Are you responsible for bathing vulnerable persons?

Many health and social care providers are responsible for vulnerable individuals who may be at higher risk on contact with hot water and surfaces. This could include older people, children, and people with a range of disabilities or those who could not react to temperature quickly enough to prevent injury. Places such as hospitals, care homes, schools and residential assisted accommodation are typical of the environments where this assistance may be required.

Water temperatures, particularly over 44^oC, can create a risk of scalding and should be controlled at outlets with devices such as thermostatic regulatory valves. This ensures that water within the system is not reduced to a level where doing so could introduce other hazards such as Legionella bacteria.

At the end of 2015 a care provider was prosecuted and fined £75,000 due to breaches of section 3(1) of the Health and Safety at Work etc. Act 1974 for failing to provide adequate training, instruction and supervision to its workers. A care worker had lowered a 60 year old man who had epilepsy and cerebral palsy into a bath of hot water. During the lowering procedure he suffered a prolonged epileptic fit in which time his feet and lower legs remained in the water and received severe scalds to them. He died 14 days later in hospital.

The gentleman had a support plan which identified his love of the water but it also identified that he did not like it to be too hot. The Health and Safety Executive (HSE) found the staff had not received training or instruction in relation to water temperature for bathing and the company was not aware of guidance relating to safe bathing. The company also did not provide thermometers or carry out adequate risk assessments for bathing their service users.

The individual’s assessment needs to take into consideration:

• The person’s ability to recognise and react to water being too hot.
• Is the person likely to try and add more hot water to the bath or shower?
• Is the person’s sensitivity to water impaired in any way?
• The person’s lack of mobility.
• Can they summon assistance if required?
• Are any lifting aids required?

In order to try to prevent similar tragedies from happening again a number of processes can be put in place to ensure the safety of vulnerable people during bathing.

• Ensure a suitable and sufficient risk assessment has been carried out on bathing for the individual.
• A review of the individual’s care plan should be undertaken to ensure personal preferences are taken into account.
• Provide training to care workers in safe bathing techniques.
• Provide care workers with a thermometer to ensure water temperature is not above 44^o
• Install water temperature controls at water outlets such as thermostatic mixing valves. Where this is not possible other equally effective controls should be in place.

If you would like to speak to Ellis Whittam about how we can support you with any of the challenges highlighted here, please call 0845 226 8393.