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💧 Susceptible Occupants · ACOP L8

Legionella Risk Assessment for Care Homes & Supported Living

Legionnaires' disease is a serious pneumonia at any age. In people who are elderly, immunosuppressed, recovering from illness or living with a chronic respiratory condition, it is considerably more dangerous — and those are precisely the people in your building. Care settings also tend to have the water systems most likely to grow the bacteria: stored water, long runs, assisted bathing, and outlets in empty rooms that nobody has used for weeks.

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High-Consequence Occupants

Susceptibility is the reason care settings are treated differently. The assessment is written for the people actually living there.

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Control Scheme, Not Just a Report

Temperatures, flushing, tank checks and shower descaling laid out as a calendar your maintenance staff can follow without training.

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Evidence for CQC and the HSE

A dated written assessment plus monitoring records — the two things you get asked for and the two most often missing.

Why Care Settings Are Different

The Bacteria and the Occupants Meet in the Worst Place

Legionella multiplies in water held between roughly 20°C and 45°C, and it infects people who inhale it as an aerosol. A care home combines both halves of that: water sitting at the wrong temperature in a complex system, and showers, spray taps and assisted bathing turning it into a fine mist beside someone whose lungs are already compromised.

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    Vacant rooms are the classic failure. A room stands empty between residents and its shower and taps go unused for weeks. The water in that dead leg warms up and stagnates, and the first person to use it takes a face full of aerosol. Void-room flushing is the single most important routine control in this sector and it is very often not happening.
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    Temperature is the primary control and it is frequently wrong. Hot water should be stored hot enough and delivered hot enough; cold water should stay cold. Systems that have been tempered down — understandably — to prevent scalding can sit squarely in the growth range if the tempering is done in the wrong place.
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    Scald prevention and Legionella control pull against each other. The resolution is thermostatic mixing valves at the outlet, so the stored and distributed water stays hot while what reaches the resident is safe. TMVs then need their own servicing regime, which is a control in its own right.
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    Assisted bathing and spa baths raise the aerosol risk. Hoists, bath lifts, spray attachments and any spa or hydrotherapy facility all generate aerosol close to a susceptible person, and any spa pool needs a far more demanding regime than a bathroom.
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    The system is usually older and more altered than the plan suggests. Extensions, blanked-off pipework from a former layout and redundant tanks accumulate over decades. Dead legs are where the bacteria breed, and finding them is a large part of the job.
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    The duty is continuous, not annual. ACOP L8 requires you to control the risk, which means monitoring and recording. An assessment sitting in a folder with no monitoring behind it does not discharge the duty and will not satisfy an inspector.

What we work through with you

A full schematic of the water system as it now is · Cold water storage: temperature, condition, lids, insulation, turnover · Hot water generation and distribution temperatures · TMV locations and servicing · Dead legs and redundant pipework · Void room and little-used outlet flushing · Shower heads and hoses: condition and descaling · Assisted bathing, spa and hydrotherapy facilities · Any cooling or humidification plant · Who currently monitors what, how often, and whether it is written down · The written control scheme and the logbook to run it from.

On Site

What We Assess in a Care Home

The system is surveyed as built, not as drawn, and the assessment ends with a scheme your own staff can operate.

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Cold Water Storage

Temperature, tank condition, lids and screens, insulation, and whether turnover is fast enough to matter.

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Hot Water & Distribution

Storage and return temperatures measured at sentinel points, and how far the system drifts at the outlets furthest from the plant.

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Dead Legs & Redundant Pipework

Traced and mapped. Blanked-off runs from previous layouts are the most common hidden source of growth.

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Void Rooms & Little-Used Outlets

The rooms between residents, the guest bathroom, the outside tap — the outlets a flushing regime exists to cover.

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Showers, Hoses & Assisted Bathing

Aerosol-generating outlets, descaling intervals, and any spa or hydrotherapy facility, which needs its own regime.

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Monitoring & Records

What is being checked now, by whom, and whether the logbook would satisfy an inspector who asked for it today.

In Practice

What We Most Often Find

Consistent across nursing homes, residential care and supported living.

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Void Rooms Never Flushed

Everyone agrees it should happen. Almost nobody has a record showing that it does.

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Hot Water Tempered in the Wrong Place

Scald prevention applied at the cylinder rather than at the outlet, leaving the whole distribution system in the growth range.

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Redundant Tanks Still Connected

Left in place after a system upgrade, still holding water, and no longer part of anyone's checks.

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An Assessment With No Monitoring Behind It

A report from three years ago and an empty logbook. The assessment is the start of the duty, not the end of it.

The Stakes

Susceptibility is what changes the arithmetic

Legionnaires' disease is fatal in a meaningful proportion of cases, and that proportion is higher among older people and those with existing health conditions. The duty to assess and control the risk sits under the Health and Safety at Work etc. Act 1974 and, where applicable, COSHH, with ACOP L8 setting out how the HSE expects it to be done — and an approved code of practice has a particular legal status: depart from it and you must show you achieved the same standard another way. Outbreaks in care settings are investigated thoroughly, and the first documents requested are the risk assessment and the monitoring records.

Tell Us About the Premises. Fixed Fee in 2 Hours.

Property type, rough size, number of storeys and what it is used for is enough for us to quote. Survey within days, and your written report within 48 hours of the visit.

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Frequently Asked Questions

Do care homes legally need a Legionella risk assessment?
Yes. As an employer and as the person in control of the premises you have a duty under the Health and Safety at Work etc. Act 1974, and under COSHH where it applies, to assess and control the risk from Legionella. ACOP L8 is the HSE's approved code of practice setting out how that is expected to be done. Unlike a simple domestic let, where the HSE accepts that a low-risk system may only need a simple assessment, a care setting has both a complex water system and highly susceptible occupants — so a proper assessment is clearly warranted.
How often should it be reviewed?
The assessment should be reviewed regularly and whenever something changes — building work, a change to the water system, a change in how a wing is used, or after any case of Legionnaires' disease associated with the premises. Two years is a commonly used interval for review in the absence of change, but the more important point is that control is continuous: the monitoring set out in your scheme has to keep happening in between.
What temperatures should our water be at?
The principle is to keep hot water hot and cold water cold, so that neither sits in the range where Legionella multiplies — roughly 20°C to 45°C. In practice that means hot water stored and distributed above the growth range, cold water kept below it, and both checked at sentinel outlets on a set schedule. Your assessment specifies the check points, the target figures and the frequency for your particular system, because the right monitoring regime depends on how the system is built.
How do we manage scalding risk at the same time?
With thermostatic mixing valves fitted close to the outlet. That keeps the stored and distributed water hot enough to suppress bacterial growth while limiting the temperature reaching the resident. The valves themselves then need periodic servicing and testing, and that becomes part of the control scheme. Turning the cylinder thermostat down is the intuitive answer and the dangerous one — it protects against scalds by creating ideal growth conditions throughout the system.
What about rooms that are empty between residents?
They need flushing on a set routine — running each outlet for long enough to draw fresh water through, with the record to show it was done. Empty rooms are the most consistent source of risk in care settings, because the water in that branch stagnates at room temperature and the first use of the shower produces an aerosol straight into the breathing zone of whoever is in there. The control scheme sets the frequency and gives you the log sheet.
Do we need to test the water for Legionella?
Not routinely in most care settings. Sampling has a place — for example where the control scheme is not being achieved, where there is a spa pool, or following a suspected case — but the primary control is temperature and turnover, not testing. A provider who leads with water sampling rather than with an assessment of the system is selling you the wrong thing first.
Can our own maintenance staff run the control scheme?
That is exactly how it should work, and it is how we write the scheme — as a calendar of specific checks at specific points, with log sheets, so a competent maintenance person or facilities manager can run it without specialist training. We are there for the assessment, the scheme and the review, not to sell you a monthly visit you do not need.
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