'Zero-tolerance' on abuse, 6th March 2009, Scunthorpe Telegraph
Following an 8% increase in referrals, North Lincolnshire council is set to roll out a zero-tolerance approach to the abuse of vulnerable adults. Councillor Pauline Carlisle, cabinet member for adult services, explained the increase in reports was mostly due to greater awareness, training and better understanding of what help is available.
Four held in care home abuse probe, 6th March 2009, Liverpool Echo
Four members of staff of Windy Knowe Nursing Home, Oxton, Merseyside, were arrested by police last week on suspicion of willful neglect, following allegations that dementia sufferers were being mistreated.
The four individuals were quizzed by officers from Merseyside Police’s Vulnerable Adult Team and later released on bail to appear on 21st April 2009. The home has 49 residents, seven under the age of 65 and 42 over 65.
Protection of vulnerable adults (POVA) scheme: 3rd March 2009 CSCI eNewsletter
The Independent Safeguarding Authority (ISA) has taken over the responsibility for POVA referrals. Find out what this means for you when you are recruiting staff. There is a new referral form and the guidance and other notes have been updated and changed.
Revised POVA guide
The Social Care Institute for Excellence (SCIE) has produced revised guidance to making referrals for inclusion in the POVA List. The guide can be found at www/tinyurl.com/b37pfn.
Supporting older people in care homes at night
CSCI has written prompts to help providers to think about whether they have the best arrangements in place for night time care.
Reminder: important change to the distribution of medical device and equipment alerts
The process for receiving medical device and equipment safety alerts has changed. You need to register your email address with the Department of Health by 31 March 2009.
World Elder Abuse Awareness Day, 15th June 2009
This is in its fourth year now. For more information, email firstname.lastname@example.org or call 0208 765 7000.
The Care Quality Commission and the Future of Regulation: conference to be held on 7th May 2009 in central London
Planned sessions will examine: the role of the Care Quality Commission; what the CQC will mean for service users and service providers; learning from regulation of other sectors; co-ordination between agencies; how the CQC will deal with taking on the work of the previous three agencies; and using regulation to drive quality improvements. Speakers include Baroness Young, Chair of CQC.
Management of Legionella risk in Care Homes
The Health & Safety Executive recently carried out 28 inspections of nursing homes across Wales. Several of the nursing homes visited did not have adequate arrangements for controlling the risk of Legionella. In nine of the homes, the risk management systems were so poor that Improvement Notices were issued.
Legionnaires disease is a potentially fatal form of pneumonia which can affect anybody, but which principally affects those who are susceptible because of age, illness, immunosuppression, smoking, etc.
In the UK, Legionella pneumophila serogroup 1 is the most common cause of Legionnaires’ disease. Infection occurs by inhalation of water droplets (or aerosols) infected with the bacteria. There are no recorded instances of person to person transmission of the disease.
Legionella bacteria can be found naturally occurring in environmental water sources such as rivers, lakes and reservoirs, usually in low numbers. Where conditions allow, they can infect the water in cooling towers, whirlpool spas and purpose built hot and cold water systems, as found in care settings.
Where conditions are suitable for the growth of Legionella, the risk is increased. There is a risk of disease when droplets of water, infected with the bacteria, are inhaled.
Whilst showers may present a particular problem in care homes, water droplets created from taps are also a potential source.
Any equipment that can generate water droplets that could be inhaled should be assessed for potential risk.
There is a duty on nursing homes under the Health and Safety at Work etc Act 1974 to consider the risks from Legionella that may affect their employees and the people in their care.
Homes should carry out a full assessment of their hot and cold water systems and ensure adequate controls are in place to ensure that the conditions are not suitable for Legionella growth.
A schematic drawing of the water system is essential in the vast majority of premises to help manage the risks. The most commonly
used method of managing the risk is through temperature control. Other systems include copper and silver ionisation or ozone and UV treatment. However, these require regular maintenance, servicing and inspection to ensure they remain effective.
Where temperature control is to be used, it is vital that the controls detailed in the HSE publication “Legionnaires’ Disease – The control of Legionella bacteria in water systems” (L8) are in place. These include the following:
• hot water storage should be kept above 60 degrees Celsius
• hot water distribution should be kept above 50 degrees Celsius (prior to thermostatic mixers where they are found)
• hot and cold water systems should remain separate until point of use
• cold water storage and distribution should be kept below 20 degrees Celsius all year round
• cold water storage tanks should be appropriately sized (normally sufficient for a day’s use to avoid stagnation), have lids, be insulated and be kept clean and free from debris
• infrequently used outlets should be flushed out on a regular basis
• there should be no dead legs in the pipe work
• monitoring of temperatures should be carried out on regular basis
• analysis of water samples for Legionella should be carried out periodically (frequency to be determined by level of risk)
• responsible persons should be adequately trained and monitored
Whilst the inspection of nursing homes in Wales found that many premises were failing to manage the risks from Legionella, the risks can be easily managed.
There is no excuse not to assess hot and cold water systems in such premises and implement adequate controls where there are
vulnerable people with increased risk from exposure to such bacteria.
It should be noted that where temperature control is to be used to manage the risk from Legionella bacteria, thermostatic mixer valves will be required close to outlets accessible to service users. This is especially the case on showers and baths. Temperatures will have to be monitored to ensure that outlets do not achieve temperatures greater than 43 degrees Celsius. Temperatures for management of Legionella will, therefore, need to be taken prior to the mixer valve.
Further information on the risks from scalding can be found in HSE Sector Information Minute (SIM) 7/2207/08 available from the HSE website.
Further information on this important topic can be found on HSE ‘s website at http://www.hse.gov.uk/legionnaires, or call the HSE helpline on 0845 345 0055.
This article has been prepared by the Health and Safety Executive in Wales.
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