Infection control


Legionella detection: taking a robust approach


Greg Rankin, CEO of Legionella testing experts Hydrosense, explains how care home providers can go beyond compliance and raise the bar in Legionella control to reduce the risk for residents, staff, and visitors


Care home residents, who are more likely to be older and have reduced immune systems, are far more vulnerable to any infection. It is therefore imperative that greater care is taken to protect them from exposure to all possible risks, particularly Legionella bacteria.


Yet care-home acquired cases of Legionnaires’ disease continue to happen, as demonstrated by a number of high- profile outbreaks and tragedies in recent years.


The importance of robust water management in care homes, where residents are often more susceptible to infection due to age and underlying health conditions, is regularly highlighted by announcements and press coverage concerning Legionella outbreaks. In 2018, for example, a Legionella outbreak occurred in a care home facility in Birkenhead, Merseyside as the result of poor water management, resulting in a £900,000 fine.1


Two years later, a 56-year


old resident at a Hampshire care home died of Legionnaires’ disease.2


The care home


provider was subsequently prosecuted for failing to provide safe care and treatment exposing other residents. Then just last year, a Nottinghamshire care home hit the headlines for failing to inform inspectors that Legionella bacteria was found in its water system, thus placing residents at serious risk.3


Of course, the number of Legionella cases across any sector will never be zero. Even with the most robust and comprehensive water management strategy in the world, it is not possible to completely eliminate the risk of a water system becoming contaminated by Legionella bacteria. However, in our experience, there is scope to do more to limit exposure and reduce the risk of infection – a large part of which hinges on the adoption of a more robust and regular approach to Legionella detection.


The Legionella lowdown To understand why and how, it is important to first explore what Legionella is, and understand the full breadth of risks involved.


As many care home providers will already


know, Legionella is the bacterium that causes Legionnaires’ disease. It can be found in a range of man-made water systems including taps, showers, air conditioning units, pools, and hot tubs. Though there are different species of Legionella, Legionella pneumophila is the most common pathogenic species and responsible for most cases of Legionnaires’ disease. Generally speaking, most healthy


people exposed to Legionella will not fall ill. However, for older people or those with specific health issues – common among care home residents – Legionnaires’ can prove fatal.


Importantly, it is estimated that seven out of eight survivors of Legionnaires’ disease4


suffer with long-term impacts. These include fatigue, memory loss, insomnia and PTSD; the upshot of which, for the already vulnerable care home resident, does not bare thinking about.


As a result, it is critical that care homes


have even greater measures in place to protect their residents from exposure to the Legionella bacteria.


Complexities and challenges What may be less established, however, is the fact that there are a number of practical challenges which put care homes at greater risk of Legionella contamination. Foremost, care homes often have bigger and more intricate water systems compared to other premises, due to the number of residents and the components and services needed. Key contributing factors include the size and complexity of the building, along with the scope for multiple en suite facilities, assisted bathrooms, commercial grade catering facilities, and high rates of hot water consumption during periods of peak demand. This can not only increase the potential for Legionella bacterial growth but make control more challenging.


May 2025 www.thecarehomeenvironment.com 25


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