The residential care sector caters for a wide range of client needs which involve a variety of workplace activities.

Residential Care Homes are those homes providing round the clock social assistance to children, the aged and others, where the provision of education or health is not the main activity.

The responsibilities of care home proprietors are subject to a range of health and safety legislation. For each workplace activity there should be a safe system of work, staff should receive appropriate training and all equipment should be maintained in good condition.

Advice or complaints about any health and safety matters relating to a residential care home in the Braintree District should be directed to the Health Protection Team at Braintree District Council (Tel 01376 552525 x2211) as the enforcing authority for residential care homes.

Advice or complaints about health and safety in nursing homes, or assisted living units should be directed to the Health and Safety Executive as the enforcing authority for these premises (Tel 01245 706200).

MAIN LEGISLATIVE REQUIREMENTS

1. The Health and Safety at Work etc. Act 1974.

Employers have a general duty to ensure, so far as is reasonably practicable, the health, safety and welfare at work of their employees and others who may be affected by their work activities (including residents and visitors).

2. The Management of Health and Safety at Work Regulations 1999 require employers to assess the risks to employees and others who may be affected by their undertaking, ie. residents.  Don't forget to include all maintenance and gardening tasks when carrying out your risk assessments.

3. The Control of Substances Hazardous to Health Regulations 1999.  Employers are required to prevent or control exposure to hazardous substances at work.

Hazardous substances can include cleaning chemicals as well as potentially harmful biological agents contained in clinical waste or soiled laundry.

MAIN HAZARDS ASSOCIATED WITH RESIDENTIAL CARE HOMES

a) Injuries Arising from Lifting

Almost four out of every ten accidents reported by this sector arise from manual handling.  In order to prevent such injuries The Manual Handling Operations Regulations 1992 require employers to avoid hazardous manual handling operations so far as is reasonably practicable.

Employers should make a suitable and sufficient assessment of hazardous manual handling operations which cannot be avoided and reduce the risk of injury via appropriate systems of work, including training

b) Lifting Equipment

Equipment used for lifting residents (hoists, lifts etc) are subject to the requirements of The Lifting Operations and Lifting Equipment Regulations 1998.  As such they are required to have a thorough examination every six months.  Slings used with the hoists must also be examined at this time.  Before use staff must ensure that they check that the sling is in good condition (eg no frayed edges etc) and is the correct size for the resident.  Managers are advised to ensure that all staff are aware of which slings are to be used for which residents (for example a list attached to the hoist).  All lifting equipment (including slings) must be marked with their safe working load.

Staff must not be permitted to use lifting equipment until they have been properly trained in its use.

A certificate is issued following every thorough examination.  If a piece of equipment fails with a defect which is or could become a danger to persons the piece of equipment must be taken out of use immediately and should not be put back into use until the defect has been rectified.  Paperwork detailing the works done and the date should be kept with the relevant lift report.

All other lifting equipment (eg goods lifts, dumb waiters etc) are subject to a thorough examination every 12 months.  Lifts which have not been examined at 6 monthly intervals must not be used to lift persons.

c) Biological Agent Hazards

Hazards arise from the handling of clinical waste and soiled laundry, which can be contaminated with a variety of pathogenic organisms.  Such hazards should be identified and assessed under the provisions of the COSHH Regulations 1999.  Procedures for the safe handling, segregation, storage, spillage control and disposal should be laid down and staff should be trained accordingly. Staff should be protected against hazardous substances they may use in their work activities. Staff in residential care homes are particularly at risk from clinical waste, including soiled laundry. Therefore, staff should be trained in safe working procedures and hygiene standards, as well as being provided with appropriate protective equipment.

Legionellosis is caused by the inhalation of airborne droplets, which contain legionella bacteria.  Infection can only occur under certain conditions that permit the growth and multiplication of the organism and involve the creation of droplets, which can be inhaled.  To avoid the growth of Legionella bacteria care homes should ensure that all hot water is stored at 60ºC or above and circulated at 50ºC or above.  The cold water temperature must be less than 20ºC (measure the cold water temperature on a hot day as this will be the worst scenario).  Dead legs (unused pieces of pipework) should be removed as water will lay in these pipes and stagnate.  Pipework pending removal, or rarely used showers etc should be flushed through regularly (weekly is recommended) to remove the stagnant water.  Shower heads and taps should be de-scaled regularly to remove the nutrients that the Legionella bacteria will feed on.

d) Scalds and Burns

At water temperatures over 43ºC there is a risk of scalding which rises with increasing temperatures.  The risk is increased in care homes as residents maybe elderly and may be prone to sensory loss.   It is recommended that water temperatures should not exceed 43ºC in areas that are accessible to residents.

Safe hot water systems include thermostatic mixers with fail safe devices, single lever mixers or control mechanical mixers with built-in tamperproof hot water limiting devices. Access to areas should be restricted and some residents may require supervision by adequately trained staff.

Residents may suffer burns if they come into contact with surface temperatures in excess of 43ºC.  Managers should ensure that no such surfaces are accessible (eg beds should not be positioned against radiators, radiators next to toilets should be guarded etc)

e) Electrical Safety

The Electricity at Work Regulations 1989 require employers to maintain electrical systems and equipment in safe working order.  All electrical equipment should be installed and maintained by a competent person.  Fixed electrical installations should be inspected at least once every five years.  Simple, regular in-house checks of equipment should also be carried out by a competent person at a frequency appropriate to the risk.

Portable appliances should be tested regularly and annual testing is recommended, managers should ensure that any portable appliances bought into the home by residents are checked prior to use and are included in any testing regime.

Any required corrective action should be carried out immediately.

Extension leads should be avoided.  An electrician should be employed to provide additional sockets if they are required.  If an extension lead is used (eg for occasional maintenance work) managers should ensure that the cable is fully uncoiled and that the cable does not present a trip hazard to others in the vicinity.

f) General Environment Hazards

Floors: In order to prevent slips, trips and falls, floors should be of a non-slip design and the use of mats and rugs on polished floors should be avoided. Floors should be kept clean, in good repair and free from obstacles at all times.

Where possible dry cleaning techniques should be used.  During cleaning warning signs should be used to make residents and staff aware of potentially slippery surfaces.

Stairs: Stairs should be properly maintained, constructed and well lit with hand rails on both sides of the stairway.

Windows: Several fatal accidents have occurred in residential care homes when people have fallen through windows. Windows which are sufficiently large enough to allow a person to fall through when open should be modified to reduce the size of the opening. All windows should be glazed with toughened safety glass, which conforms to BS6262, and be marked so that people are made aware of the presence of glazed areas.