In October 2013, an inquest hearing traced the death of a 95-year-old man in care home to Legionnaires’ disease, an infection of the respiratory system caused by inhalation or exposure to water droplets contaminated with Legionella bacteria. According to reports, the man complained of feeling sick just three weeks into his stay in the Whitley, Berkshire home. The symptoms worsened rapidly, leading to his death, despite being provided medical attention and given prescriptions for antibiotics against Legionella.
The investigation that followed revealed that the most likely source of Legionella exposure was the wash basin located in his room in the care home. The presence of bacteria was also discovered in an upstairs shower and a tap in an outdoor area. Meanwhile, the care home manager admitted that they are not aware of Legionella policies and therefore did not practise standard measures such as regular Legionella testing in the facility.
The incident has prompted the district council to implement additional precautionary measures and to re-emphasise the importance of following essential health and safety systems. The risk of Legionella infection is high in care homes due to the usual size of the facilities and the water system. Moreover, elderly residents usually have a weakened immune system, making them susceptible to respiratory infections. In fact, the elderly are considered the demographic at highest risk – even with immediate medical attention, Legionnaire’s disease can be fatal to them.
It is thus mandated by law that care homes follow a strict regimen of checking, cleaning and maintenance of their water systems to guard against bacterial contamination. Responsible owners and managers of such facilities are also expected to implement key action steps to establish Legionella controls, get expert help in managing determined risks, and seek practical, realistic and doable solutions, such as the use of a high-quality Legionella testing kit.
Some of the recommendations from The Health and Safety Executive (HSE) include:
- Developing an accurate diagram of the water system layout.
- Ensuring efficient temperature control of water services (To prevent Legionella growth, hot water in storage should be at least 60 °C, hot water being distributed should be at least 50 °C, and cold water should be maintained below 20 °C).
- Showerheads should be dismantled, cleaned and descaled at least quarterly.
- Calorifiers, sentinel outlets and representative sectors of outlets should be cleaned and checked for temperature control.
- Regular flushing, especially of infrequently used taps and showerheads, should be done to prevent stagnant water from remaining in the pipeline.
- Regular assessment and water quality tests to check for contamination and determine the necessary next steps for immediate action.