Health and Safety in Care Homes: A 2021 Guide

Most of us will come to rely on social care at some point in our lives, to help us or our loved ones live as comfortably and as independently as possible when ill health or age-related difficulties arise.

Care home environments present many hazards not found in other workplaces and it is vital that carers and those being cared for are protected in ways that respect their rights and dignity.

With the UK enduring its third lockdown in response to the emergence of a new, highly transmissible strain of COVID-19 and a sharp rise in the number of confirmed cases, protecting our most vulnerable people — including those in care homes and front-line care workers — has never been so important. If you are responsible for managing health and safety in a care home, this guide will help you to understand and mitigate risks to your service users and their carers.

Common Safety Hazards Found in Care Homes

• Slips, trips and falls
• Hazards associated with specific areas of the workplace
• Injuries from operating specialised equipment
• Water-based hazards such as Legionnaires’ disease
• Hazards associated with moving or handling

Prevention of Infection and Diseases

Care workers and their patients may be exposed to risks of transmitting infections and diseases not commonly found in other workplaces. Soiled laundry and bodily fluids, for example, may present a risk to health. Care home providers must assess and mitigate such risks.

The current pandemic has disproportionately affected care home residents. In the UK, 28-50% of all COVID-related deaths have occurred in care home residents. Providers must be particularly vigilant about infection prevention and control by:

• Providing appropriate Personal Protective Equipment (PPE) for staff and ensuring it is used effectively
• Delivering appropriate and adequate staff training
• Providing PPE and information on safety procedures for visitors
• Reviewing policies and processes in line with changing government guidelines and regulations
• Establishing a process for quarantining COVID positive residents
• Implementing a system of routine asymptomatic testing of staff

This is not an exhaustive list; care home providers should assess their provision in light of the current national guidelines and ensure that they are doing all that is possible to minimise the risk of COVID transmissions.

• Health and Safety at Work etc. Act 1974
• Management of Health and Safety at Work Regulations 1999

In 2014, the Health and Safety Executive (HSE) produced a comprehensive guide on managing health and safety in care homes. In this guide, the HSE highlighted three essential elements for managing health and safety:

• Good leadership and management
• A trained and skilled (competent) workforce
• An environment where people are consulted and feel involved

Howlett Health and Safety Services has recently launched a new training course that covers all aspects of safe working in care homes and is suitable for both new and experienced staff.

Once these core elements are in place, the HSE recommends a four-stage approach:

1. Plan — what needs to happen and how will this be achieved?
2. Do — what risks have been identified? How can these be organised into a cohesive plan? What preventive measures are necessary? What equipment and systems are required for staff to do their job safely?
3. Check — are the planned safety measures being implemented correctly and consistently? When accidents, incidents or near misses occur, are these thoroughly investigated? Under The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), care home providers are required by law to report certain incidents to the appropriate enforcing authority.
4. Act — Is performance routinely reviewed? What lessons can be learned?

Regulation of Health and Safety in Care Homes

The Care Quality Commission (CQC) monitors, inspects and regulates care homes in the UK to ensure compliance with safety and quality standards. It also acts as the lead investigator in cases of abuse or neglect of care home residents.

All care homes should have a health and safety policy that embeds key pieces of legislation, including the Care Quality Commission (Registration) Regulations 2009. Under these regulations, service users have the right to expect the following standards:

• Person-centred care
• To be treated with dignity and respect
• To be asked for consent before care or treatment is administered
• To be kept safe
• Clean and suitable premises and equipment
• Safeguarding from abuse
• Sufficient food and drink to remain healthy
• The opportunity to complain about care and treatment
• Good governance that ensures optimum health and safety standards are met
• Suitably qualified and competent staff
• A duty of candour from the provider
• The provider must display their CQC rating

Consequences of Non-Compliance

If a service user is harmed and investigation by the CQC reveals negligence, the care home provider responsible may receive a significant fine.

In 2016, Reading Borough Council was fined £100,000 after an investigation into the death of a pensioner from exposure to Legionella.

In some cases, the parties deemed responsible can receive a prison sentence. In 2017, two care assistants were each sentenced to six months after a disabled woman in their care was scalded by hot bathwater. The carers were found guilty of neglecting the patient.

Let Us Help You Deliver the Best Standards of Care

Ray Howlett has over 30 years’ of experience providing occupational health and safety services. Howlett Health and Safety Services can help you conduct risk assessments, write or review health and safety policies and train your staff via online training courses.

We are excited to announce the launch of a brand new online course on Health and Safety in Care Homes/Care Settings. Contact us to find out more or to book a free 10-minute consultation.