COSHH in Care Homes

When considering which workplaces are affected by COSHH, care homes aren’t often the first place that comes to mind. However, COSHH in health and social care is actually a large part of the industry and those who work in care homes have a responsibility to follow the guidelines laid out by the legislation.

The products generally used in care homes do not usually contain large amounts of harmful substances, but prolonged exposure or misuse of these products does have the potential to cause serious harm to both residents and employees. Here’s an overview of what you need to know about COSHH principles and regulations in care homes.

What is COSHH?

The Control of Substances Hazardous to Health Regulations (2002), or COSHH, is a piece of health and safety legislation that outlines how hazardous substances should be handled, stored, used and disposed of in the workplace. The regulations were brought in to reduce the risk of exposure to or harm from substances that have the potential to damage someone’s health.

COSHH requires that the employer in charge of a workplace take the necessary measures to prevent staff from being exposed to hazardous substances or to reduce their exposure as much as possible. This usually involves completing a COSHH risk assessment, providing necessary health and safety training and implementing procedures that reduce or remove the risk of harm from a hazardous substance.

Hazardous Substances in a Care Home

Several different kinds of substances are categorised as ‘hazardous to health’ under COSHH. These can be substances that are directly used in work, substances that are produced during work activities, substances that naturally occur or biological substances like bacteria.

COSHH defines these substances into five categories:

• Any substance that is officially classified as very toxic, toxic, harmful, corrosive or an irritant. These can be chemicals, dust, vapours, gases, fumes or mists.
• Substances that have a workplace exposure limit assigned to them, which affect how long you can handle or be around a substance
• Substances that are considered biological agents
• Types of dust that are not classified as toxic, harmful corrosive or irritants but have a specified high concentration in the air
• Any substance that does not fall into one of the above categories but has properties that create a health risk that is covered in COSHH

Hazardous substances that may be found in a care home fall into three different categories; cleaning products, maintenance work products and biological agents. 

Cleaning

• Bleach based cleaning products for toilets and surfaces
• Chlorine-based products used to clean spillages of things like blood 
• Oven cleaners
• Drain-cleaning products that are corrosive
• Washing detergents
• General cleaning products which cause contact dermatitis after prolonged use

Maintenance Work

• Paint
• Solvents
• Glue
• Dust released during maintenance work
• Water treatment substances

Biological Hazards

• Potentially infectious bodily substances
• Clinical waste
• Soiled bedding, clothing or other upholstery
• Infectious pathogens
• Medicines that contain hazardous biological agents

Hazardous substances like lead or asbestos may be present in a care home environment but are not covered by COSHH as they have their own health and safety legislation. 

Complying with COSHH Regulations in Care Homes

The basis of COSHH relies on a risk assessment being carried out to identify all the potentially hazardous substances present in a care home and decide on what needs to be done to prevent them from causing harm. It is the responsibility of the employer under COSHH to protect the workers and residents of a care home from exposure to harmful substances, which involves either completing a risk assessment yourself or organising someone else to complete it.

Whoever carries out the COSHH assessment of potential hazards in a care home must:

• Fully understanding the legislation and related codes of practice
• Have the necessary authority, time and resources to complete an assessment
• Be able to access all safety information required to assess levels of risk
• Have the ability to talk to employees, assess the care home workplace and find relevant product information
• Know how to produce a risk assessment report and how to action what it outlines

Identifying Potential Hazards in a Care Home

To carry out a COSHH risk assessment, you first need to identify all of the substances that are potential hazards in a care home. You can use the above section to help you with this step.

Note down all of the hazardous substances in the care home and what activities they are used for. As well as tasks such as cleaning and administering medication, also consider housekeeping activities that involve the disposing of hazardous substances in a care home such as changing soiled bedding or washing dirty clothes.

Your risk assessment should also factor in potential situations where hazardous substances could be brought into the home, for example, if decorating was taking place.

Products that contain hazardous substances should come with safety data sheets that outline the risks associated with using them. You should also look out for COSHH hazard symbols on products which will let you know what it is about the substance that makes it hazardous.

Next, identify all the people who may come into contact with potentially hazardous substances. This is likely to mainly be care home staff, but can also include residents of the home and visitors, tradespeople or healthcare professionals.

The next step in a risk assessment is to evaluate the risk that the hazardous substances pose and decide what steps will be taken to remove or reduce the likelihood or harm. You will have to consider how each substance is used, how frequently employees or residents come into contact with it, how hazardous the substance actually is and what the consequences could be if the substances were handled or used in an unsafe way.

Reducing or Eliminating COSHH Hazards

When deciding how to control, reduce or remove COSHH hazards, the hierarchy of control can be followed. This hierarchy gives 6 different ways to control risk from the most effective to the least effective and can be used to advise what levels of risk control should be taken.

1. Elimination - If possible, you should avoid using hazardous substances in the workplace, as this removes both the risk and the need to implement health and safety controls.
2. Substitution - If elimination isn’t possible, the next stage of risk control is to assess the hazardous substances that are used in the care home and research whether a safer alternative can be used instead.
3. Isolation - If a substance is hazardous because it produces fumes, vapours or dust that can be inhaled, employers can consider using equipment that encloses a hazardous substance as it is used to reduce who is exposed to it.
4. Engineering - In cases where total isolation of a hazardous substance isn’t possible in a care home, consider whether a process can be engineered or adapted so that exposure is minimised.
5. Administration - If an exposure risk is only minimal, such as the risk of dermatitis from the use of cleaning products, administrative measures can be put in place. These may include giving employees with health and safety training, installing warning signs into the workplace and rotating staff who work with hazardous substances to reduce how much they are exposed to.
6. PPE - A control measure that should always be implemented with hazardous substances is personal protective equipment like masks and gloves so that individuals who are working directly with or around hazardous substances reduce their exposure.

Storing and safely containing hazardous substances is another key part of the protective measures that should be decided on in a COSHH risk assessment, to ensure that certain substances are kept safe when not in use. Most hazardous products come with storage instructions, and these should be listed in the COSHH policy along with safety measures that stop substances from getting spilt or damaged when they are moved.

Creating a COSHH Policy in Care Homes

Once all the necessary information has been gathered about the hazardous substances present in the care home, who is at risk of harm, what harm might be caused and what steps are going to be taken to prevent this harm, you need to write up your findings. This is only necessary if you employ five or more people in the care home; if you have less staff then an official COSHH report is not required.

Your risk assessment will inform the COSHH health and safety policy that you implement in the care home and should be circulated amongst all employees so that they know what safety measures they should be following. A care home health and safety policy should be regularly reviewed and updated if any of the following occur:

• A process involving a hazardous substance changes
• Official legislation changes
• An employee voices concern about risk control measures
• An accident takes place or an injury is sustained because of a hazardous substance
• A problem in your control measures is reported
• Exposure monitoring reveals that risk may be higher than originally thought

In order to fulfil the last point, exposure monitoring may be required if substances are used in a way that involves more exposure than recommended, or if there is a serious risk to health if control measures fail. This could take the form of airborne particle monitoring, biological monitoring or health surveillance.

FAQs

Why is COSHH important?

The purpose of COSHH is to manage the risks to health that are posed by hazardous substances. It is an important piece of legislation as it ensures that harmful substances are stored, used and disposed of properly to protect both the people that use them and the people around them.

Who is responsible for COSHH in the workplace?

The main responsibilities of COSHH apply to the employer of a workplace, who must ensure that control measures are taken and appropriate COSHH risk assessments are carried out. Those who are self-employed and use hazardous substances are responsible for carrying out these risk assessments, implementing risk controls and following guidance.

Employees who work with hazardous substances have a responsibility to follow the guidance that has been set out for them by their employers. 

Why was COSHH introduced?

COSHH legislation was introduced after it was identified that numerous accidents and injuries at work were happening in conjunction with hazardous substances. The regulations and guidance associated with COSHH protects employees and employers in the workplace and also protects members of the public who may also come into contact with products that contain harmful substances.

Summary

Care homes are workplaces that must be kept clean, safe and hygienic at all times, which is why following steps to comply with COSHH is so important. Whilst the majority of substances that employees come into contact with will mainly be products with only small amounts of harmful chemicals, it is still very important to take necessary safety precautions and keep them and your care home residents safe.

If you work in or employ others in a care home and would like to learn more about the Control of Substances Hazardous to Health, we offer an online ‘COSHH Training’ course that has all the information you need to better understand harmful substances and how to minimise the risk they pose.