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.

Important Safety Information:

In the interests of safety of our customers, we would like to bring to your attention to the correct assembly of the D-Clip that connects the actuator to the Invacare Birdie lifter’s arm.

As a result of some vigilance cases where the actuators D-Clip becomes damaged and the lifter arm falls down, we become aware that if the D-Clip is always placed backwards and pointing down towards the actuator, it can start to become damaged after a number of cycles.

However:

•          The bending (damage) of D-Clip only happens if it is touching the actuator backwards and at its maximum height
•          After the first cycle, the D-Clip is not touching the actuator anymore (unless manually pushed);
•          The complete clevis Pin doesn’t detach immediately from the actuator, when the D-Clip becomes damaged – the pin stays          in the arm’s plates that hold the actuator
•          Only over 140kg it starts to bend severely. 

If you are concernced that your Birdie Hoists may have an issue or require further information on this field safety notice please contact us on 01423 331000 or email sales@andwayhealthcare.org.uk. 

We are here to help in more than one way, here's a little bit of sound advice for you:

With the emphasis on both mattress integrity for patient comfort and pressure sore prevention and ensuring robust infection prevention control, 6 monthly mattress audits are highly recommended and regarded as industry best practice.

All healthcare organisations must be registered with the Care Quality Commission (CQC) and be actively working towards improving cleanliness and reducing the infection rates in their organisation.

Regular auditing is just one action you can take towards meeting national CQC regulations and safeguarding your patients and staff. Being able to identify when products are no longer ‘fit for purpose’ will ensure that you always have the most effective equipment in use and enable you to maintain the highest standards of care in your organisation

Your decision as a Care Home Manager is very much around whether you decide to train your staff to carry out these audits or to bring in an outside and potentially more expensive external provider.

In-house training has the added training advantage of helping to raise awareness of mattress health, mattress checking and the importance of mattress condition in relation to patient well- being, comfort and pressure sore prevention.      

Helpful Online Audit Tools

There is an abundance on online tools available to download and use, here is just one issued by the NHS: 

http://www.infectionpreventioncontrol.co.uk/content/uploads/2015/07/Audit-Tool-Mattress-for-Care-Homes.pdf

Andway Healthcare offer Mattress Audits as part of our Service and Maintenance packages, prices given on application.

The Safe Use of Bedrails

The Medicines and Healthcare products Regulatory Agency (MHRA) receives many reports of incidents relating to bed rails and associated equipment. These incidents are of concern as several result in patient harm or death, primarily from entrapment.

See full report and bedrail checklist

At Andway Healthcare Ltd we are committed to helping our clients by disseminating industry best practice advice, prevention information & tips and key insights from our care home clients who use bedrails on a daily basis.

The report by the MHRA looks in-depth at the key areas of:

•          Risk management and risk assessment for each bed occupant
•          Management responsibilities
•          Meeting legal requirements
•          Training on safe and best use
•          Planned preventative maintenance
•          Checking and ensuring that a bed rail is necessary
•          The need for good communication between bed occupant and carers or staff

Risk Assessment Training: avoidance of entrapment ALWAYS starts with bed occupant risk assessment and making sure your staff are fully aware of the need to perform this each and every time and are trained to carry out this vital assessment

Bed and Mattress Fit: avoidance of entrapment means ensuring you minimise the gap between the bottom of the bedrail and the top of the mattress and bedframe, as well as measuring gaps between bedrail bars.

Your mattress must comply with and fit exactly within your bedframe. This snug fit is essential in helping to reduce any potential gap between bedrail and mattress.

If you are unsure of correct bedrail usage and best practice please click here to read the report in full or if you would like to see one of the Andway team to discuss further please call the team on 01423 331000

CUTTING COSTS WITHOUT COMPROMISING CARE: INNOVATIVE PRODUCT BUYING TO MAKE SAVINGS.

The cash crunch facing Britain’s care homes is starting to have an impact on the quality of care being provided to the elderly, making it ever-more challenging to provide high level of quality care.

Here at Andway we understand the vast amount of pressure that care homes are under and we are therefore constantly sourcing the most innovative products which we know will help keep costs low and maintain or even improve quality of care.

INNOVATIVE BUYING TO MAKE SAVINGS

1) ACTICHEM CLEANING STARTER KIT

The Actichem cleaning products are a simple, no-nonsense range of cleaning products designed to minimise your stocking, streamline your range of more effective cleaning, make staff training simpler and save you £1000s per year in the process.

This range of cleaning products allows you to drastically cut the amount of different cleaning products needed. This streamlined feature covers the vast amount of chemical products you require making it a huge money saving product innovation.

Along-side this money saving benefit, this range of products boasts other advantages including a simple colour coding system which promotes correct application, this system is well established in most European countries and therefore makes the product easy to use for any non-English speakers.

2) SAPHAIR MATTRESS RANGE

Providing residents with a clean living environment can be challenging and expensive, with the average full mattress decontamination costing around £55 this can soon add up. However with the UK's 1^st washable mattress this cost can be almost eliminated.  The Saphair LYRA is a Full Replacement mattress system suitable for High to Very High Risk residents.  This extremely economical system enables you to fully decontaminate the mattress using your in house washing machines. This allows for easy cost effective cleaning and enables you to demonstrate a higher level of infection control to CQC and the familes of your residents.

The Saphair range also includes a selection of budget friendly mattress types including both overlay and replacement systems designed to suit a wide range of patient requirements.

Andway Healthcare are at the forefront of innovation product sourcing, finding methods that will help you cut costs, to allow your already tight budgets stretch further without compromising levels of care.    

FOR MORE INFORMATION OR TO ORDER PLEASE CALL 01423 331000

OR EMAIL help@andwayhealthcare.org.uk

Recent weeks have certainly been eventful for the UK in many ways, with the care industry featuring high on the list of hot topics.

Whilst it is too early to say what effect the referendum will have on the Care Industry, there is no doubt the vote for Brexit is having a huge effect on the UK’s currency and economy. Whilst this may or may not be a short term ‘knee jerk’ reaction by the markets we must be aware of and be preparing for the long term impacts of the Brexit on one of the country’s largest industries, the ‘Social Care Sector’.

1) Staffing

Brexit could potentially have a huge impact on this area, over 55000 of the NHS’s 1.3million staff members and 80000+ of the Adult Social Care workers are not UK born and hail from other EU countries.  Post Brexit these workers may be forced to return to their home nations leaving the UK with a massive staffing shortage with vacancy rates reported to be already at 5.4%.

The government will need to urgently clarify its position on EU national’s ability to work in the UK in the years after Brexit.  If not, the Care Sector will experience severe staffing shortages with major impacts on the Industries ability to provide the required high levels of care for our elderly.

2) Funding & Finance

The vote Leave campaign have been arguing that the EU was costing the UK £350 million per week, money they said could be pumped into the Care Sector and in particular the NHS.  Whilst the leading figures in the Leave campaign have moved to distance themselves from these claims post referendum there may well be additional funds allocated to boost the sector that would have otherwise gone to the EU.

3)  Government Policy Changes

During the pre-referendum campaign the chancellor said that if the UK were to vote for Brexit there would need to be further cuts to public spending.  Whilst these cuts may or may not happen the adult social care sector cannot afford to suffer any more cuts to already over stretched budgets.  Consequences of further cuts would likely include increased home closures and further cuts to vital NHS budgets both of which will have huge knock-on effects for the wider industry and its ability to cope with the demands placed upon it.

4) European Research and New Treatments

The EU has a vast system for surveillance and providing early warning of diseases including the rapid sharing of information and expertise in response to potential pandemics - will the UK still be part of this vital early warning system?

The EU has also been able to access and draw together talent and funding for significant scientific research into new drugs and treatment methods, something which no single nation would have been able to undertake independently, indeed according to the EU the UK itself has been the recipient of 8.8 Billion Euros for research and development. This kind of cooperation and flow of research funding and talent is vital and could be severely hampered by Brexit until new agreements can be established.

5)  Economic Devaluation

A number of industries have been effected by the economic and financial instability post the referendum result.  Continued uncertainty could effect the number of care homes being built across the UK with the obvious knock on effect of reduced care places and additional strain on home care services.

The devaluation of the British Pound will have continued effects for organisations who currently do and are looking to procure from abroad and in particular the European Union with prices likely to rise on a number of care critical products placing further strain on the finances of care institutions.

Conclusion

Whilst there is no doubt that the result of the referendum has left the UK in a state of uncertainty there is no way to tell the long term effect leaving Europe on the economy.  The issues identified in this article are just a small selection of the questions that remain unanswered and only time will prove how much or how little the result will have on the economy.

Pre-warning for all customers that our furniture factory is on shutdown from the 18th to 29th July for summer maintenance meaning the lead times for the bedroom furniture sets will be a little more extended.  

The good news is though that you can still get your bedroom furniture before the closure sets in if you order before Wednesday 6 July 2016 and to make it even better we have some great special deals on at the moment including a bedroom furniture set for only £299.00 + VAT delivered ready assembled.

Call 01423 331000 to reserve your manufacturing slot and ensure your pre shutdown delivery today...