipework is identified and removed

To manage these risks in accordance with legislation, a scheme of control should be put in place to prevent an outbreak. The scheme of control should contain the following information:

  • Consideration of the nature and condition of the water system
  • A determination whether current control measures in place are effective
  • The identification of any areas of high risk, for example, where systems with stored or recirculated water has the capacity to produce aerosols
  • A review of the susceptibility of any persons exposed to these aerosols
  • An identification of areas not in consistent use, and no regular flushing regime in place

It is recommended that you have a trained risk assessor to make a thorough assessment of your premises to ensure that your water system remains compliant.

Actions for Vacant Rooms

In the instance of vacant rooms within your care home, the risk of a Legionella bacteria outbreak is increased. It is important that these rooms are not neglected and are included within a scheme of control. This is what your risk assessor will include in their assessment, but there are measures that you can put in place to ensure that these vacant rooms are not the source of an outbreak. These measures include:

  • Not leaving water stagnant
  • Applying the general principle – outlets on hot and cold water systems should be used at least once a week
  • Consideration should be given to implementing a suitable flushing regime for these rooms.

Hydraclean Ltd have developed an app to ensure that clients can always access the data for these schemes of control, at any time, to ensure they are compliant and can carry out some of the routine tasks simply ‘In House’. Delta Compliance Online enables multiple sites to be monitored at the same time, saving on admin time and the handling of log books. To find out more about Delta Compliance Online, please visit our website or phone 0161 430 5100.

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