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CH181-Burns and Scalds Prevention and Management Policy

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Registration Number: {{org_field_registration_no}}

Burns and Scalds Prevention and Management Policy

1. Purpose

The purpose of this policy is to set out how {{org_field_name}} prevents, identifies, manages and learns from burns and scalds within its care home services in England. Burns and scalds are a significant risk for people living in care homes, particularly older people, people with reduced mobility, frailty, reduced skin integrity, diabetes, sensory impairment, cognitive impairment, dementia, learning disability, autism, communication needs, or reduced ability to recognise or respond to danger.

This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and CQC requirements, including Regulation 9 Person-centred care, Regulation 10 Dignity and respect, Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 15 Premises and equipment, Regulation 17 Good governance, Regulation 18 Staffing, and Regulation 20 Duty of candour.

The policy aims to ensure that people living at {{org_field_name}} are protected from avoidable harm while maintaining independence, choice, dignity and positive risk-taking wherever this can be achieved safely.

2. Scope

This policy applies to all employees, nurses, care staff, support workers, ancillary staff, catering staff, housekeeping staff, maintenance staff, activities staff, volunteers, contractors, agency workers, students and any other person working in or on behalf of {{org_field_name}}’s care home services in England.

This policy applies to all areas of the care home, including bedrooms, en-suite facilities, assisted bathrooms, shower rooms, toilets, sluice rooms, kitchens, dining rooms, lounges, laundry areas, treatment rooms, staff areas, corridors, gardens and any other internal or external area where people may be exposed to hot water, hot liquids, steam, hot surfaces, chemicals, fire, electrical equipment or heat-generating appliances.

This policy applies to risks arising from, but not limited to, bathing, showering, washing, personal care, hot drinks, food service, cooking activities, laundry, cleaning, radiators, exposed pipework, portable heaters, electrical equipment, smoking materials, emollient products, oxygen use, chemicals and fire safety risks.

3. Related Policies

4. Legal and Regulatory Framework

This policy must be read and implemented in line with the following legal and regulatory requirements:

{{org_field_name}} will ensure that burns and scalds risks are assessed, monitored, mitigated and reviewed as part of safe care and treatment, safe premises and equipment, safeguarding, staffing, governance, incident reporting and learning from events.

5. Common Causes of Burns and Scalds in Care Homes

Burns may be caused by dry heat, fire, hot surfaces, friction, radiation, electricity or chemicals. Scalds are caused by wet heat, including hot water, hot drinks, hot food, steam or other hot liquids.

In a care home, common causes include:

Staff must understand that burns and scalds may occur during routine care and everyday activities. Controls must be proportionate, person-centred and designed to reduce avoidable harm while supporting independence, dignity and choice.

6. Risk Assessment and Prevention

Each person living at {{org_field_name}} must have an individual burns and scalds risk assessment where their needs, environment, care arrangements or health conditions may expose them to a risk of burns or scalds. This assessment must be completed before or on admission, reviewed as part of the care planning process, and updated immediately following any incident, near miss, change in health, change in mobility, change in cognition, change in skin integrity, new diagnosis, medication change, deterioration, hospital discharge, safeguarding concern or change in the environment.

The risk assessment must consider:

Where risks are identified, the care plan must include clear control measures. These may include staff supervision, safe bathing procedures, use of bath thermometers, safe positioning, safe transfer arrangements, use of suitable cups or lids, kettle tippers, adapted equipment, staff assistance with hot drinks, radiator covers, pipe boxing, signage, environmental checks, referral to maintenance, occupational therapy advice, tissue viability advice, or review by a health professional.

For people assessed as vulnerable to scalding, safe bathing and showering procedures must be in place. Baths and showers must be fitted with suitable thermostatic mixer valves where required, and water outlet temperatures must be checked, recorded, monitored and maintained so that water from baths and showers does not exceed 44°C. TMVs and outlet temperatures must be included in the home’s planned maintenance and audit programme.

Where hot water storage and distribution temperatures are maintained for legionella control, the service must not reduce storage temperatures in a way that creates legionella risk. Scalding risks must be controlled at the point of use through appropriate engineering controls, maintenance, monitoring and staff practice.

Risk assessment must be balanced and person-centred. Staff must support people to do what they can safely for themselves and must not use blanket restrictions unless these are necessary, proportionate, documented and reviewed. Any restriction must comply with the Mental Capacity Act 2005 where the person may lack capacity to consent.

7. Equipment, Premises and Environmental Safety

{{org_field_name}} will ensure that all premises and equipment used to provide care and treatment are safe, suitable, properly maintained, properly used and appropriately located. This includes equipment supplied by the home and any equipment used by staff to deliver care.

The Registered Manager and maintenance lead must ensure that the following controls are in place:

Staff must remove unsafe equipment from use immediately where it is safe to do so, label it clearly, report it to the person in charge, and record the action taken. Where equipment belongs to a person living in the home, family member, visitor or external professional, staff must still take reasonable steps to prevent avoidable harm and escalate concerns to the Registered Manager.

The Registered Manager must ensure that environmental risks are reviewed through audits, health and safety checks, maintenance records, incident analysis, resident feedback, staff feedback and care plan reviews.

8. Safe Practice During Personal Care, Bathing and Showering

Staff must follow the person’s care plan and risk assessment when supporting personal care, bathing, showering, shaving, hair washing or any activity involving hot water or heated equipment.

Staff must:

Where a person refuses support or chooses to take a risk, staff must not automatically prevent the activity. Staff must consider capacity, provide information in a way the person can understand, offer safer alternatives, involve the nurse or senior staff member where appropriate, and record the discussion and agreed plan.

9. Safe Practice with Hot Drinks, Meals and Kitchen Activities

People living at {{org_field_name}} must be supported to maintain independence, choice and dignity when preparing, receiving or consuming hot drinks and meals. Where a person is at risk of burns or scalds from hot drinks, hot food or kitchen activities, this must be assessed and included in their care plan.

Staff must:

Where a person wishes to make their own hot drinks or participate in cooking, the risk assessment must balance the person’s independence and wellbeing with the need to prevent avoidable harm.

10. Responding to Burns and Scalds

In the event of a burn or scald, staff must act immediately and calmly. The first priority is to make the person safe and prevent further injury.

Staff must:

All burns and scalds must be reported immediately to the person in charge and Registered Manager. An incident form must be completed before the end of the shift, or sooner where required. The person’s family, representative or relevant person must be informed in line with consent, confidentiality, safeguarding and duty of candour requirements.

The person’s care plan and risk assessment must be reviewed following any burn, scald or near miss. The review must identify immediate actions, further controls, referrals, equipment checks, staff learning, safeguarding considerations and whether CQC, the local authority, the police, RIDDOR or other agencies must be notified.

11. Safeguarding Considerations

Burns and scalds may be accidental, but they may also indicate neglect, acts of omission, poor care, unsafe practice, abuse or improper treatment. Staff must treat the following as potential safeguarding concerns:

Staff must report safeguarding concerns immediately in line with CH13 – Safeguarding Adults from Abuse and Improper Treatment Policy. The Registered Manager or Safeguarding Lead must consider referral to {{org_field_local_authority_authority_name}}, notification to CQC, referral to the police, duty of candour requirements, disciplinary action, suspension from duty where required, and action to protect other people from harm.

All safeguarding concerns must be recorded clearly, investigated appropriately and reviewed to identify learning and prevent recurrence.

12. CQC Notifications, Duty of Candour and External Reporting

The Registered Manager must consider whether any burn, scald or near miss requires notification to CQC under the Care Quality Commission (Registration) Regulations 2009, Regulation 18, including where the incident results in serious injury, requires treatment to prevent serious injury, involves abuse or an allegation of abuse, is reported to or investigated by the police, or affects the safe running of the service.

Where a burn or scald is unintended or unexpected and has resulted in, or may result in, death, severe harm or moderate harm, the Registered Manager must consider whether it is a notifiable safety incident under Regulation 20 Duty of Candour. Where duty of candour applies, {{org_field_name}} must act in an open and transparent way, apologise, provide a truthful account of what is known, explain what further enquiries will take place, keep written records, and provide reasonable support to the person and/or their relevant person.

The Registered Manager must also consider whether reporting is required to the local authority safeguarding team, police, Health and Safety Executive under RIDDOR, commissioners, insurance provider, environmental health, fire and rescue service, or other relevant agencies.

All decisions about external reporting must be recorded, including the rationale where a notification or referral is not made.

13. Staff Training and Responsibilities

All staff must receive training, supervision and support appropriate to their role so that they can prevent, identify, respond to and report burns and scalds. Training must be provided during induction and refreshed at intervals set by {{org_field_name}} or sooner where incidents, audits, supervision, competency checks or changes in guidance identify a need.

Training must include, where relevant to the staff member’s role:

The Registered Manager must ensure that staff competency is checked where staff support people with high-risk activities, including bathing, showering, hot drinks, meal service, laundry, kitchen activities or use of specialist equipment. Staff must not undertake tasks unless they have the competence, confidence and authorisation to do so safely.

14. Governance, Monitoring and Learning from Burns and Scalds

{{org_field_name}} will monitor burns and scalds risks through effective governance systems. This includes:

The Registered Manager must ensure that all burns, scalds, near misses and unsafe conditions are reviewed to identify patterns, themes and opportunities for improvement. Learning must be shared with staff and, where appropriate, people living in the home, relatives, representatives, commissioners and professionals.

Where audits or incidents identify shortfalls, an action plan must be created with named responsibilities, timescales and evidence of completion. The provider must monitor completion and effectiveness of actions.

15. Policy Review

This policy will be reviewed at least annually, or sooner if there is:

The Registered Manager is responsible for ensuring this policy is implemented, monitored and reviewed. The provider is responsible for ensuring that adequate resources, maintenance systems, training, staffing and governance arrangements are in place to reduce avoidable harm.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.

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