How much does a legionella risk assessment cost for a care home?
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Key points
- Typical assessment cost: £400 to £900 for a care home, against £180 to £450 for a similar-sized office. The premium buys vulnerability-aware assessment, not extra pages.
- TMVs are the hidden cost centre. Every valve is a scald control that creates a legionella risk, and each one needs servicing on a schedule.
- CQC inspectors ask for the paper trail: risk assessment, written scheme of control, and recent monitoring records.
- The ongoing regime usually costs more per year than the assessment: monthly temperatures, quarterly TMV checks, shower head descaling, periodic sampling.
- The responsible person must be a named senior member of staff. The duty cannot be contracted out.
A legionella risk assessment for a care home typically costs £400 to £900, roughly double what an office of the same size would pay. The premium is not for the building; it is for the people in it and the valves on the pipework. Residents are the highest-risk group for Legionnaires' disease, and the thermostatic mixing valves that protect them from scalding turn every bathing outlet into a piece of plant that needs its own control regime.
What follows breaks down where the money goes, using a worked example, and which parts of the spend are one-off, which are annual, and which are the ones homes most often forget to budget for.
Worked example: a 40-bed residential home
Take a typical 40-bed home: en-suite rooms, two assisted bathrooms, a kitchen, laundry and sluice, one or two calorifiers, and TMVs on every bath, shower and assisted wash basin. That is easily 60 or more outlets and 25 or more TMVs.
| Item | Frequency | Typical cost |
|---|---|---|
| Risk assessment (survey and written report) | Every 2 years, or on change | £400 – £900 |
| Monthly temperature checks at sentinel outlets | Monthly | Often in-house; £0 if staff do it |
| TMV inspection and servicing | At least annually; often more frequent | Priced per valve × 25+ valves |
| Shower head descale and disinfection | Quarterly is common practice | In-house or per-visit charge |
| Calorifier inspection and temperature checks | Monthly checks, annual inspection | Usually inside the monitoring contract |
| Legionella sampling where the scheme requires it | As set by the written scheme | Per sample, lab fee; see testing cost breakdown |
The pattern to notice: the assessment is the smallest line. The recurring cost is the regime, and the regime is priced largely per valve and per outlet. A home that budgets only for the assessment has funded the map but not the journey.
Why TMVs drive the budget
A thermostatic mixing valve blends hot and cold water to a safe outlet temperature to prevent scalding, which is essential where residents may be frail, have reduced sensation, or cannot react quickly to hot water. But the blended water downstream of the valve sits squarely in the 20°C to 45°C range where legionella multiplies, and the valve itself collects scale and biofilm. Every TMV is therefore two things at once: a scald control you must have, and a legionella risk you must manage. See the scalding versus legionella balance and TMV servicing and legionella for the detail, and TMV2 versus TMV3 for which valve specification healthcare settings expect.
For costs, the consequence is simple: count your TMVs before you compare monitoring contracts, because a quote that looks cheap often services only a sample of valves, or services them annually when the written scheme says otherwise. Healthcare guidance expects hot water at 55°C at outlets within one minute upstream of the mixing point, and the valve regime has to evidence that the whole arrangement, hot side and blended side, stays under control.
What the CQC actually looks for
The CQC does not publish a legionella price list or demand a particular certificate. What inspectors expect is evidence that water safety is actively managed, and in practice that means three documents produced without prompting: the current risk assessment, the written scheme of control, and the recent monitoring records that show the scheme is being followed. A home with an expensive assessment and no monitoring records is in a weaker position than a home with a modest assessment and two years of signed, dated temperature logs in a log book.
Most care homes also work to HTM 04-01, the healthcare safe-water standard, which sits above HSG274 and brings expectations such as a water safety plan for larger providers. Our care homes guide covers the full duty picture.
Free legionella risk assessment template
A structured Word document following the five-step approach in ACOP L8. Covers risk identification, written scheme, monitoring, and records. If it isn't written down, you can't evidence it.
Follows ACoP L8 and HSG274 Part 2. Free. No spam.
How to keep the cost proportionate without weakening control
Three levers move the budget without touching safety. First, do routine monitoring in-house: monthly temperature checks and weekly flushing of little-used outlets are well within trained domestic or maintenance staff, and the temperature checker turns each reading into a pass/fail against the right threshold. Second, buy the assessment and the TMV servicing on competence, not price: a cheap assessment that misses the TMV register or the dead legs in a closed-off wing is the most expensive document in the building. Third, get the written scheme right once: if it correctly names every outlet, valve and frequency, the monitoring contract can be priced against reality instead of a contractor's worst-case assumption.
In a care home the assessment is the cheap part. The budget that matters is the regime: every TMV serviced, every sentinel outlet checked monthly, every flush recorded. Fund the journey, not just the map.
Use the cost calculator for an indicative figure for your home's size and system, and the monitoring schedule to sanity-check what any annual contract should contain before you sign it.
Free legionella risk assessment template
A structured Word document following the five-step approach in ACOP L8. Covers risk identification, written scheme, monitoring, and records. If it isn't written down, you can't evidence it.
Follows ACoP L8 and HSG274 Part 2. Free. No spam.
Frequently asked questions
How much is a legionella risk assessment for a care home?
A professional legionella risk assessment for a care home typically costs £400 to £900, depending on the number of beds, outlets, calorifiers and thermostatic mixing valves. That is the one-off survey and report. The ongoing control regime, monthly temperature checks, quarterly TMV servicing, shower head descaling and periodic sampling, is a separate annual cost that usually exceeds the assessment itself.
Why does a care home pay more than an office of the same size?
Three reasons. The residents are a high-risk group, so the assessment has to be more thorough and the tolerance for weak controls is lower. The water system is more complex, with TMVs on bathing outlets, assistive bathing equipment and stored hot water serving many bathrooms. And the CQC expects providers to demonstrate active water safety management, so the assessment has to stand up to inspection, not just exist.
Does the CQC require a legionella risk assessment?
The CQC does not name a specific document, but it expects registered providers to manage health and safety risks effectively, and water safety is part of that. In practice inspectors routinely ask to see the risk assessment, the written scheme of control and recent monitoring records. A home that cannot produce them will struggle to demonstrate it is managing the risk, whatever its rating in other areas.
How do thermostatic mixing valves affect the cost?
TMVs are the main reason care-home water hygiene costs more to run than to assess. Every bath and shower feeding vulnerable residents needs a TMV to prevent scalding, and each valve blends water down into the temperature range legionella grows in. The valves need regular inspection and servicing, typically at least annually and often more frequently in healthcare, and each one adds to the monitoring contract price.
Can care home staff do the legionella checks themselves?
Routine monitoring such as monthly temperature checks and weekly flushing can be done in-house by trained staff, and many homes do exactly that. The risk assessment itself and TMV servicing are usually contracted out, because the assessor must be demonstrably competent and TMV work needs the right training and parts. The named responsible person should be a senior member of staff, not the contractor, because the duty under ACOP L8 cannot be contracted out.
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