Castlefields Surgery - Stafford A & L Reference : …...Risk Assessment for Legionellosis Associated with Water Usage Castlefields Surgery - Stafford Client Specific Areas Only Castle

South Staffordshire PCT Survey Date: 04/07/2012Report Ref: 10395Castlefields Surgery - Stafford

Risk Assessment for Legionellosis Associated with Water Usage

Castlefields Surgery - Stafford

Client Specific Areas OnlyCastle Way

Stafford StaffordshireST16 1BS

A & L Reference : 10395

Survey Date : 04/07/2012

Survey Conducted By: C Morris

Checked By: C Morris Compiled By: J CraggSigned: Signed:

Check Date: 06/07/2012 Compiled Date: 05/07/2012

Commission by:Lorraine Cleary

,

A&L Consultants Page 1 of 87Office 3, Derek Ashton Court, Mottram Road, Stalybridge, Cheshire, SK15 2LYTel: 0161 338 3444 Fax: 0161 338 3999 e-mail: [email protected]


1. Introduction º Background º Scope and Purpose º Overview º Areas Excluded from the Survey º ACOP L8 º Other Health & Safety Regulations

2. Sources of Data º Background Information º Elements of a Risk Assessment º Parameters of the Risk Assessment º Assessment Score Classification º Data Sheets

3. Conclusions & Recommendations º Additional Inspection, Sampling and Testing º Labels and Warning Signs º Internal Arrangements

4. Caveats 5. References 6. Emergency Procedures 7. Appendices

º Appendix A: Documentation º Appendix B: Data sheets and Photographic Evidence º Appendix C: Annotated Floor Plans



Introduction

Background

Legionnaires' disease is a potentially fatal form of pneumonia which can effect anybody, but which principallyaffects those who are susceptible because of age, illness, immunosuppression, smoking etc. Legionnaires' iscaused by the bacterium Legionella pneumophila and other related bacteria. Legionella bacteria can alsocause other less serious illnesses which are not fatal such as Pontiac fever and Lochgoilhead fever. Thecollective term to cover the group of diseases caused by Legionella bacteria is LEGIONELLOSIS. The firstrecognised outbreak was in Philadelphia, USA. It occured in July 1976 at a convention of the AmericanLegion. There were 182 cases (29 deaths) and in 1977 it was established that the causative organism wasLegionella pneumophila.

There are several types of illness the Legionella bacteria can cause;Legionnaires Disease - Caused by L. pneumophila sero group 1 bacteria. This has a 5% attack rate andan incubation period of 2 to 10 days. The symptoms displayed are acute bacterial pneumonia, delirium,diarrhoea and vomiting. This is usually treated with antibiotics with a slow recovery rate. There is an average12% fatality rate. Pontiac Fever (caused by L. pneumophila sero group 1 bacteria) and Lochgoilhead fever (Caused by Tatlockia micdadej bacteria) - The symptoms displayed are short fevers without pneumonia. The incubationperiods are: - Pontiac Fever 2-3 days and Lochgoilhead Fever up to 9 days. So far no fatalities have beenattributed to either of these diseases.

Scope and Purpose

South Staffordshire PCT: has commissioned A & L Asbestos Consultants to undertake a Legionella riskassessment and water hygiene risk assessment of Site ref. The purpose of the Legionella risk assessmentand water hygiene risk assessment was to:

• Ascertain the possible risk of contracting legionnaires' disease from the water systems.

The purpose of the report is to:

• Establish compliance with current legislation • Identify any remedial works that may be required. • Enable the client to take appropriate precautions so that people who work at or attend the building are

not exposed and related health risks. • Provide information to assist the client in developing.



Overview

The remainder of this Section provides an overview of the situation of the site at the time of the assessment.For a more detailed appraisal, the reader should also refer to the annotated floor plans and to the DataSheets at Appendix B.

General Findings and Services

Details of Installations No of items CommentsMains water supply to site / otherwater supplies

1 Situated within Room 0-013, PracticeSisters Room.

Employees / site personnel 15(No Employees x 15 Litres) = 225Litres per day.

Cold water storage 2

2 x plastic cold water storage tankslocated within Room 2-001, LoftSpace. the second tank was seen tobe disconnected from the mains supplyat the time of the assessment.

Domestic hot water services -calorifiers

1Pre lagged calorifier located withinRoom 1-003, Boiler Room.

Domestic hot water services - Smallvolume heaters

0 None Present.

Domestic hot water services - Point ofuse heaters

0 None Present.

Showerheads 0 None Present.Little used outlets 0 None Present.Ultrasonic humidifiers, foggers andmisting systems

0 None Present.

Spray Humidifiers 0 None Present.Water Softeners 0 None Present.

Closed Systems 1Underfloor heating system fitted to thesite fed from the heating boiler locatedin room 1-003 boiler room.

Display fountains and water features 0 None Present.Logbook present and up to date 0 No logbook is held on site.Record of temperaturemeasurements

0 No records of temperaturemeasurements are held on site.

High Temperature outlets labelled 0 None Present.

Miscellaneous Items 2Heating Boiler within Room 1-003,Boiler Room and Water Cooler withinRoom 0-021, Corridor.



Cold Water Storage:

Room Description: 0-013/Practice Sisters Room

Source/Description Mains In /Water Supply

CommentThe mains supply to the site was seen to enter the site in the area at thetime of the assessment.

Recommendation No further action required.

Cold Water Tank Type: (0)

Cold Tank Capacity and Daily Usage: (0)

Condition of Water in Cold Tank: (0)

Cold Water Temperature: (0)Mains temperature less than 20c

Total Risk Score: 0



Room Description: 2-001/Roof Void

Source/Description Cold Water/Storage Tank

Cold Water Tank Type: (0)Insulated plastic tank with lid

Comment: The cold water storage tank wasseen to be of plastic construction with lid,was well insulated and matched the dailyusage for the site.

Recommendation: The condition of the coldwater storage tank and its contents shouldcontinue to be monitored.

Cold Tank Capacity and Daily Usage: (0)Capacity matches daily usage

Condition of Water in Cold Tank: (1)Clear with small deposits

Cold Water Temperature: (0)Mains temperature less than 20c

Total Risk Score: 1 Review Date: 04/07/2014



Hot Water Storage:

Room Description: 1-003/Boiler Room

Source/Description Immersion Tank/Water Heater

Hot Water Tank Type: (0)

Hot Water Temperature: (0)Outgoing water 60c or greater

Hot Water Supply Type:(0)Domestic Calorifier / immersion heater (intemp range)

Comment: The immersion heater was seento be in good working order at the time of therisk assessment.

Recommendation: The immersion heatershould be maintained in accordance with themanufacturers specifications.

Total Risk Score: 0



Potential Risks and Remedial Actions

Room # Details of Installation Risk ScoreRemedial Actions

Required0-001/Entrance Doorway No Services/ 0 No actions required.0-002/Waiting Room No Services/ 0 No actions required.0-003/Toilet Lobby No Services/ 0 No actions required.0-004/Gents Toilet Toilet/ 0 Monitor0-004/Gents Toilet Hand Wash Basin/Cold

Water Tap4 Monitor

0-004/Gents Toilet Hand Wash Basin/HotWater Tap

4 Monitor

0-005/Ladies Toilet Toilet/ 0 Monitor0-005/Ladies Toilet Hand Wash Basin/Cold

Water via Mixer Tap4 Monitor

0-005/Ladies Toilet Hand Wash Basin/HotWater via Mixer Tap

4 Monitor

0-006/Reception Office No Services/ 0 No actions required.0-007/Practice Managers Office No Services/ 0 No actions required.0-008/General Office No Services/ 0 No actions required.0-009/Treatment Room Hand Wash Basin/Cold

Water Tap4 Monitor

0-009/Treatment Room Hand Wash Basin/HotWater Tap

4 Monitor

0-010/Gents Toilets Toilet / 0 Monitor0-010/Gents Toilets Urinal / 0 Monitor0-010/Gents Toilets Hand Wash Basin/Cold

Water Tap4 Monitor

0-010/Gents Toilets Hand Wash Basin/HotWater Tap

4 Monitor

0-011/Cleaners Store Sluice Sink/Cold WaterTap

4 Monitor

0-011/Cleaners Store Sluice Sink/Hot Water Tap 4 Monitor



Potential Risks and Remedial Actions (continued)

Room # Details of Installation Risk ScoreRemedial Actions

Required0-012/Ladies Toilets Toilet 1/ 0 Monitor0-012/Ladies Toilets Toilet 2/ 0 Monitor0-012/Ladies Toilets Hand Wash Basin/Cold

Water Tap4 Monitor

0-012/Ladies Toilets Hand Wash Basin/HotWater Tap

4 Monitor

0-013/Practice Sisters Room Hand Wash Basin/ColdWater Tap

4 Monitor

0-013/Practice Sisters Room Hand Wash Basin/HotWater Tap

4 Monitor

0-013/Practice Sisters Room Mains In /Water Supply 0 Monitor0-014/Main Corridor No Services/ 0 No actions required.0-015/Treatment Room Hand Wash Basin/Cold

Water Tap4 Monitor

0-015/Treatment Room Hand Wash Basin/HotWater Tap

4 Monitor

0-016/Consulting Room Hand Wash Basin/ColdWater Tap

4 Monitor

0-016/Consulting Room Hand Wash Basin/HotWater Tap

4 Monitor

0-017/Osteopaths Room Hand Wash Basin/ColdWater Tap

4 Monitor

0-017/Osteopaths Room Hand Wash Basin/HotWater Tap

4 Monitor


4 Monitor


4 Monitor


4 Monitor


4 Monitor


4 Monitor


4 Monitor

0-021/Corridor Sink Unit/Cold Water Tap 4 Monitor



Potential Risks and Remedial Actions (continued)

Room # Details of Installation Risk Score Remedial Actions Required0-021/Corridor Sink Unit/Hot Water Tap 4 Monitor0-021/Corridor Water Cooler/Misc Item 0 Monitor0-022/Computer Room No Services/ 0 No actions required.0-023/Store No Services/ 0 No actions required.0-024/Store No Services/ 0 No actions required.0-025/Office Hand Wash Basin/Cold Water Tap 4 Monitor0-025/Office Hand Wash Basin/Hot Water Tap 4 Monitor1-001/Conference Room No Services/ 0 No actions required.1-002/Staff Kitchen Sink Unit/Cold Water Tap 4 Monitor1-002/Staff Kitchen Sink Unit/Hot Water Tap 4 Monitor1-003/Boiler Room Immersion Tank/Water Heater 0 Monitor1-003/Boiler Room Boiler/Heating System 0 No actions required.1-004/Corridor No Services/ 0 No actions required.1-005/Store No Services/ 0 No actions required.1-006/Store No Services/ 0 No actions required.1-007/Lobby No Services/ 0 No actions required.1-008/Landing / Stairwell No Services/ 0 No actions required.2-001/Roof Void Cold Water/Storage Tank 1 Monitor2-001/Loft Space Cold Water/Storage Tank 0 No actions required.External/Stairwell No Services/ 0 No actions required.First Floor/Dentists Not Accessed/ 0 Not Accessed.



Non-Comformance Register

Room #Details of

InstallationActions Completed Date of Works

0-001/EntranceDoorway

No Services/

0-002/Waiting Room No Services/ 0-003/Toilet Lobby No Services/ 0-004/Gents Toilet Toilet/ 0-004/Gents Toilet Hand Wash

Basin/Cold WaterTap

0-004/Gents Toilet Hand WashBasin/Hot WaterTap

0-005/Ladies Toilet Toilet/ 0-005/Ladies Toilet Hand Wash

Basin/Cold Watervia Mixer Tap

0-005/Ladies Toilet Hand WashBasin/Hot Watervia Mixer Tap

0-006/Reception Office No Services/ 0-007/PracticeManagers Office

No Services/

0-008/General Office No Services/ 0-009/Treatment Room Hand Wash

Basin/Cold WaterTap

0-009/Treatment Room Hand WashBasin/Hot WaterTap

0-010/Gents Toilets Toilet / 0-010/Gents Toilets Urinal / 0-010/Gents Toilets Hand Wash

Basin/Cold WaterTap

0-010/Gents Toilets Hand WashBasin/Hot WaterTap

0-011/Cleaners Store Sluice Sink/ColdWater Tap

0-011/Cleaners Store Sluice Sink/HotWater Tap

0-012/Ladies Toilets Toilet 1/ 0-012/Ladies Toilets Toilet 2/


South Staffordshire PCT Survey Date: 04/07/2012Report Ref: 10395Castlefields Surgery - Stafford0-012/Ladies Toilets Hand Wash

Basin/Cold WaterTap

0-012/Ladies Toilets Hand WashBasin/Hot WaterTap

0-013/Practice SistersRoom

Hand WashBasin/Cold WaterTap


Hand WashBasin/Hot WaterTap


Mains In /WaterSupply

0-014/Main Corridor No Services/ 0-015/Treatment Room Hand Wash

Basin/Cold WaterTap

0-015/Treatment Room Hand WashBasin/Hot WaterTap

0-016/ConsultingRoom




0-017/OsteopathsRoom


0-017/OsteopathsRoom













South Staffordshire PCT Survey Date: 04/07/2012Report Ref: 10395Castlefields Surgery - Stafford0-020/Consulting

RoomHand WashBasin/Hot WaterTap

0-021/Corridor Sink Unit/ColdWater Tap

0-021/Corridor Sink Unit/Hot WaterTap

0-021/Corridor Water Cooler/MiscItem

0-022/Computer Room No Services/ 0-023/Store No Services/ 0-024/Store No Services/ 0-025/Office Hand Wash

Basin/Cold WaterTap

0-025/Office Hand WashBasin/Hot WaterTap

1-001/ConferenceRoom

No Services/

1-002/Staff Kitchen Sink Unit/ColdWater Tap

1-002/Staff Kitchen Sink Unit/Hot WaterTap

1-003/Boiler Room ImmersionTank/Water Heater

1-003/Boiler Room Boiler/HeatingSystem

1-004/Corridor No Services/ 1-005/Store No Services/ 1-006/Store No Services/ 1-007/Lobby No Services/ 1-008/Landing /Stairwell

No Services/

2-001/Roof Void Cold Water/StorageTank

2-001/Loft Space Cold Water/StorageTank

External/Stairwell No Services/ First Floor/Dentists Not Accessed/



Areas Excluded from the Survey

During the assessment the following areas were excluded because they were found to be either inaccessibledue to the physical nature of the premises or where access could have endangered the assessor:

• All concealed voids, spaces and pipes. • Beneath fitted carpets and floorings. • Areas above three meters in height (unless safe access has been provided by the client). • The grounds surrounding the building(s). • Incoming water supply outside the perimeter of the building.



L8 - The Control of Legionella Bacteria in Water Systems

The Control of Substance Hazardous to Health Regulations 1999 and L8, The Control of Legionella Bacteriain Water Systems refer to the risk from hazardous micro organisms and chemicals such as biocides andchlorine. These regulations, place a responsibility on employers and "Duty Holders" to:

• Identify possible sources of risk • Assess possible sources of risk • Preparing a scheme for preventing / controlling any risks. • Implementation and management of required precautions • The collation and saving of records of any precautions implemented • The appointment of a "Responsible person"

"Responsible Person" As detailed in Paragraph 39 of L8, The Control of Legionella Bacteria in WaterSystems "if the assessment shows there is a reasonable foreseeable risk and it is reasonably practicable toprevent exposure and control the risk from exposure, the person to whom the statutory duty falls shouldappoint a person or persons to take managerial responsibility and to provide supervision for theimplementation of precautions"

Other Health & Safety Regulations

Under Section 2 of the Health and Safety at Work etc. Act 1974 (As amended 2006), employers have a dutyof care for the health, safety and welfare of their employees whilst at work. In addition, employers that are incontrol of premises have a duty of care, under Section 4 of the HSWA (As amended 2006), towards all otherpeople (non-employees) who use or work at their premises. This report can be used as a reference to assistthe client in fulfilling its duties and obligations under present regulatory framework.



Sources of Information

Background Information

The assessment is directed at systems susceptible to colonisation by legionella bacteria and whichincorporate a potential means of creating and dissemination of water droplets. This assessment takes intoaccount:

• The potential of droplet formation • The temperature of hot and cold water systems • The potential risk of inhalation of water droplets • Preventative and controlling measures to be implemented • Possible exposure of people classed as "AT RISK"

Elements of a Risk Assessment

Certain elements must be so as to ensure a "Suitable and Sufficient" risk assessment. These elements are:

1. A detailed plan of the site showing the system in place at the time of the assessment. 2. Details of how the system works, including details of:

º The mains supply º Cold water storage (as applicable) º Hot water storage calorifiers (as applicable) º Other sources of hot water (instantaneous heaters, combi boilers etc) º Hot and Cold water services

3. The nature and degree of the risk posed by the system including the potential of human exposure. º Exposure - Approximation of the number of people using the area. º Frequency of use - Approximation of how often the area is used. º Time of Use - Approximation of how long the area is used for.

4. From this information, each item must have details of any and all remedial actions required so as tominimise / control the identified risk.

5. The setting in place of required management actions including º Details of the chain of responsibility. º Methodology for the monitoring of future risks. º The means of recording and storing all information, including any changes to the site which may

supersede the information in the original assessment.

Parameters of the Risk Assessment

1. Water Supply 2. No of employees / site personnel 3. Approximate daily water consumption (based on national standard 15 litres /day/person)



Cold Water Storage

Type of Tank and Condition Risk ScoreInsulated plastic tank with lid 0 Insulated plastic tank without lid 2 Insulated non-plastic with lid 2 Insulated non-plastic without lid 3 Non Insulated plastic tank with lid 2 Non Insulated plastic tank without lid 3 Non insulated non-plastic with lid 3 Non Insulated non-plastic without lid 4

Capacity of tank and daily usage Risk ScoreCapacity matches daily usage 0 Capacity is double daily usage 1 Capacity is > double daily usage 2

Condition of Water in Tank Risk ScoreClear and no deposits 0 Clear with small deposits 1 Clear with large deposits 2 Visible Bio film and deposits 3

Temperature of water Risk ScoreMains temperature < 20C 0 Remote temperature < 20C 0 Mains temperature > 20C 1 Remote temperature > 20C 1 Mains temperature > 25C 2 Remote termperature > 25C 3

These parameters for this element of the assessment give a possible risk score between 0 and 12.



Hot Water Storage

Type of hot water storage tank Risk ScorePre Lagged domestic calorifier 0 Insulated domestic calorifier 0 Non insulated domestic calorifier 1 Insulated Industrial calorifier 1 Non insulated Industrial Calorifier 2 Insulated Hot/cold water calorifier 3 Non / Insulated Hot/cold water calorifier 3

Hot water storage tank temperatures Risk ScoreOutgoing water 60C or greater 0 Incoming water 50C or greater 0 Outgoing water < 60C 1 Incoming water < 50C 1 Outgoing water < 55C 2 Incoming water < 45C 2

Other sources of hot water

Type of Supply Risk ScoreDomestic Combi Boiler (in temp range) 0 Small volume heater (in temp range) 0 Instantaneous heater (in temp range) 0 Domestic Combi Boiler (outside temp range) 1 Small volume heater (outside temp range) 2 Instantaneous heater (outside temp range) 2

The parameters for this element of the assessment give a possible risk score between 0 and 7.



Hot and cold Water Services.

Redundant Services Risk ScoreLittle used outlets 3 Low use outlets upstream of high use 3 Vacant areas 3 Blind / dead ends at site 3

Aerosol Generation Risk ScoreSprinklers fitted to taps 1 Excessive water pressure at taps 1 Showers present (frequent use) 2 Showers present (infrequent use) 5

Temperature Regimes Risk ScoreCold water < 20C after 2 mins 0 Cold water > 20C after 2 mins 2 Hot water > 50C after 1 min 0 Hot water < 50C after 1 min 2

Documentation/ Records and Labels Risk ScoreLogbook present and up to date 0 No logbook present 2 Record of temperature measurements 0 No record of temperature measurements 2 High temperature outlets labelled 0 High temperature outlets not labelled 2

These parameters for this element of the assessment give a possible risk score between 0 and 16.



Assessment Score Classification for Water Services*

The Assessment Score for the water services, is derived by adding together the above classification numbersand assigning the scores High, Medium and Low as follows:

High Assessment Score of 8 or moreThe element of the assessment requires urgent attention. It should either be removedor treated as soon as possible following the recommendations stated within theassessment.**

Medium Assessment Score of between 7 and 8The element of the assessment is in a location/condition that requires remedial action.The action may entail medium scale remedial works / actions and should be completedwithin the time frame stated within the assessment.**

Low Assessment Score of between 1 and 6The element of the assessment is in a location/condition that requires remedial action.The action may entail minor remedial works / actions and should be completed withinthe time frame stated within the assessment.**

Please note that hot and cold water storage parameters for assessment are based on that items individualrisk assessment, please see the relevant date sheet / sheets for this element of the assessment for details ofany remedial works / actions that are required.

** Please note that the risk scores generated within the body of this report are for guidance purposes only.For all remedial works/actions required please see the relevant date sheet / sheets and the Potential Risksand Remedial Actions breakdown for each element of the assessment.



Data Sheets

The above risk assessment methodology has been incorporated in the data sheets at Appendix B. The datasheets provide recommendations concerning remedial measures that should be adopted at each location.

The reader is reminded of the significance of the colour coding that is adopted on the Data Sheets, asfollows:

WHITENO WATER SERVICES OR SUPPLIES SEEN IN THEAREA

GREENTHE WATER SERVICES IN THE AREA ARE DEEMEDAS LOW RISK AND NO IMMEDIATE REMEDIALACTIONS ARE REQUIRED

AMBER

THE WATER SERVICES IN THE AREA ARE DEEMEDAS A MEDIUM RISK AND REMEDIAL ACTIONS AREREQUIRED TO BE CARRIED OUT AT THE EARLIESTOPPORTUNITY

REDTHE WATER SERVICES IN THE AREA ARE DEEMEDAS A HIGH RISK AND IMMEDIATE REMEDIALACTIONS ARE REQUIRED

Conclusions and Recommendations

Labels and Warning Signs

It is recommended that labels and warning signs should be provided to identify:

• Drinking water • Hot water points (risk of scalding)

The programme for providing labels and warning signs should be systematic, beginning with the areas thatare most readily accessible and where risk is greatest.

Training and Communications

It is required as stated within L8 that all employees who are directly or indirectly in control of activities thatmay affect the working of the services on the site should receive the necessary training and should haveaccess to all relevant information contained within the assessment report and all other related information.



Management Responsibility

Responsibility should be allocated to a specific individual "responsible person" to provide a source ofinformation, advice and authority for situations where decisions relating to the on site services are required.The nominated individual "responsible person" should also be responsible for:

• Communication of all relevant information • Controlling the all required parameters as outlined within the assessment report • Liaising with specialist contractors, as required • Monitoring of all required documentation

Caveats

During this assessment A&L consultants have made every reasonably practicable effort to locate and makenote of all services at the site, where in the opinion of A&L consultants, there is likelihood for the possible"growth" of Legionella bacteria. Although every effort is made to trace all water services, floor voids, ceilingvoids and fixed boxing are not accessed as not to cause unnecessary damage to the site during the riskassessment.

References

1. The Health and Safety at Work Act 1974 (as amended 2006) 2. The Management of Health and Safety at Work Regulations 1999 3. The Control of Substances Hazardous to Health Regulations 2002 (as ammended) 4. Acop L8, The Control of Legionella Bacteria in Water Systems (2001)



Emergency Procedures

General

Legionnaires` disease is not notifiable under public health legislation in England and Wales but, in Scotland,Legionellosis (i.e. all diseases caused by legionella) is notifiable under the public health (notification ofinfectious disease) (Scotland) regulations 1988. An "outbreak" of Legionellosis as defined by the public healthlaboratory service (PHLS) consists of two or more "confirmed" cases at the same locality within a six monthtime period. Required Actions The "Responsible Person" (as detailed previously) has a set procedure tofollow including

• Notifying the local authority, CCDC or EHO so as established incident plans may be activated.

As part of this investigation, the following requests and recommendations may be made, including

• The shut down / closure of any and all processes capable of generating airborne water droplets • The taking of water samples as required from the system / parts of the system prior to disinfection of the

system. • Provision of all on site documentation (see appendix A for examples of site documentation) • Provision of staff health records • To co-operate fully with the investigating body including • 1. Tracing of all pipe work runs

2. Scrutiny of operational records 3. Personnel statements form staff / plant operators / managers 4. Statements from water treatment contractors and any external consultants for the site

Further requests or recommendations may be made by the local authority, CCDC or EHO, at the time of the"outbreak". All these further requirement should be complied with as far as is reasonable practicable.



Appendix A: Documentation



Appendix B: Data sheets and Photographic evidence:

Room Description: 0-001/Entrance Doorway

Source/Description No Services/

CommentNo services were seen to be present in the area at the time of theassessment.


Redundant Services: (0)

Aerosol Generation: (0)

Temperature Regimes: (0)

Documentation/Records & Labels: (0)

Total Risk Score: 0



Room Description: 0-002/Waiting Room








Total Risk Score: 0



Room Description: 0-003/Toilet Lobby








Total Risk Score: 0



Room Description: 0-004/Gents Toilet

Source/Description Toilet/

CommentThe toilet was seen to be in good working order at the time of theassessment.

Recommendation The condition of the toilet should be monitored.





Total Risk Score: 0




Source/Description Hand Wash Basin/Cold Water Tap



Temperature Regimes: (0)Cold water less than 20c after 2 minutes

Comment: The cold water reached atemperature below 20 degrees centigradewithin 2 Minutes.

Recommendation: The water service shouldcontinue to be monitored following currentlegislative guidelines.

Documentation/Records & Labels: (4)No log book or temperature records

Comment: No record of temperaturemeasurements was available at the time ofthe assessment.

Recommendation: Records should be madeavailable at the time of the next assessment.





Source/Description Hand Wash Basin/Hot Water Tap



Temperature Regimes: (0)Hot water greater than 50c after 1 minute

Comment: The Hot water reached atemperature in excess of 50 degreescentigrade within 1 Minute.








Room Description: 0-005/Ladies Toilet

Source/Description Toilet/







Total Risk Score: 0




Source/Description Hand Wash Basin/Cold Water via Mixer Tap













Source/Description Hand Wash Basin/Hot Water via Mixer Tap












Room Description: 0-006/Reception Office








Total Risk Score: 0



Room Description: 0-007/Practice Managers Office








Total Risk Score: 0



Room Description: 0-008/General Office








Total Risk Score: 0



Room Description: 0-009/Treatment Room


























Room Description: 0-010/Gents Toilets

Source/Description Toilet /







Total Risk Score: 0




Source/Description Urinal /

CommentThe urinal was seen to be in good working order at the time of theassessment and a flushing regime managed via a slow release valve andball cock arrangement.

Recommendation The condition of the urinal should be monitored.





Total Risk Score: 0





























Room Description: 0-011/Cleaners Store

Source/Description Sluice Sink/Cold Water Tap












Room Description: 0-011/Cleaners Store

Source/Description Sluice Sink/Hot Water Tap












Room Description: 0-012/Ladies Toilets

Source/Description Toilet 1/







Total Risk Score: 0




Source/Description Toilet 2/







Total Risk Score: 0























































Room Description: 0-014/Main Corridor








Total Risk Score: 0




Sentinel Tap














Sentinel Tap













Room Description: 0-016/Consulting Room


























Room Description: 0-017/Osteopaths Room













Room Description: 0-017/Osteopaths Room


































































Sentinel Tap














Sentinel Tap








Comment: All site records were seen to beup to date and accurate at the time of theassessment.

Recommendation: Continuing recordsshould be kept to allow for the ongoingmanagement of the services at the site.




Room Description: 0-021/Corridor

Sentinel Tap

Source/Description Sink Unit/Cold Water Tap













Sentinel Tap

Source/Description Sink Unit/Hot Water Tap













Source/Description Water Cooler/Misc Item

CommentThe water cooler was seen to be in good working order at the time of theassessment.

RecommendationThe water cooler should be maintained in accordance with themanufacturers specifications.





Total Risk Score: 0



Room Description: 0-022/Computer Room








Total Risk Score: 0



Room Description: 0-023/Store








Total Risk Score: 0











Total Risk Score: 0



Room Description: 0-025/Office













Room Description: 0-025/Office













Room Description: 1-001/Conference Room








Total Risk Score: 0



Room Description: 1-002/Staff Kitchen

Sentinel Tap

Source/Description Sink Unit/Cold Water Tap












Room Description: 1-002/Staff Kitchen

Sentinel Tap

Source/Description Sink Unit/Hot Water Tap












Room Description: 1-003/Boiler Room

Source/Description Boiler/Heating System

CommentThe boiler was seen to be in good working order and was used by theheating system only at the time of the assessment.






Total Risk Score: 0











Total Risk Score: 0











Total Risk Score: 0











Total Risk Score: 0



Room Description: 1-007/Lobby








Total Risk Score: 0



Room Description: 1-008/Landing / Stairwell








Total Risk Score: 0



Room Description: 2-001/Loft Space

Source/Description Cold Water/Storage Tank

CommentThe cold water storage tank was seen to be disconnected from all watersupplies and contained no water within at the time of the assessment.


Redundant Services: (0)Disconnected Service

Comment: The cold water storage tank wasseen to be disconnected from all watersupplies and contained no water within atthe time of the assessment.

Recommendation: No further actionrequired.




Total Risk Score: 0



Room Description: External/Stairwell








Total Risk Score: 0



Room Description: First Floor/Dentists

Source/Description Not Accessed/

CommentNo access was gained to the dentists section of the first floor at the requestof the client.






Total Risk Score: 0



Appendix C: Annotated Floor Plans








Documents

Castlefields Surgery - Stafford A & L Reference : …...Risk Assessment for Legionellosis Associated with Water Usage Castlefields Surgery - Stafford Client Specific Areas Only Castle