COSHH Training for Care and Healthcare Settings

Care and healthcare settings use hazardous substances every day, from surface disinfectants and laundry chemicals to clinical waste and the water systems that can harbour legionella bacteria. The Control of Substances Hazardous to Health Regulations 2002 (COSHH) is the UK law that sets out how employers must identify, assess and control these risks, and COSHH training is how care staff learn to work with these substances safely as part of their everyday duties.

For care providers, COSHH is not a one-off paperwork exercise. It sits alongside related obligations such as infection prevention and control and feeds directly into wider staff development, which is why many providers build it into their CPD training programmes rather than treating it as a standalone induction task.

What is COSHH?

COSHH stands for the Control of Substances Hazardous to Health Regulations 2002, the UK regulations made under the Health and Safety at Work etc. Act 1974 and enforced by the Health and Safety Executive (HSE). COSHH requires employers to control substances that are hazardous to health and to stop them causing harm to employees, and it applies to almost every UK workplace where chemicals, dusts, fumes, vapours, or certain biological agents are present, including care homes, domiciliary care, and healthcare settings.

In Ireland, there is no direct equivalent to COSHH by name, but employers carry analogous duties to identify and control chemical and biological hazards under the Safety, Health and Welfare at Work Act 2005 and its associated chemical agents regulations. Irish care providers should check current guidance from the Health and Safety Authority (HSA) for the specific regulatory detail that applies to their service.

What counts as a hazardous substance in a care setting?

Care and healthcare environments are full of substances that fall within COSHH's scope, even where staff may not immediately think of them as "chemicals". Common examples include:

• Cleaning chemicals and detergents used for general environmental cleaning
• Disinfectants and sporicidal products used for infection control, including concentrated products that require dilution
• Certain medications and pharmaceutical products that are hazardous to handle or that create hazardous waste
• Clinical and offensive waste, including sharps and contaminated dressings
• Biological agents, including legionella bacteria found in poorly maintained water systems

Legionella is an important and sometimes overlooked example. Because it is a biological agent that can cause serious illness through inhalation of contaminated water droplets, HSE guidance confirms that managing legionella risk in water systems is itself a COSHH duty: providers must carry out a suitable risk assessment of hot and cold water systems, identify who could be affected, and put in place control measures such as temperature control and regular monitoring. Staff who work in settings with showers, water outlets, or infrequently used taps benefit from dedicated legionella awareness training alongside general COSHH training, since the two topics overlap directly.

The employer's core duties under COSHH

HSE guidance sets out a clear sequence of duties that employers must follow for any hazardous substance used in the workplace. In a care setting, these translate as follows:

• Assess the risk. Identify which substances are used or produced, how staff might be exposed, and who is at risk, then record this as a COSHH risk assessment.
• Prevent or adequately control exposure. Where a hazardous substance cannot be eliminated or substituted for a safer alternative, exposure must be adequately controlled to protect staff, residents, and visitors.
• Ensure control measures are used and properly maintained. Equipment such as extraction systems, storage cabinets, and PPE only work if they are used correctly and kept in good working order.
• Monitor exposure where relevant. Some substances and environments call for exposure monitoring or health surveillance to check that controls remain effective.
• Plan for accidents, incidents, and emergencies. This includes clear procedures for spillages, needlestick or sharps injuries, and other foreseeable incidents.
• Provide information, instruction, and training. Staff need to understand the risks of the substances they work with and how to use control measures correctly, which is the core purpose of COSHH training.

Practical control measures in care settings

Good COSHH management in a care environment is usually a combination of simple, practical measures rather than complex engineering solutions. These typically include:

• Safe storage of cleaning chemicals in locked or access-controlled areas, away from residents and visitors, and never decanted into unlabelled containers
• Appropriate personal protective equipment (PPE), such as gloves and eye protection, selected to match the specific substance being handled
• Safe systems of work for tasks such as diluting concentrated chemicals, handling clinical waste, and dealing with bodily fluid spillages
• A COSHH data sheet (safety data sheet) and a specific risk assessment for each hazardous substance in use, kept accessible to staff who use it
• Clear labelling of all containers and colour-coded systems for cleaning equipment and waste streams
• Regular review of risk assessments when a new product, task, or piece of equipment is introduced

Why COSHH training matters for care staff

Many care roles involve regular, hands-on contact with cleaning products and clinical waste as a routine part of the working day, whether that is a healthcare assistant cleaning equipment between residents, a domiciliary care worker using disinfectant in someone's home, or a nurse handling sharps and pharmaceutical waste. Without proper training, staff may not recognise which products need PPE, how to store or dilute chemicals safely, or what to do if an incident such as a spillage or accidental exposure occurs.

COSHH training also supports the wider safety culture expected in regulated care services. Where a COSHH-related incident does occur, it should be captured and reviewed through the provider's standard processes for incident investigation and documentation, so that lessons are learned and control measures are strengthened rather than repeating the same failure.

CQC relevance: Regulation 12 and Regulation 15

For providers regulated by the Care Quality Commission (CQC) in England, COSHH compliance is directly relevant to two fundamental standards. Regulation 12 (Safe care and treatment) requires providers to assess risks to the health and safety of people using the service and to do all that is reasonably practicable to mitigate them, which includes the safe management of hazardous substances and medicines. Regulation 15 (Premises and equipment) requires that premises and equipment used by the service are clean, secure, suitable for the purpose, properly used, and properly maintained, which links directly to safe storage of chemicals and well-maintained water systems. Demonstrating strong COSHH practice also supports the wider evidence base for good governance, which is covered in more detail in this overview of CQC Regulation 17 and good governance.

Frequently Asked Questions

Does COSHH apply to care homes and domiciliary care?

Yes. COSHH applies to any UK employer where staff may be exposed to hazardous substances, and this includes care homes, supported living services, domiciliary care, and healthcare settings that use cleaning chemicals, disinfectants, certain medications, or generate clinical waste.

Is legionella covered by COSHH?

Yes. Legionella bacteria are a biological agent, and HSE guidance confirms that managing legionella risk in hot and cold water systems is a COSHH duty. Employers must carry out a suitable risk assessment and put in place controls such as temperature management and regular monitoring.

How often should COSHH risk assessments be reviewed?

COSHH risk assessments should be reviewed whenever circumstances change, such as a new product, process, or piece of equipment being introduced, and periodically as part of routine review, to ensure control measures remain adequate and effective.

Does COSHH replace the need for infection control training?

No. COSHH and infection prevention and control are related but distinct. COSHH governs the safe handling of hazardous substances, while infection prevention and control focuses on stopping the spread of infection; care staff typically need training in both areas.

COSHH training gives care and healthcare staff the practical knowledge they need to handle hazardous substances safely, from everyday cleaning products to legionella risk in water systems, while helping providers meet their legal duties and CQC expectations. Building it into a structured CPD programme ensures the knowledge stays current as products, equipment, and regulations evolve.