Care homes are where scalding risk is taken most seriously, and for good reason. The people living there are often the least able to protect themselves from hot water. They may not feel heat properly, may not recognise the danger, or may not be able to move away quickly. Water that would make most of us flinch and step back can cause serious burns.
TMVs are a big part of the answer. But they're one part. Here's how they fit with everything else a home needs to do.
What HSE expects
HSE's guidance on scalding and burning in health and social care is the place to start. It's short, readable and worth ten minutes of any manager's time. The key points for hot water are:
- High water temperatures, particularly over 44°C, create a scalding risk for vulnerable people.
- Where vulnerable people are at risk during whole-body immersion, such as bathing and showering, the water must not exceed 44°C.
- Where high temperatures are being used to control Legionella, baths and showers should be fitted with TMVs so the water at the outlet doesn't go over that limit.
- Outlet temperatures and TMVs should be monitored and maintained so the controls actually work.
- Basins carry a lower risk because there's no full-body immersion, but if a resident is assessed as vulnerable at a basin, the temperature there should be controlled too.
The same guidance also covers hot surfaces such as radiators and exposed pipes. That's a separate job from TMVs, but it often comes up in the same risk assessment.
Why you can't just turn the boiler down
This is the question we hear most from new managers, and it's a fair one. If hot water is dangerous, why store it so hot?
The answer is Legionella. Under ACOP L8 and HSG274, hot water is normally stored at 60°C or above and circulated at 50°C or above, because the bacteria don't survive well at those temperatures. Turn the system down and you swap a scalding risk for a Legionella risk, which is no better.
A TMV squares that circle. The system stays hot enough to control Legionella, and the valve blends the water down to a safe temperature right before the outlet. That's also why the valve should be as close to the outlet as practical: the short run of warm water after it is the bit that needs watching.
Typical outlet temperatures
Your risk assessment sets the final figures, but these are the ones you'll usually see in care settings:
| Outlet | Typical maximum | Notes |
|---|---|---|
| Shower | 41°C | Whole-body contact, and it's hard to step out quickly. |
| Washbasin | 41–43°C | 41°C is often used where hands are washed under running water. HSE care guidance refers to 43°C. |
| Bath | 44°C | Healthcare guidance quotes 46°C as the maximum for bath fill. Always check before anyone gets in. |
Our TMV compliance guide goes through where these figures come from in more detail.
TMVs alone aren't enough
A TMV is an engineering control, and a good one. But HSE is clear that homes should also have safe bathing procedures for residents assessed as vulnerable to scalding. In practice that usually means:
- Checking the water before every bath or shower, with a thermometer, not a hand or an elbow.
- Never leaving a resident alone while a bath is filling, if they're assessed as at risk.
- Training staff, including agency and bank staff, on the procedure and what to do if the water seems wrong.
- Reporting problems: a shower that runs hotter than usual, surges hot and cold, or has a weak flow should be reported and checked, not worked around.
Summer is a good time to refresh this. Holiday cover means more unfamiliar faces on shift, and new staff won't know which bathroom has the temperamental shower unless someone tells them.
Keeping the valves working
A TMV that's never tested is a guess. Valves drift, scale up and wear out, and the only way to know one still works is to measure it. That means checking the supply and mixed temperatures and doing the fail-safe test, where the cold is isolated to make sure the valve shuts down.
For care homes, six-monthly testing is a common starting point, with the interval adjusted based on results. HTM 04-01 is written for healthcare premises rather than care homes, but many homes follow its approach because it's practical. We've covered intervals in more depth in how often should TMVs be serviced?, and what to do when a valve fails in your TMV failed its fail-safe test.
Records matter too. If an inspector or your insurer asks how you manage scalding risk, a clear register of every valve, its location, its last test result and when it's next due answers the question in one go. Our asset registers page explains how we set those up.
A typical scenario
Imagine a home that's just taken over a neighbouring building to add a new wing. The original building has TMVs on every bath and shower, tested regularly. The new wing has old-style mixers on the basins and an unvalved bath in one en-suite. A sensible first step is to survey the new wing outlet by outlet, fit TMV3 valves where residents will be bathing or showering, assess the basins against the residents' needs, and bring everything onto the same register and test schedule before anyone moves in.
Where we come in
We test, service and install TMVs in care homes across the country, and we work around residents' routines so bathrooms aren't out of action for long. Have a look at how we work with care homes and other sectors, or see what's included in a TMV service.
Looking after a care home's valves?
Tell us how many beds and roughly how many TMVs you've got. We'll come back with a clear, fixed quote for testing and servicing.