The Health and Safety Executive (HSE) says organisations should follow its guidelines to avoid deaths from scalding hot water. 
The HSE warning follows the death of an elderly patient who suffered terrible injuries when she was placed in scalding hot water by care home staff. The death led to the prosecution of managers at the home.

The HSE guidelines says managers of care homes, hostels, and sheltered housing for the elderly and mentally ill in particualr must prevent scalding hot water in basins, showers and baths by installing tamperproof thermostatic mixing devices. Despite the guidance, deaths and injuries from scalding hot water continue.

Safe hot water systems include fail-safe thermostatic mixing valves (TMVs) and in healthcare, TMVs certified to Buildcert TMV3 must be fitted. 

The problem of scalding water has become more acute in communal and public buildings because, to prevent risks from Legionella, hot water must be stored at a temperature of at least 60 C and distributed at 50 C minimum- a fatally hot temperature for bathers.  A fail-safe mixing control at the outlet is as a result a vital requirement to prevent scalding. 

At water temperatures over 50ºC there is a risk of scalding and where whole body immersion occurs for baths and showers, water temperatures should be controlled to 43ºC.

The elderly are at particular risk because their skin tends to be less sensitive, so may not pull away from hot water quickly enough to avoid scalding.  Scalding injuries often cover a large area of the body, leading to high rates of morbidity and mortality.

Martin Strom, business manager for Honeywell Water Products said 'Valves to the domestic TMV2 standard, such as Honeywell TM300, are acceptable for most other premises but a risk assessment should be carried out to determine if the facilities are used by vulnerable people, such as the elderly, young children or the mentally or physically disabled.  If so, TMV3 valves should be installed to provide the maximum safety level.'