Thermostatic mixing valves (TMVs) play a crucial role in helping care home managers comply with regulations and keep their residents safe.
There are two interlinked risks around water provision for elderly people in these environments – the risk of injury through scalding and the primary need to keep water hot enough to avoid outbreaks of the potentially fatal Legionnaires’ Disease.
While avoiding Legionnaires’ Disease by keeping water at temperatures above 50 degrees C, care homes must then be mindful of the potential for scalding and take steps to ensure this does not happen. TMVs provide this peace of mind.
The often vulnerable and confused residents could harm themselves when bathing or showering, or where there are hot surfaces, like pipes. The issues are that care home residents cannot in general react or move quickly when faced with scalding water and they may have impaired mental capacity.
Contact with surfaces above 43 degrees C is a risk and can lead to serious injuries. It may be that residents have fallen in the bathroom but are unable to move so the exposure to the scalding water or hot pipe is extended.
The legal position
Care home managers have a legal duty to control all risks linked with hot water supplies. The Health and Safety at Work Act, 1974 is comprehensive in scope – and care home managers must consider all risks that may affect those in their care.
At the same time care home managers must assess risks to staff and residents from Legionella and other bacterial threats and take suitable precautions, under the Control of Substances Hazardous to Health Regulations 2002.
Standard 25 of the National Minimum Standards for Care Homes also underlines that water in a care home should be stored at a temperature of at least 60°C and distributed at a minimum 50°C to prevent risks from Legionella.
The same standard advises that pre-set valves that are not affected by water pressure changes and that have fail-safe devices should also be fitted locally to provide water close to 43°C to prevent scalding accidents.
Further regulatory points are covered under the Provision and Use of Work Equipment Regulations 1998 (PUWER).
What to do
All care home managers need to carry out a thorough risk assessment survey to pinpoint potential scalding and burning risks to those being looked after.
The risk assessment should at the same time identify the types of control technology needed as well as developing a comprehensive management and maintenance schedule. Every individual care assessment should be informed by this overall plan.
Individual assessments needs should determine whether the resident would be likely to draw a bath or take a shower when unattended. Naturally, this is paramount for those with impaired mental capacity.
It should also assess the resident’s degree of mobility and determine whether or not they would be able to move away rapidly from over-hot water or surfaces, and whether they can summon assistance
Other key points to address are whether the resident’s sensitivity to temperature is impaired and/or whether their mental condition suggests that means they are unable to recognise or react to hot water or a hot surface.
The assessment would also take into account particular technology such as lifting aids that would affect mobility in the bath, for example.
TMVs are essential in these environments and are one of a range of technologies that will help to prevent serious injury from scalding, ensuring safe water temperatures. Regular safety testing is essential and if TMVs are not fitted to baths or showers, then equally effective controls should be in place.
Type 3 TMVs are required by the Department of Health’s Health Technical Memorandum 04-01: “The control of legionella, hygiene, safe hot water, cold water and drinking water systems”.
Type 3 TMVs should be installed when replacing older valves and in new installations. The TMVs should be installed as close as possible to the outlet and ensure that water hotter than 44 degrees C is not discharged from residents’ taps and showers.
Cool Touch solution
Products like the Methven Cool Touch are a good solution incorporating Cool-to-touch technology that ensures the bar valve never gets warmer than the mixed water temperature, providing a safer shower environment.
The Methven thermostatic technology monitors and continually adjusts the temperature level preventing cold shocks or hot scalds.