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Care homes are supposed to be safe from bacteria. After all, these facilities are run by a staff whose primary duty is to safeguard the health and security of its residents. However, this was not the case in Essex, where a care home lost one of its residents due to Legionnaires’ disease.

Bupa Care Homes Case

In 2015, a resident died after contracting Legionnaires’ disease in a care home. When investigators collected water samples from the bathtub tap, they found high concentrations of Legionella bacteria. Further findings revealed that:

● Non-implementation of control measures for both the hot and cold water systems
● The care home administrators knew of the Legionella problem for quite some time

In 2018, the court found the care home guilty of negligence and had to pay £3 million in fines. This case was a wake-up call for other care homes to treat Legionella seriously as a health threat to its residents.

You’ve heard of Legionella or Legionnaires’ Disease, but how much do you know about it?
Legionella is the bacteria that causes Legionnaires’ disease and often thrive in clean, warm, and stagnant water. The disease causes pneumonia-like symptoms and primarily targets the elderly due to their:

● Reduced immunity
● Frail health
● Weak respiratory system

The unwitting victim can get infected by taking a shower, a bath or even by simple washing of hands. Bacteria enter the lungs through water droplets or aerosol. In the Bupa care home incident, the victim was infected by Legionella from water that came out of the bathroom taps.

How Legionella Enters Water System

Care homes are vulnerable to Legionella bacteria for the following reasons:

● Water outlets in rarely used rooms become stagnant making it ideal living spaces for bacteria
● Legislation and business needs make it necessary to carry out building renovations and additions which can affect the water systems
● A lack of strict monitoring with regards to temperature control for showers and water outlets

How to Detect Legionella

There are no legal requirements for legionella water testing. However, you need to conduct risk assessments to determine if the bacteria could grow your system. Depending on what the risk assessment finds, the necessity to test for legionella will be calculated along with the frequency and the outlets which require the checks. Typically frequencies are 6 monthly but can be as much as weekly if the requirements below are not met.

Hot Water System:

● Stored water temperature is at least 60°C at all times
● Water temperature at the furthest outlet of the property is maintained above 50°C (55°C in Healthcare environments) within 1 minute of opening the tap

Cold Water System:

● Legionella bacteria do not grow below 20°C. However, once the temperature rises above 20°C, the risk also goes up considerably.

Why the Need for Water Tests?

It’s often prudent to test for Legionella, not just for the ‘peace of mind’ it gives, but also:

● To detect if Legionella bacteria are present, what sort and how many
● To protect the health and safety of both residents and staff
● To serve as documentation in case of legal actions
● To avoid possible fines and penalties
● To collect supporting data for your current risk assessment

Other Preventive Measures

Prevention is always better than administering a cure. Here are additional ways you can take to prevent these bacteria from infiltrating your water system.

● Check, inspect, and properly treat your water system
● Descale the showerheads regularly, even 3 months as a minimum
● Flush rarely used taps and water outlets weekly
● Clean water storage tanks and hot water cylinders regularly

Care home operators should consider upgrading their water system against Legionella. Upgrades can include:

● Installation of short and direct pipework
● Proper insulation for pipes and tanks
● Use of lids and screens to protect water sources from possible contamination

Possible Ways to Remove Legionella

If Legionella managed to infiltrate your hot water system, it’s possible to get rid of the bacteria through the following options.

● Pasteurisation – Increase and maintain the temperature at 70°C for at least an hour or more in the storage vessel. Afterwards, open all your taps in sequence to run the high-temperature water throughout your system. Make sure that the water temperature is maintained. If not, you’ll need to wait for the system to re-heat again to 70°C before continuing with the flushing.
● Chemical Disinfection – You can resort to this method if the pasteurisation process fails.

If your cold water system is positive for Legionella, chemical disinfection is the most viable option.

For Legionella testing kits, recommendations or advice, you can contact AquaCert.