COSHH in Care Homes – All you need to know

The importance of COSHH in care homes should never be overlooked. According to the UK Health and Safety Executive (HSE), over 1.4 million people working in the UK suffer from a work-related illness, costing businesses an estimated £15 billion last year.

The Control of Substances Hazardous to Health Regulations (COSHH) is a set of guidelines and requirements placed on employers. The guidelines highlight the need for risk assessments and control measures in working environments to control exposure to hazardous substances and keep employees and customers safe from harm or injury.

Failure to comply with COSHH recommendations and legislation can result in injury, financial penalties, business closure, and death in extreme cases. COSHH compliance is vital in care home environments, and reasonable steps must be taken to minimise or eliminate exposure of residents, visitors, and employees to hazardous substances stored or used on the premises. If exposure cannot be reduced, it must be controlled to the lowest level that is reasonably practicable for all parties.

This could include the provision of personal protective equipment (PPE), training, and implementing frequent risk assessments to monitor COSHH adherence in care homes throughout the UK.

In this short guide, we’ll explain precisely what COSHH is and why COSHH is essential in care homes. We’ll also outline specific employer and employee duties related to COSHH compliance, and discuss the places that hazardous substances are most likely to be found in care homes.

We’ll then explain how to carry out a risk assessment in a care home and who is responsible for managing this procedure. We’ll also take a look at the hazardous substance symbols that appear on product labels. We’ll explain what each of these symbols means, as well as outlining that PPE should be used in care homes, and why COSHH training is essential.

What is COSHH?

COSHH stands for ‘Control of Substances Hazardous to Health’, and is a set of regulations enforced to protect workers from illness and injury when working with certain materials or substances.

It is a criminal offence for a care home employer or employee to breach COSHH regulations, which is punishable by unlimited fines. COSHH was introduced as a way to control exposure to hazardous substances in the workplace. COSHH assessments highlight the risks and hazards associated with substances in the care homes by asking questions such as –

• Whereabouts is there potential for exposure to substances that could be hazardous to health?
• How could these substances harm or injure a person?
• What jobs or task increase the risk of exposure?
• Are there any areas of concern that must be addressed as a matter of urgency?

COSHH regulations were first introduced over 25 years ago, with the latest iteration (2002) re-enacted using amendments of the Control of Substances Hazardous to Work Regulations (1999).

In care homes, COSHH is supported by two sets of legislation, REACH, and CLP –

REACH

REACH stands for ‘Registration, Evaluation, Authorisation and Restriction of Chemicals’.

This EU regulation requires that all companies importing or manufacturing a preparation or substance weighing 1 tonne or above have to register the substance with the European Chemicals Agency (ECHA).

When managing and controlling hazardous substances, care homes must provide clear information about any dangerous properties a chemical mixture stored or used on their premises may have. REACH requires suppliers of hazardous substances to compile and deliver a Safety Data Sheet (SDS) alongside all potentially hazardous products.

CLP

CLP stands for ‘Classification, Labelling and Packaging’.

CLP regulations were introduced in 2009, requiring suppliers to use Globally Harmonised System (GHS) pictograms as visual warning labels on the packaging of hazardous products. The purpose of these illustrations is to make warning recognisable to employees and employers throughout the EU.

Both CLP and REACH support COSHH as they help to create a system that indicates and controls regulation and awareness around harmful substances and chemicals.

Why is COSHH important?

Hazardous or harmful substances can cause a multitude of short and long-term health problems. They can also cause fires, explosions, and fatalities if they are not controlled or regulated efficiently. COSHH is vital in care homes as it encourages managers to conduct thorough risk assessments and raise awareness around any potentially harmful substances used or stored on the premises.

Mild effects from exposure to dangerous substances include eye or skin irritation. More severe effects include respiratory diseases and some forms of cancer. That said, severe conditions only tend to develop amongst people that are frequently exposed to harmful substances for extended periods of time.

If a care home fails to follow COSHH guidelines, they risk a loss of business productivity, severe damage to their reputation, harm to staff, residents, and visitors, and prosecution, with the possibility of substantial fines.

COSHH employer responsibilities

There are several responsibilities outlines under COSHH regulations, including –

• Coordinating and implementing control measures to protect all workers from hazardous substances.
• Adequately controlling or preventing exposure to any hazardous substances within the care home premises.
• Making sufficient and suitable instructions, training, information, and protective equipment available to employees wherever necessary.
• Ensuring that all control measures are maintained and remain in full working order.
• Creating procedures and plans to deal with any accidents or emergencies that involve hazardous substances.
• Undertaking COSHH risk assessments.
• Making sure that harmful substances do not exceed the workplace exposure limit (WEL).
• Ensuring that all employees that may be exposed to hazardous substances while working have access to suitable health surveillance.

Some larger care homes may have more risks present than smaller social care organisations. As an employer, you should be assessing these risks at least once a year so that safety procedures and appropriate training are all up to date, accessible, and outlined for your team.

It’s not just care home managers that are responsible for COSHH compliance; employees must also play their part in implementing safety protocols and adhering to guidelines.

Employee responsibilities include –

• Making sure that any personal protective equipment (PPE) is returned after use and stored appropriately.
• Wearing PPE whenever necessary.
• Using facilities and control measure put in place by management.
• Maintaining a high level of personal hygiene at all times.
• Using washing and shower facilities whenever they are required.
• Removing potentially contaminated PPE before drinking, eating, or making contact with other staff, residents, or guests.
• Reporting any insufficiencies or defects related to control measures.
• Complying with all instructions, training, and information supplied in relation to COSHH.

Where are hazardous substances found in care homes?

Some of the typical hazardous substances that could be present in a care home environment include –

Medicines and biological hazards –

• Certain pharmaceutical medicines administered to residents may be hazardous or contain harmful ingredients.
• Pathogens can be found in faeces and urine, which could be present on soiled bed linen and clothing. Blood may also be present if a resident has a fall or cuts themselves accidentally. Some of these materials and human waste substances have the potential to be infectious.
• Infectious pathogens require adequate infection control safeguards; this prevents the spread of infections throughout care homes.

Cleaning –

• Several cleaning products are classed as irritants. These include bleach-based toilet or surface cleaners, or any products that release vapours or fumes into the air.
• Chlorine-based disinfectants that are used to clean up blood spillages can be harmful if regularly inhaled.
• Drain cleaning materials that contain caustic soda, or sulphuric acid can be corrosive and harmful to the skin.
• Oven cleaning products used in care home kitchens can release irritant fumes.
• Touching the face, skin, or eyes after handling any of these substances can lead to inflammation, irritations, and chemical burns.
• Floor cleaning products, general detergents, and surface cleaning materials can be irritant if they frequently come into contact with the eyes or skin.

Maintenance work –

• If ongoing maintenance work releases concrete or wood dust into the air, these dust particles can irritate the lungs, eyes, and throat.
• Paints, solvents, glues, and lubricants can all be irritants and may be unsafe to use in confined spaces unless appropriate ventilation is provided.
• Some water treatment chemicals used to reduce the risk of legionnaires disease can be harmful to humans.

Who should carry out a risk assessment in a care home?

It is the legal responsibility of the employer or care home manager to ensure that a risk assessment is carried out. The employer may undertake the risk assessment themselves, delegate the task to an appropriate manager or trained employee, or hire an expert from outside of the care home to complete the task.

Whatever their choice, the employer must ensure that whoever completes the risk assessment has –

• The time, authority, and necessary facilities to complete the task professionally and appropriately.
• Access to and understanding of UK COSHH guidelines and all other relevant codes of practice.
• Access to sufficient information concerning potentially hazardous substances and their uses.
• Completed training, and is experienced and knowledgeable enough to make professional decisions about risks and actions required.
• Freedom to thoroughly examine the workplace, review existing records, and talk to appropriate staff whenever necessary.
• Clearly defined reporting arrangements so that all findings can be acted on and necessary actions can be authorised without delay.

We recommend that whoever completes the risk assessment for your care home has completed relevant COSHH training, is qualified in health and safety, or is a member of an appropriate professional body.

Ideally, assessments should be started in-house. However, if the necessary experience and knowledge are unavailable, outside consultants may be employed. For particularly complicated or hazardous situations, expert specialists may need to be employed.

Efficient COSHH assessments depend on valuable insights about working processes inside the workplace. Therefore, employees, especially those who carry out such operations, can provide useful insights for a successful COSHH risk assessment.

How to carry out a risk assessment

As we mentioned earlier, COSHH is incredibly important in health and social care. All care homes must carry out COSHH risk assessments.

To fully comply, we recommend that you follow the eight steps listed below –

1. Assess all potential risks.
2. Decide any precautions required to minimise/eliminate these risks.
3. Prevent or control exposure to harmful chemicals or substances.
4. Ensure that your control measures are implemented and maintained.
5. Monitor levels of exposure to any substances that you have identified.
6. Conduct appropriate health surveillance on any people exposed to such substances.
7. Prepare a robust plan for accidents and emergencies.
8. Make sure that all relevant employees are adequately informed, trained, and supervised.

If you decide to hire a third-party expert to complete a COSHH risk assessment for your care home, make sure you provide them with sufficient knowledge and experience so that they can make informed decisions about risks and actions needed.

Hazardous substance symbols on product labels

There is a total of nine primary hazard symbols that relate to COSHH. The following information will present and explain these symbols.

Although some of these symbols are relatively self-explanatory, some require a clear explanation.