Bathroom safety in nursing and care homes

It is estimated that 90% of nursing home residents need assistance with bathing.

The care home manager has a duty of care to both their staff and to the residents to ensure all areas within the home are safe to use. In a care environment the bathroom is a work environment and as such there are health and safety and infection control considerations which will need to be assessed through robust risk assessment.

1.       Hazards in a bathroom

A risk assessment will help you identify the potential hazards within a bathroom and highlight any further controls needed to ensure it remains safe to all users. You will need to consider and risk assess:

·         Available space

·         Adequate lighting

·         Temperature of water

·         Potential for slip, trips, falls

·         Infection control strategies

·         Bathroom equipment

·         Mould prevention

Space

There should be adequate space for the user to be comfortable when using the toilet, bath or shower. If a hoist is required there must be space to allow staff a sufficient area to work in and to ensure the safe use of the hoist.

Lighting

The lighting must be suitable and sufficient for the use of the bathroom, allowing both staff and residents to be able to see what they are doing properly.

Water temperature

The temperature of the water must be checked at regular intervals to eliminate the risk of burns to the residents and must not exceed 44°C and the correct mixing taps should be used, e.g. thermostatic mixing valves (TMVs).

Slip, trips, falls

The flooring should be suitable for the intended use of the bathroom ie anti-slip in wet environments.

Infection control strategy

A schedule of cleaning and bin emptying must be in place and monitored to prevent the spread of pathogenic microorganisms.

Bathroom Equipment

All equipment including bath lifts and hoists used within the bathroom are subject to LOLER  regulations so need scheduled service checks. 

Mould prevention

Good ventilation will help prevent the development of mould in the bathroom. Where possible, use natural ventilation but if you do open a window ensure that there are windows restrictors in place.

The bathroom is a relatively safe area but will still need to be risk assessed to ensure it remains safe for each individual resident. The care home manager should ensure that regular planned inspections are carried out to ensure the bathroom remains a low risk environment.

Useful links

http://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-15-premises-equipment

http://www.nhs.uk/Conditions/social-care-and-support-guide/Pages/hygiene-and-washing.aspx

Best Practice for moving and handling

Moving & handling is a key part of the working day for most care staff from moving  equipment, laundry, catering, supplies or waste to assisting residents.

 Poor moving and handling practice can lead to back pain and musculoskeletal disorders, which can lead to inability to work

- moving and handling accidents – which can injure both the             person being moved and the employee

- discomfort and a lack of dignity for the person being moved

- All care homes are responsible for putting the right measures,         equipment and training in place to prevent or minimise the risk of     injury.

Patient-centred care plans

No-one should routinely manually lift patients. Hoists, sliding aids, electric profiling beds and other specialised equipment are substitutes for manual lifting. Patient manual handling should only continue in cases which do not involve lifting most or all of a patient's weight. This rules out for example, the shoulder or Australian lift. Patients often have complex and varying needs. The Health and Safety Executive advise a balanced approach to managing the risks from patient handling. These include:

Equally, care workers are not required to perform tasks that put them and their clients at risk

A client's personal wishes on mobility need to be respected wherever possible

A client's independence and autonomy must supported as fully as possible.

A patient-centred care plan should include information on immobility and detail any handling risks and/or needs

Care environments are governed by the following legislation and helpful for assessing moving and handling risks:

·         Health and Safety at Work etc Act 1974 (HSWA)

·         Manual Handling Operations Regulations 1992 (MHOR) (as amended 2002)

·         Management of Health and Safety at Work Regulations 1999

·         Provision and Use of Work Equipment Regulations 1998 (PUWER)

·         Lifting Operations and Lifting Equipment Regulations 1998 (LOLER)

Legally, employers are obliged to provide a safe working environment for their staff. Under the Manual Handling Operations Regulations 1992 (as amended) employers are required to:

·         assess the risk of a back injury at work

·         reduce the risk of injury to the lowest level reasonably practicable

·         provide training for staff on safe manual handling practices

·         supervise staff to ensure compliance with the regulations.

Risk assessments could be generic and individual.  A generic risk assessment would consider the needs of the workplace/environment e.g. the equipment needed, safe staffing levels, emergency procedures and the suitability of the physical environment.  Individual risk assessments consider the specific moving and handling needs (e.g. help needed, specific equipment needs and number of staff needed to support the patient) to ensure the safety of staff and the patient/service user.

There is a requirement for a ‘competent person’ to conduct risk assessments. Competency is a mixture of skills, knowledge and qualifications to carry out the role.

For further details please see

http://www.hse.gov.uk/healthservices/moving-handling.htm

https://www.rcn.org.uk/get-help/rcn-advice/moving-and-handling

Odour elimination vs odour control

If you look at almost any written or online guide helping families to choose a nursing home for a loved one, they all suggest you ask the all-important question: "How does the facility smell?" If it smells anything like an old bedpan, you are urged to keep looking. Equally as bad is a heavily perfumed smell trying to cover up malodours.

The first and most important step in any odour-control strategy is to try to eliminate the source of malodours rather than merely trying to combat the odours themselves. Disinfectants, enzymatic agents and detergents are the first and best line of defence against malodours, because these products can remove or kill the material causing the unpleasant smells.

The second line of defence is odour-control products.

There are basically three types of odour-control products: air fresheners, odour counteractants and odour-eliminators.

Odour control has improved significantly in recent decades, giving care home managers a real choice of ‘control’ vs ‘elimination. These advances have allowed healthcare housekeeping and maintenance departments to move away from using fragrances designed simply to mask unpleasant smells with pleasant ones and to now actually eliminate malodours.

Our best selling odour eliminator OdorBac Tec Pure2 for example is a cleaner, odour eliminator, stain remover and bacterial killer all in one.

Highly effective against odours associated with urine, faeces, vomit, body odour, household/food waste, damp, tobacco and many more. Designed to tackle dirt, grease and grime in a variety of applications.

Odorbac Tec⁴ is a powerful stain remover and can be used in hot water extraction machines and quick dry bonnet systems to help keep carpets and soft furnishings in perfect condition.