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Registration Number: {{org_field_registration_no}}

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Burns and Scalds Policy

1. Purpose

This policy outlines the procedures in place at {{org_field_name}} for preventing, identifying, responding to, and managing incidents involving burns and scalds. It reflects our commitment to delivering a safe and responsive care environment in line with the Regulation and Inspection of Social Care (Wales) Act 2016, the Health and Safety at Work etc. Act 1974, the Manual Handling Operations Regulations 1992, and CIW’s expectations for protecting people from avoidable harm. The purpose of this policy is to ensure that every possible precaution is taken to minimise the risk of burns and scalds to people receiving care, that any incidents are managed efficiently and safely, and that staff are fully trained and competent in prevention and first response.

2. Scope

This policy applies to all staff, including care staff, domestic staff, maintenance workers, kitchen personnel, volunteers, and agency staff. It relates to all people receiving care at {{org_field_name}}, including those who are particularly vulnerable due to frailty, mobility issues, cognitive impairment, or sensory deficits. The policy also covers equipment, environmental controls, water safety, and staff training.

3. Related Policies

This policy should be read alongside:
CHW11 – Safe Care and Treatment Policy
CHW16 – Health and Safety at Work Policy
CHW18 – Risk Management and Assessment Policy
CHW24 – Management of Accidents, Incidents and Near Misses Policy
CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy
CHW37 – Moving and Handling Policy
CHW40 – Assisting with Personal Care Policy

4. Policy Details

4.1 Understanding Burns and Scalds Risks in a Care Setting

Burns are caused by dry heat, such as contact with hot surfaces or equipment, while scalds are caused by contact with hot liquids or steam. People receiving care may be at increased risk due to thin or sensitive skin, reduced mobility, poor reaction times, or inability to communicate discomfort. Common causes in care settings include hot drinks, cooking areas, radiators and heaters, hot water during bathing or washing, hair styling tools, heated pads or blankets, and accidental spills of hot food or fluids.

4.2 Risk Assessment and Individual Personal Planning

The risk of burns and scalds must be considered as part of the assessment of risks to each individual’s health, safety and well-being. The assessment must take account of the individual’s particular circumstances and must include, where relevant:

• mobility and ability to move away from a source of heat;
• cognitive impairment, confusion or reduced awareness of danger;
• sensory impairment or reduced ability to recognise temperature;
• communication difficulties or inability to communicate pain or discomfort;
• skin condition, frailty or other factors that increase susceptibility to injury;
• ability to safely prepare, carry or consume hot food and drinks;
• ability to safely use baths, showers and wash-hand basins;
• access to radiators, exposed pipework, heaters, cooking equipment or other hot surfaces;
• use of heated equipment or appliances; and
• any previous burns, scalds, near misses or other relevant incidents.

Where a risk is identified, the individual’s personal plan must clearly specify the measures required to reduce that risk and how staff are to provide care and support safely. Measures may include supervision, assistance with bathing or showering, temperature controls, support with hot food or drinks, environmental adaptations, guards or other appropriate precautions.

The individual’s wishes, preferences, independence and ability to make decisions must be taken into account when assessing and managing risk. Restrictions must not be imposed solely for staff convenience and any measures used must be proportionate to the identified risk.

The provider assessment must be kept under review and revised whenever necessary, including following a significant change in the individual’s needs, abilities or circumstances, or following a burn, scald, near miss or other relevant incident.

The individual’s personal plan must be reviewed whenever required and at least every three months in accordance with Regulation 16 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended. Where a review identifies a change in risk, the personal plan and relevant risk assessment must be updated without delay and the changes communicated to staff involved in the individual’s care and support.

4.3 Environmental Controls and Equipment Safety

{{org_field_name}} must ensure that risks from hot water, hot surfaces, hot liquids and heated equipment are identified and reduced so far as is reasonably practicable. Environmental controls must reflect the needs and assessed vulnerability of the individuals using the service.

The following controls apply:

• Where an individual is assessed as being vulnerable to scalding from whole-body immersion, the temperature of water available from baths and showers must not exceed 44°C.
• Appropriate thermostatic mixing valves (TMVs), temperature-limiting devices or other suitable engineering controls must be provided where required by the risk assessment to prevent unsafe water temperatures. Where TMVs are used, they must be appropriately located, regularly monitored, maintained and tested by competent persons to ensure that they continue to operate effectively.
• Water-temperature controls must be managed in conjunction with the service’s arrangements for controlling the risk from Legionella and other waterborne hazards. Measures introduced to prevent scalding must not compromise the effective control of Legionella.
• Where an individual is assessed as vulnerable to scalding from a wash-hand basin or other accessible hot-water outlet, appropriate controls must be implemented having regard to the individual’s assessed risk.
• Accessible radiators, hot-water pipes, heaters and other hot surfaces that present a foreseeable burn risk to vulnerable individuals must be controlled. Where there is a risk that an individual could fall against, become trapped against or remain in prolonged contact with a hot surface, the accessible surface temperature must not exceed 43°C or suitable guarding, insulation or another effective control measure must be provided.
• Radiator guards, pipe covers and other protective devices must be securely fitted where required and included within the service’s maintenance and inspection arrangements.
• Heating systems, hot-water systems, temperature-control devices, guards, electrical appliances and other equipment capable of causing burns or scalds must be maintained in safe working order. Defects that could place an individual at risk must be addressed promptly and the equipment or area must not be used where it cannot be used safely.
• Hot food and drinks must be prepared, carried, served and positioned in a way that minimises the risk of spillage or contact with vulnerable individuals. Individual risk assessments and personal plans must specify any assistance or supervision required.
• Kitchens, laundries and other areas containing significant sources of heat must be appropriately secured or supervised according to the needs and assessed risks of individuals using the service. Access must not be restricted unnecessarily where an individual is able to use the area safely.
• Hairdryers, hair straighteners, heated blankets, heating pads and other heated equipment must be used in accordance with the manufacturer’s instructions and the individual’s assessed needs. Appropriate supervision must be provided where required and equipment must be switched off and stored safely after use.

4.4 Safe Personal Care Practices

Staff assisting individuals with bathing or washing must always check the temperature of the water using a thermometer and their elbow before helping the person into the bath or shower. Staff must never allow taps to run unattended. Residents must not be left alone with access to hot water or heat sources if they are assessed as being at risk. All personal care involving heat or hot fluids must be documented and carried out according to the individual’s care plan and in line with our procedures under CHW40. Where appropriate, bath aids, thermostatic controls, and anti-scald devices are used to support safe practices.

4.5 Staff Training and Awareness

All staff receive mandatory training in:
Burn and scald prevention and risk identification
Safe handling of hot liquids, food, and care equipment
Water temperature monitoring procedures
Emergency first aid for burns and scalds
Incident reporting and documentation

This training is included at induction and refreshed annually. The Registered Manager is responsible for ensuring training is completed and records are maintained.

4.6 First Aid Response to Burns and Scalds

Where a burn or scald occurs, staff must respond immediately and must give priority to the individual’s safety and the provision of appropriate first aid.

Staff must:

• remove the individual from the source of heat where it is safe to do so;
• cool the affected area under cool or lukewarm running water for at least 20 minutes as soon as practicable;
• remove clothing or jewellery from around the affected area where this can be done safely, but must not remove anything that is stuck to the skin;
• not apply ice, creams, ointments, butter, grease or other substances to the burn;
• after cooling, cover the affected area loosely with an appropriate clean, non-fluffy dressing or suitable cling film where appropriate;
• monitor the individual for deterioration, shock, breathing difficulties, airway involvement or other signs requiring urgent medical assistance; and
• obtain appropriate medical advice or emergency assistance according to the nature, location, size and severity of the burn or scald and the condition of the individual.

Emergency medical assistance must be requested without delay where the person’s condition indicates that urgent treatment is required.

Following the immediate response, staff must:

• record the incident accurately in the individual’s care records;
• complete the required accident or incident documentation in accordance with CHW24 – Management of Accidents, Incidents and Near Misses Policy;
• inform the Registered Manager or the person in charge without delay;
• preserve relevant evidence where neglect, abuse, equipment failure or another safeguarding or safety concern may be involved;
• ensure that the individual’s risks are reassessed and that their provider assessment, risk assessment and personal plan are reviewed and revised where necessary;
• implement any immediate additional controls required to prevent recurrence; and
• ensure that any required safeguarding referral, statutory notification or other external report is made in accordance with sections 4.7 and 4.8 of this policy.

The individual must be informed about what has happened and the action taken in a manner they can understand. Information may be shared with the individual’s representative where the representative has the appropriate legal authority or the individual’s consent, or where disclosure is otherwise required or permitted by law. Family members must not automatically be given confidential information solely because they are related to the individual.

4.7 Incident Reporting and CIW Notification

Every burn or scald, including any relevant near miss, must be recorded in accordance with the service’s accident and incident reporting procedures and reviewed by the Registered Manager or other authorised senior person.

A burn or scald must not automatically be treated as requiring notification to Care Inspectorate Wales solely because an injury has occurred. The Registered Manager must consider whether the event meets a notification requirement under Regulation 60 and Schedule 3 of the Regulated Services (Service Providers and Responsible Individuals) (Wales) Regulations 2017, as amended.

Care Inspectorate Wales must be notified of a serious accident or injury where the criteria for notification under Regulation 60 and Schedule 3 are met. In accordance with CIW statutory guidance, this includes an accident or injury which, in the reasonable opinion of a healthcare professional, requires treatment by that or another healthcare professional and has or may have resulted in:

• damage or impairment of the individual’s sensory, motor or intellectual functions that is permanent or is likely to last for more than 28 days;
• a change to the structure of the individual’s body;
• prolonged pain or prolonged psychological harm; or
• death or a shortening of the individual’s life expectancy.

A burn or scald may also require notification to CIW under another category in Schedule 3. This includes, where applicable:

• abuse or an allegation of abuse involving the service provider, a member of staff or a volunteer;
• an allegation of misconduct by a member of staff;
• an incident that has been reported to the police; or
• an event which prevents, or could prevent, the service provider from continuing to provide the service safely.

Where more than one statutory reporting requirement applies, the Registered Manager must ensure that all applicable requirements are considered and met.

Notifications to CIW must be made without delay and in the manner and form required by CIW. CIW guidance states that notifications are usually expected within 24 hours of the event occurring. Notifications must be submitted through CIW Online in accordance with CIW’s current notification arrangements.

The Registered Manager must ensure that:

• the facts surrounding the incident are established and appropriately documented;
• immediate and continuing risks to the individual and other people using the service are addressed;
• relevant healthcare advice and treatment are obtained;
• safeguarding procedures are initiated where appropriate;
• relevant risk assessments, the provider assessment and personal plan are reviewed and revised where necessary;
• any required notification to another statutory body or agency is completed; and
• evidence of the notification, including the date, time and information submitted, is retained in accordance with the service’s record-keeping arrangements.

Burn and scald incidents and near misses must be monitored for patterns or trends. Where analysis identifies a recurring risk, equipment defect, environmental hazard, unsafe practice or other concern, the service provider must take timely action to reduce the risk and must monitor whether the action taken has been effective.

4.8 Safeguarding Considerations

Any burn or scald where abuse, neglect or improper treatment is known, alleged or suspected must be treated as a potential safeguarding concern and managed in accordance with CHW13 – Safeguarding Adults from Abuse and Improper Treatment Policy and the Wales Safeguarding Procedures.

This includes concerns that an injury may have resulted from:

• deliberate harm;
• neglect or an omission in care;
• a failure to provide required supervision or assistance;
• failure to follow the individual’s personal plan or risk-control measures;
• unsafe use of hot water, equipment, food or drinks;
• failure to respond to a known environmental or equipment hazard;
• inappropriate restraint or restrictive practice; or
• repeated accidental incidents indicating that known risks have not been appropriately assessed or managed.

Where abuse, neglect or improper treatment is alleged or suspected, staff must:

• take immediate action to protect the individual and any other person who may be at risk;
• obtain necessary first aid and medical attention;
• immediately inform {{org_field_safeguarding_lead_name}}, {{org_field_safeguarding_lead_role}}, or the person designated to act in their absence;
• preserve relevant records, evidence and equipment where appropriate;
• make an appropriate safeguarding referral to {{org_field_local_authority_authority_name}} in accordance with the Wales Safeguarding Procedures and the service’s Safeguarding Policy;
• contact the police where a crime is suspected or where immediate police assistance is required;
• record the substance of the allegation or evidence, the action taken and all referrals made; and
• ensure that any notification required to Care Inspectorate Wales under Regulation 60 and Schedule 3 is made without delay.

Where the safeguarding concern or allegation involves the service provider, a member of staff or a volunteer, the Registered Manager must ensure that the corresponding CIW notification requirement is considered and complied with.

The service must co-operate with the local authority, police, CIW and other relevant agencies during any safeguarding enquiry or investigation and must not undertake internal enquiries in a manner that compromises a statutory safeguarding or criminal investigation.

An incident described as accidental must not automatically be excluded from safeguarding consideration. Repeated incidents, failure to follow agreed precautions, failure to respond to a known risk, or an omission in necessary care may constitute neglect or improper treatment and must be considered under the safeguarding procedures.

4.9 Monitoring and Quality Assurance

The Registered Manager oversees audits of environmental safety, care documentation, incident reports, and maintenance records. Regular checks ensure compliance with this policy and the implementation of preventative measures. Any areas of non-compliance are addressed through supervision, training, or disciplinary procedures if required. Lessons learned from any incident are shared in staff meetings and action plans are created and monitored through the quality assurance cycle.

5. Policy Review

This policy will be reviewed annually or earlier if prompted by changes in legislation, guidance from CIW or Public Health Wales, or following any burn or scald-related incident. The review is part of {{org_field_name}}’s wider commitment to safety, continuous improvement, and learning.

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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}}
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