CANINE HYDROTHERAPY ASSOCIATION

pg. 1 © CHA Quality Standards V2.3 062021

CANINE HYDROTHERAPY ASSOCIATION

Quality Standards

October 2021

Version 2.4 062021


INDEX 1 Introduction 2

2 Becoming a Member 4

2.1 Criteria for membership

2.1.1 Qualified Animal Physiotherapist, Veterinary Surgeon or Veterinary Nurse

2.2 Other Regulations

2.3 Categories of Membership

2.4 Application Process

2.5 Multi Centres

3 Existing Members 7

3.1 Continual Professional Development (CPD)

3.1.1 Policy Statement

3.1.2 Purpose

3.1.3 Benefits

3.1.4 Requirements

3.1.5 Standards

3.1.6 Audits

3.1.7 Sanctions

3.1.8 Other – Cancelled CPD, registering as non-practicing and avoiding CPD

3.1.8.1 Cancelled CPD

3.1.8.2 Registering as non-practicing

3.1.8.3 Avoidance of CPD

3.1.9 External CPD (Category 1)

3.1.10 Internal CPD (Category 2)

3.2 First Aid

THE STANDARDS

4 Veterinary Liaison & Consent 11

4.1 Consent Forms

4.2 Vaccinations

4.2.1 Unvaccinated animals

5 Treatment Methods 12

5.1 Due Care and Attention

5.2 Treatment Sessions

5.2.1 Treatment Records

5.2.2 Treatment Times

5.2.3 Session cut short

5.3 Veterinary Reporting

5.3.1 Initial Hydrotherapy Assessment

5.3.2 Veterinary Progress Report

5.3.3 Repeat Consent Form

5.4 Documentation Retention Periods

6 Water Quality Management 14

6.1 UK Legislation Requirements

6.2 Risk to Service users & Staff

6.2.1 Duty to minimise the risk to service users & Staff

6.2.2 Legionnaires Risk Assessment

6.2.3 Material Safety Data Sheets (MSDS)

6.2.4 The Personal Protective Equipment (PPE) Regulations 2002

6.2.5 Safe Storage of Chemicals

6.3 Emergency Procedures – Action Plan

6.4 Water Testing


6.4.1 Sanitisers

6.4.2 Water Testing Equipment

6.4.3 Water Quality Levels and Ranges

6.5 Water Temperatures

6.6 Monthly UKAS Testing

7 Equipment Specifications & Safety 18

7.1 Requirements

7.2 CHA Recommended Equipment

7.2.1 Hoist Slings

7.2.2 Floatation Jackets

7.2.3 Restraint Harnesses

8 Normal Operating Procedures 19

8.1 Health & Safety

8.2 Emergency Procedures

8.2.1 Requirements

9 Centre Insurance 20

9.1 Requirements

10 Inspection & Certificates 21

10.1 Inspections

10.2 Membership Certificates

10.2.1 Staff within the centre

10.3 Adding an additional member to the team

10.4 Reporting a long-term absence

10.5 Member returning to work or leaving the centre

11 Website & Social Media

12 Renewal Procedure 22

13 Version Control 22


1. Introduction

The Canine Hydrotherapy Association (CHA) is striving to raise and regulate the quality, standard and consistency of canine hydrotherapy in the UK.

The need for regulation is twofold; firstly, there exists a real threat that unless the industry regulates itself, in time regulation will be forced upon it. Secondly, there are commercial benefits to be attained through regulated

quality and standards, with both the insurance and veterinary professions having a method of identifying those centres with which it is safe to work. The CHA is committed to promoting its member centres and the use of canine hydrotherapy by regulated CHA members to dog owners, veterinary surgeons and others to aid greater understanding of the use of hydrotherapy for canine welfare and to that end we may release members' relevant information where appropriate so to do.

All centres wishing to hold CHA membership, and all individuals working within those centres, will have to comply with the quality standards detailed within this document. In order to add extra weight and credibility to these standards. Centres will be inspected as part of the membership application process and from time to time

thereafter.

The quality standards detailed in this document are in no way intended to replace or amend any legislative requirements.

2. BECOMING A MEMBER

2.1. Criteria for membership

The Canine Hydrotherapy Association represents most hydrotherapy centres in the UK and welcomes new members who are currently operating or imminently opening a canine hydrotherapy centre and formally agree to abide by the Quality Standards set by the CHA.

Every centre must have at least one operative holding a minimum Level 3 Certificate in Hydrotherapy for Small Animals on the Qualifications and Credit Framework (OCN Midlands, ABC or OCNLR).

From October 2019 any new application for a centre where an underwater treadmill is used at least one qualified operative must have undertaken and achieved additional Advanced treadmill qualifications. On the old ABC framework (prior to 2020) this may have formed part of your Diploma or you may have undertaken the Advanced Treadmill theory and practical modules. For OCNLR, OCN Midlands and the new ABC qualifications this now forms part of their L4 Awards.

All new centres open for less than 12 months are required to undertake an Individual Assessment Day

(IAD) with CHA nominated assessors (Depending on number of staff at the centre, this may need to be split over 2 days). We no longer accept IAD’s from training providers. Where the new applicant’s nominated operative has recognisable length and evidence of experience specific to canine hydrotherapy, they may be exempt from completing the IAD’s. At application stage additional information will be requested to identify if an IAD is required or not and membership will also be subject to a satisfactory centre inspection. All other regulations (2.2) will still apply.

2.1.1 Qualified Animal Physiotherapist, Veterinary Surgeon or Veterinary Nurse

For Veterinary professionals who have already obtained small animal qualifications they should liaise with their course provider regarding APL/RPL (approved prior learning) as they may be offered APL/RPL to complete the Level 3 qualification in Hydrotherapy for Small Animals on the Qualifications and Credit Framework. For membership with the CHA the current minimum qualifications from such professionals will be:

✔ Veterinary/Nursing/Physiotherapy Degree ✔ Introduction to Hydrotherapy ✔ Water Management


✔ Small Animal First Aid – Physiotherapist only ✔ Treadmill therapy – Where operating a UWT

In all cases, two IAD’s will be required where the applicant is not sufficiently and specifically experienced in canine hydrotherapy. All other regulations (2) apply.

I've had a look through and there are a couple of points we would suggest for feedback and potential

reconsideration at the next qualification review:

Veterinary Physiotherapists (additional information)

The Level 4 Certificate in Canine Hydrotherapy for Veterinary Physiotherapists (OCN London) is accepted as membership to the CHA where this has been undertaken by suitably qualified Veterinary Physiotherapists (ie, those who have undertaken a Degree, Post Graduate Cert/Diploma or MSc at a recognised UK University).

As an association, we would not require suitably qualified Veterinary Physiotherapists to undertake the following Ofqual Units: Y/618/7226 Orthopaedic referrals for Canine Hydrotherapy and D/618/7227 Spinal and Neurological Conditions for Canine Hydrotherapy as these conditions are assessed and covered in more depth

as part of Level 6/7 Veterinary Physiotherapy qualifications. Please speak to your training provider directly regarding this.

2.2. Other regulations:

⮚ All qualified operatives will be required to directly supervise the methodology and practice of all trainee/assistant Hydrotherapists and never allow them to work unsupervised

⮚ All qualified operatives will be required to complete a minimum of 25 hours continual professional development per annum of which 12 hours must be external CPD, I.e. Courses, conferences, lectures etc

⮚ The nominated CAT A retains overall responsibility for the actions of all its employees and events occurring at the centre.

⮚ All centres will receive an initial inspection

⮚ All centres will receive an annual remote audit to ensure 25 hours CPD completed, First Aid certificate validity, Monthly bacteria testing completed, valid centre insurance in place. Failure to evidence will result in

membership being revoked

⮚ All centres will receive annual website and social media audits to ensure only quality hydrotherapy treatment is being delivered and in a safe manor

⮚ Triennial (once every three years) audit of client paperwork and centre which may be a remote or drop in audit.

2.3. Categories of membership:

When applying for membership you will be required to identify the team into the following categories:

CAT A This member takes full responsibility for the centre and ensures the team are working within the CHA Quality Standards

CAT A-NP This member takes full responsibility for the centre and ensures the team are working within the CHA Quality Standards however are not qualified and will not

be allowed to provide hydrotherapy treatment

CAT B Qualified Hydrotherapist

CAT SA-S Student member (actively studying and working towards recognised hydrotherapy qualification). Unable to treat dogs unless directly supervised by a CAT A Qualified or CAT B member.

CAT SA-A Associate member (any other member not qualified in hydrotherapy and not

studying toward a Hydrotherapy qualification).


2.4. Application process

Once you are happy your centre meets the above qualification criteria and you have identified the categories of membership, you can request a centre membership application form via the “Why Join the CHA” page of the CHA website. Once the membership application form has been completed it must be emailed back to [email protected]

Centre open for more than 12 months will also need to submit the following:

● Water records for the last 2 weeks

● Select 4 current client files and scan and submit: o Vet Consent Form o Clinical Reasoning session notes o Vet reports

An application fee will be invoiced at the stage. All listed pending members will have a Skills+ account set up for them. Once set up the applicants will be responsible to upload the following documents on to the system for endorsement.

CAT A Centre Details

● Centre Insurance Documents: o Public Liability o Professional Indemnity o Employers Liability – Where more than 5 staff members

● Monthly Bacteria Testing reports

● Photographs of Pool/Spa/Treadmill where applicable

Qualifications

● First Aid – L3 First Aid certificate ● All L3 Hydrotherapy Qualifications

CPD

● Development plan for the next 12 months

CAT A-NP Centre Details

● Centre Insurance Documents: o Public Liability o Professional Indemnity o Employers Liability – Where more than 5 staff members

● Monthly Bacteria Testing reports

● Photographs of Pool/Spa/Treadmill where applicable

Qualifications

● First Aid Exemption – Student or Associate depending on status

CAT B Qualifications

● First Aid – L3 First Aid certificate

mailto:[email protected]


● All L3 Hydrotherapy Qualifications

CPD

● Development plan for the next 12 months

CAT SA-S Qualifications

First Aid Exemption – Student

Development plan for the next 12 months

CAT SA-A Qualifications

First Aid Exemption – Associate

Development plan for the next 12 months

Once all the above has been loaded and endorsed a centre inspection & IAD day will then be arranged. A Board/Committee member will attend the inspection and ensure that all Quality Standards are in place and are being applied throughout treatment.

A decision will then be made:

⮚ Accept membership

⮚ IAD day required

⮚ Mentoring program required for a set period of time

A detailed inspection report will be provided and uploaded onto the Skills+ centre details.

⮚ Re-inspections in the event of a failed inspection will be chargeable at the current rate and payable before the reinspection takes place.

Where an IAD day or mentoring is required membership will be placed on hold until such time as the Board

agrees that the centre now meets the standard set by the CHA.

Once membership has been approved and all membership fees have been paid a centre certificate will be issued detailing all staff working within the centre and at what level they can work at.

2.4. Multi Centres

Where a CAT A owns or is responsible for more than one centre, they can apply for membership for each centre and identify all staff working within each centre via separate application forms. A joining fee will apply to each centre however the CAT A will only be invoiced for one membership fee once membership has been granted. Membership will be suspended for all centres if any of the centres are in breach of the Quality Standards as it is believed the same standard will apply across all. To prevent this happening the alternative option is to appoint a separate CAT A for each centre and to pay the appropriate membership fees.

3. EXISTING MEMBERS

All centre members must have completed 2. Becoming a Member above and all centre members must have at least one fully qualified practitioner holding a minimum Level 3 Certificate in Hydrotherapy for Small Animals on the Qualifications and Credit Framework including a Level 3 Treadmill module where a treadmill is present.

All hydrotherapists employed within the centre are to work and be trained under the guidance of this member of staff and this fully qualified practitioner must have direct supervision within the treatment room.

To maintain centre membership all qualified members must ensure the following is complied with;


3.1 Continual Professional Development (CPD)

3.1.1 Policy Statement

The Canine Hydrotherapy Association are are striving to ‘raise and regulate the quality, standard and

consistency of canine hydrotherapy in the UK’ and therefore are fully committed to encouraging and supporting members to improve their knowledge and skills and skills through study or training to facilitate an improved service to the animals and owners using them.

As the new minimum standard for membership is the Level 3 29 credit (equivalent to half an A level), the CHA need ensure our CPD is of such quality that any external regulator would recognise and welcome the high standards required. Recognising this can lead to increased public confidence in individual professionals and their profession as a whole.

3.1.2 Purpose

The purpose of Continued Professional Development (CPD) is to ensure that operators of canine hydrotherapy centres have the latest relevant skills and knowledge in order to provide the best, safest and most effective treatment. Well planned and executed CPD ensures that individuals maintain and enhance the knowledge and skills they have in order to deliver a professional and safe service with benefits to the individual, their clients and

the public.

3.1.3 Benefits

Planning and undertaking regular and appropriate CPD assists you in managing your personal development throughout your career. The primary function is to help you to identify, record, review and reflect on your own

learning. This is necessary to identify your own personal strengths and gaps in your skill set and capabilities which you can then address through your development plan. CPD should be seen as a career lifelong learning plan.

3.1.4 Requirements

The CPD year runs from October 1st – September 30th. All qualified members* are required to complete and upload 25 hours CPD annually, of which 12 hours must be external (Catergory 1 – see 3.1.9 External CPD). This requirement is regardless of contracted working hours.

*This has been extended to include all Cat SA – Student and Cat SA Associates

Students can evidence CPD through working towards their qualification, for example providing evidence of completed assignments/units, feedback from completed assignments, or an email from the course provider confirming completion of units within the CPD period.

Exceptions to the above are:

⮚ New members whose inception falls outside of the renewal period. In which case the requirement may be considered on a pro-rata basis.

⮚ Members who have taken a career break and or maternity/paternity leave. Such members will be

required to undertake some CPD and submit the following:

⮚ A Development plan for CPD for the year ahead

⮚ A letter from the relevant Category A member detailing the following: 1) Whether the member utilised KIT days - dates and times are required


2) What provision was made for re-induction into the working environment and updating the member of

current developments/advancements

3) The number of hours the member has worked under direct supervision until they were deemed

competent by the Centre owner to safely undertake treatment without supervision.

3.1.5 Standards

Agreeing to abide by the CHA’s Quality Standards (QS) as a member makes CPD requirements mandatory and the CHA can remove members who fail to meet these standards which impacts the centre as all staff must work within QS:

⮚ 25 hours of CPD must be undertaken

⮚ 12 hours must be Category 1 (external) CPD

⮚ Ensure that CPD contributes to enhancing your skills and knowledge needed to deliver a professional, quality and safe service to your practice.

⮚ Ensure CPD is directly relevant to improving your knowledge and experience within hydrotherapy

⮚ Maintain a continuous record of CPD by uploading on to skills+ throughout the year and in a timely manner, prior to renewal*

⮚ Ensure a development plan and critical reflection of CPD has been uploaded

Failure to upload all CPD throughout the year may result in a delay to your renewal being issued. It is the Category A member’s responsibility to support, encourage and ensure their team have participated in, completed and submitted appropriate CPD which meets standards outlined above. Failure of any member to achieve the desired and appropriate standards will result in immediate suspension of membership for the Centre to which the member is linked. These are outlined in Section 7 Sanctions.

It is members and centre owner’s responsibility to maintain up to date and appropriate CPD records. Your CPD

should reflect a range of activities. You should undertake a varied range of different CPD, repetitive CPD will not be accepted. *

Giving lectures on the same topics multiple times will not qualify as CPD as this will not develop your skills or knowledge.

3.1.6 Audits

All members CPD will be audited annually to ensure our requirements are being met. You will have 30 days from the 1st October to ensure all CPD evidence is loaded into Skills+. Members will be notified if the CPD does not fit within the CHA CPD policy.

3.1.7 Sanctions

⮚ Failure to submit FULL CPD records throughout the year Where members have not submitted and updated records throughout the year (but have submitted all required hours prior to renewal) to be endorsed, a delay can be expected in the process of their renewal, the centre to which they belong and any associated members. This delay will depend on the number of fully compliant renewals received at the time.

⮚ Failure to submit FULL CPD records prior to renewal In instances where members may have completed appropriate CPD (from Oct 1st to Sept 30th in the appropriate CPD year) and have not uploaded full evidence before renewal, an immediate suspension will be enforced

and a fine allocated. The centre/member will then be given 5 working days from the date of renewal to upload FULL CPD records, supporting evidence and to call/email the CHA to confirm this. Please note that this evidence must be that which was undertaken prior to renewal. An administration fee combined with a fine totaling £50


per non-compliant member will also be required. A delay can be expected in the process of the renewal for the

centre and any associated members. This delay will depend on the number of fully compliant renewals received at the time.

⮚ If a member does not fulfill the requirements of CPD Any member who does not fulfill the requirements of CPD or this policy will prevent members (and their associated centres) from renewing their membership (if an audit is undertaken and the member fails, the member will also be suspended immediately).

Suspended members and centres will be able to re-apply for membership after a period of 6 months from the date of contravention of this policy. A suspended centre must submit the following on re-application per member:

⮚ A £50 administration fee in addition to their re-application fee.

⮚ Evidence of completion of 25hours CPD during the period of suspended membership (previous 6 months).

⮚ A development plan for the CPD year ahead.

3.1.8 Other – Cancelled CPD, registering as non-practicing and avoiding CPD

3.1.8.1 Cancelled CPD

Any member who has booked onto a CPD event which is subsequently cancelled must book another CPD event within the CPD year. If the event is cancelled within 2 months of renewal, the CHA must be notified in advance

and an alternative CPD event booked to fulfil the requirement of 25 hours.

3.1.8.2 Registering as non-practicing.

Any Category A member who has registered as non-practicing for the avoidance of submitting CPD will be immediately suspended pending disciplinary procedures highlighted in Section 7.

3.1.8.3 Avoidance of CPD

Any member found to be actively pursuing ways to avoid appropriate CPD, or de-valuing CPD will be found to be in breach of this policy and disciplinary procedures will apply.

3.1.9 External CPD (Category 1)

Members are required to undertake a minimum of 12 hours external CPD. This should be relevant to improving your clinical practice in hydrotherapy.

⮚ Shadowing other professionals not connected with your centre – i.e. you evidence working alongside another professional outside of your normal place of work

⮚ Attending face to face courses/workshops/seminars

⮚ Further education

⮚ Higher Education

⮚ Distance learning (where certificates of achievement and attendance are given)

⮚ First Aid Refresher courses In exceptional circumstances the CHA may pre-approve other courses which are directly related to hydrotherapy and fulfill our criteria.

This list is not exhaustive, if any members are unsure, they should seek advice from the CHA board. The CHA recommends planning your CPD in advance and to use this as an opportunity to secure appropriate CPD throughout the year.


3.1.10 Internal CPD (Category 2)

Members are required to undertake a maximum of 13 hours internal/self-directed CPD.

⮚ Learning by doing

⮚ Case studies

⮚ Reflective practice

⮚ Reviewing articles

⮚ Researching/planning course lectures*

⮚ Writing articles

⮚ Reading books/articles

⮚ Learning via TV, internet or Webinars Researching and planning delivery of NEW content can be submitted on one occasion only and must be supplemented with the relevant research undertaken to complete this.

Teaching, lecturing and delivery of any formal or informal course is NOT considered CPD – please do not submit this as it will be rejected.

Webinars are Internal CPD, if a member thinks a particular Webinar is suitable to stand as External CPD, they can email the education department for confirmation of this.

This list is not exhaustive, if any members are unsure, they should seek advice from the CHA board. The CHA recommends planning your CPD in advance and to use this as an opportunity to secure appropriate CPD throughout the year.

3.2 First Aid

During treatment times there must be at least one qualified person in attendance who has attended a *CHA approved first aid revision course within the last 2 years. First aid must be refreshed every 2 years and new certificates must be immediately loaded onto Skills+ with the correct 2 year expiry date set.

*CHA approved refresher courses are those specifically offered by training establishments providing Level 3 (or

above) hydrotherapy courses and/or the Galen First Aid Refresher & Pet Owners First Aid.

This condition does not apply if the centre is run by a veterinary practice and there is a qualified practicing veterinary nurse or veterinary surgeon in attendance.

We do not accept third parties delivering First Aid on behalf of a training establishment unless this is organised directly with the establishment at their normal premises, .i.e. a company/individual employed to deliver First Aid for a training provider cannot themselves claim to be CHA Approved in relation to delivering first aid outside that of the needs of the training establishment.

4. Veterinary Liaison & Consent

All dogs are to be accepted with veterinary consent only; this includes those dogs attending for purely recreational purposes.

Purpose

⮚ An accurate diagnosis of any condition being treated is known, together with details of any treatment, surgical procedure or medication that has been undertaken or administered to the dog.

⮚ The dog’s veterinarian has the opportunity to pass on any areas of danger or caution.

⮚ A qualified veterinary surgeon has deemed that the dog’s general state of health is such that it is safe for the animal to undergo hydrotherapy.

⮚ It is established whether the dog is up to date with their vaccinations at the time of treatment.

⮚ The dog’s veterinarian is kept informed of the progress of any dog undergoing hydrotherapy treatment.

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4.1 Consent Form

As a minimum the referral must include, but not be limited to: -

⮚ The name and address of the client.

⮚ The name and details of the dog.

⮚ The name and address of the consenting vet/practice.

⮚ Diagnosed condition of the dog.

⮚ Details of any veterinary treatment or surgical procedure undertaken or administered.

⮚ Any areas of concern.

⮚ Any medication currently being taken by the dog

⮚ Expiry date on vaccination certificate where known

⮚ A signed declaration that the veterinarian believes the dog to be of suitable overall state of health to undertake hydrotherapy.

4.2 Vaccinations

All dogs are to be treated with an in-date vaccination certificate. For those dogs whose owners prefer to use alternative vaccination protocols treatment may only be given with the use of the following caveat:

4.2.1 Unvaccinated animals

All clients must be made to sign the attached or similar disclaimer prior to any treatment taking place within the centre.

Disclaimer for unvaccinated animals

I confirm I have been advised that due to the level of patients undergoing treatment at this hydrotherapy centre my unvaccinated dog is at risk particularly from Parvo virus, leptospirosis, distemper and hepatitis/adeno virus. I accept that whilst every effort is made to maintain· good hygiene this centre cannot be held responsible if for

any reason my dog contracts any such virus or disease.

Signed..............................................................................................· Date...............................

Owner of:..................................................................................

5 Treatment Methods

Once section 4 is complete and has been received treatment can commence.

5.1 Due care and attention

Centres and individuals involved in the hydrotherapy treatment of dogs operate showing due care and attention to the animal, taking into account the age and condition of each individual dog

At all times an animal undergoing treatment is under the direct supervision of the hydrotherapist.

⮚ The hydrotherapist must be in the pool at all times with each patient and the use of "fixed anchorage systems" (e.g. tri ropes) in the pool are no longer permitted.

⮚ A Hydrotherapist is permitted to be outside of the treadmill only in exceptional circumstances and where

the justification has been clinically reasoned prior.

Multi Dog Swimming


Only one animal is to be treated in the hydrotherapy pool or water treadmill at any time. The practice of multi

dog therapy is banned, irrespective of whether the animal is attending for rehabilitation treatment or ‘fun & fitness’. This applies to all members regardless of pool or treadmill size or if the patients are from the same family even if you have more than one therapist in the treatment room. For clarification: at no time will any of our members be allowed to have more than one animal in the pool or treadmill.

If "same family" dogs remain in the treatment room then a risk assessment must have been undertaken as to whether their presence could be detrimental to the therapy session being conducted. If they do remain then appropriate measures must be taken to ensure these dogs are under control at all times.

Swimming Dogs Using a Pole Restraint or long line restraint

The use of a pole attached to a collar, restraint harness or floating device is banned. The use of a long line/lead attached to a restraint harness or collar in the pool is banned. Swimming Dogs using a pole/restraint: Therapists should practice safe hydrotherapy and as such should not treat alone where they are unable to control the patient in the water. The use of any form of lead/long line attached to the animal patient in any way

(including collar, harness or floating device) during swimming is prohibited. Where assessing protraction, retraction and flexion and extension through joints is restricted for any animal patient clinically reasoning and best practice requires two therapists to safely treat the animal patient. Treadmill: Use of a lead is permitted for safe entry and exit into the treadmill and for motivational purposes only and

should not be used as a form of restraint during treatment.

Secondary Drowning

Secondary drowning has been highlighted as a risk by a number of practitioners within our field, primarily by the use of SOFT water toys that have the capacity to hold water within them (very often the "favourite" toys brought in by the owner, e.g. teddies and the like) and as such soft water toys are banned. Although less so, a slightly smaller risk is still present with non-absorbent toys if the dog bites down into the water line and ingests water whilst so doing. There are, however, plenty of excellent, purpose made aquatic toys on the market and common

sense should prevail.

All toys must be fit for purpose, in good condition and any risks highlighted should be managed to provide a safe environment for patients. Every hydrotherapist and hydrotherapy centre has a duty of care to its patients and must carry out a risk assessment with each patient and toy they propose to use. Whilst this risk assessment does not have to be a formal written one for each dog, hydrotherapy centres may find it beneficial to have a written protocol for such practice. The CHA recognise that toys can on occasion be used to motivate patients. CHA advise that toys should not be picked up from the water line by patients.

5.2 Treatment Sessions

Purpose

An audit trail of each treatment session and progress is kept retained on file and available for inspection for a minimum period of 5 years from the date of the last session.

5.2.1. Treatment Records

As a minimum, treatment records must include but not be limited to:

✔ Name of owner.


✔ Name, breed, sex & age of dog. ✔ Description of condition being treated. ✔ Initial assessment of the dog including: current diet, weight, daily exercise/ home environment, static assessment/palpation, movement assessment, goals and objectives. ✔ Date & time of session. ✔ Whether spa is used. ✔ Method of entry into pool. ✔ Duration of hydrotherapy, including time and power of anti-swim jets if used. N.B Number of laps in a pool is not adequate. ✔ Relevant comments and observations, such as: range of movement to an affected limb, muscle bulk measurements, lameness scores, gait analysis, etc.

5.2.2 Treatment Times

General guidance would suggest that the “aerobic exercise” content of initial treatment times should not exceed 2 minutes and such exercise should be increased conservatively over subsequent sessions, i.e. times should not be “doubled up”.

However, there may be times when the aerobic exercise content could exceed these guidelines and timings should be based on:

✔ an individual basis; ✔ the initial assessment; ✔ muscle fatigue; ✔ gait patterning; ✔ surgical procedures ✔ individual ability

In such cases clear documentation of the clinical reasoning behind the treatment must be kept.

In general dogs should not swim or treadmill for more than 5 minutes without a rest period and clear documentation must be kept as to the clinical reasoning for exceeding this guideline. If a complaint were to be

received by the CHA regarding treatment times this may lead to a disciplinary procedure and you would be required to clinically reason with the CHA Board why your times exceeded these guidelines.

5.2.3 Sessions cut short

In all cases where a dog appears to become distressed during treatment, treatment should be stopped immediately, the dog assessed and where necessary veterinary assistance obtained, and the event must be

documented in detail within your treatment records including any advice given to the client. An email or telephone call should be made to the vet the following day to check on the dog’s wellbeing. Where deemed necessary Veterinary consent must be obtained again prior to treatment commencing. See 7.2 Emergency Procedures

5.3 Veterinary Reporting

5.3.1 Initial Hydrotherapy Assessment

This must be sent to the consenting veterinary practice post initial assessment and must include details of your initial observations and your clinical reasoning for treatment and your hydrotherapy treatment plan.


5.3.2 Veterinary Progress reports

Feedback on the dog’s progress should be sent to the veterinarian as a minimum every 12 sessions unless there is a concern which must be reported back to the consenting vet immediately.

For long-term treatment/maintenance patients’ feedback should be sent to the veterinarian when deemed suitable by the practitioner, but at least every 6 months.

At patient discharge a final report must be sent to the veterinarian detailing the treatment plan undertaken and

findings.

5.3.3 Repeat Consent forms

For long-term treatment/maintenance patients’ a new consent must be obtained every 6 months.

Where a new/different condition is diagnosed and/or a new veterinary treatment or surgical procedure has been

undertaken or where there is a deterioration or change in the patient’s condition a new consent form must be obtained prior to commencing hydrotherapy and a new treatment plan prepared and reported on.

5.4 Documentation Retention Periods

Veterinary referrals must be retained on file and be available for inspection for a minimum of 5 years after the last hydrotherapy session has occurred and in accordance with General Data Protection Regulations (GDPR)

https://www.gov.uk/government/publications/guide-to-the-general-data-protection-regulation

6. Water Quality Management

The operative who has achieved the Level 3 (or above) qualification in Water Management and who is overseeing treatments in the centre must always be easily contactable during treatments.

Purpose

⮚ Pools and any other water-based environments used in the hydrotherapy treatment of dogs are clean, safe and conducive to the well-being of patients, clients and staff (temporary and permanent).

⮚ The water in which dogs are treated is safe from bacteria, virus and harmful micro-organisms.

⮚ The level of chemical used to sanitise the water is kept to acceptable levels in order to minimise the chance of causing adverse effects to the dogs, owners and those working in centres.

⮚ The water is regularly checked using accurate means of measurement, i.e. either a photometer or comparator.

6.1 UK Legislation Requirements

Members and operatives have a duty of care to ensure a safe environment for all users.

The CHA follows the national guidelines set out by PWTAG in their document "Swimming Pool Water" (ISBN 0951700766) for best practice and the relevant UK legislation. It is fully understood that these are aimed at humans; however much still applies as clients and staff are exposed to the aquatic environment and, as such, will be used to provide the underpinning guidance.

UK legislation states that pools (which will include UWTM and spa's) should be managed in accordance with the Health and Safety at Work regulations 1999 amongst others. Pool operators should be under no illusion that in

the event of an issue/accident it is against these pieces of legislation/guidelines that their conduct will be judged along with CHA QS and Codes of Practice.

PTWAG state that "management should define and document a policy for the general operation and safety of water treatment systems" going on to advise that "management should ensure that this policy is communicated,

https://www.gov.uk/government/publications/guide-to-the-general-data-protection-regulation


implemented and maintained" throughout the centre. This "policy" and risk assessment should be periodically

reviewed and/or amended where a change occurs.

CHA members need to be aware of and comply with (where appropriate) the following legislation/documents and their recommendations:

⮚ Management of Public Swimming Pools. British Standards Institute BSI PAS 39.2003.

⮚ Health and Safety at Work Act 1974.

⮚ Management of Health and Safety at Work Regulations 1999.

⮚ Legionnaires' disease. The Control of Legionella Bacteria in Water Systems (L8) ISBN 0717617726.

⮚ Managing Health and Safety in Swimming Pools (HSG179) 3rd Ed. ISBN 9780717626861.

⮚ Control of Substances Hazardous to Health Regulations 2002 (COSHH).

⮚ The Legionella Code of Practice & Gu9idance on Regulations (L8 Fourth Edition) including HSG274 and/or Health Technical Memorandum 04-01.

6.2 Risk to service users and staff

6.2.1 Duty to minimise the risk to service users and staff

Centres have a duty to minimise the risk to service users and staff. This is frequently in the form of risk assessments which need to be carried out as per UK legislation set out in "The Management of Health and Safety at Work Regulations 1999, 3242 Regulation 2" which states:

(1) Every employer shall make a suitable and sufficient assessment of: -

(a) the risks to the health and safety of his employees to which they are exposed whilst they are at work, and

(b) the risks to the health and safety of persons not in him employment arising out of or in connection with the conduct by him of his undertaking.

6.2.2 Legionnaires Risk Assessment

In addition to the normal risk assessments, the CHA strongly advises all its members to carry out a legionnaires risk assessment and follow any recommendations. This is a UK directive and a common expectation by investigative bodies. Legislative requirements for the control of legionella put the responsibility for compliance clearly with the owner/operator of the water systems. The above acts set out your responsibilities.

Regarding risks from legionella bacteria, all owner/operators of such systems have the responsibility to ensure that the risk is minimised and kept to an acceptable level. The Legionella Code of Practice and Guidance on

Regulations (The control of Legionella bacteria in hot and cold water systems) stresses that while the tasks required to achieve compliance to the acts may be contracted to an external specialists, it is the owner/operator's responsibility to ensure the competence of the service provider. The levels of service that should be expected from a service provider and an up to date copy of the Code of Conduct are available at www.legionella-conduct.co.uk

6.2.3 Material Safety Data Sheets (MSDS)

An integral part of managing risk will be the information contained within Material Safety Data Sheets (MSDS) provided free by the suppliers of chemicals under the Chemical (CHIP) regulations 2002).

Managers should be suitably qualified in water management and/or appoint someone who is. They should assess the risk of each chemical, its use and storage (especially where co-located with other chemicals as this may be dangerous) ensuring staff are suitably trained and deemed competent for a given task(s).

http://www.legionella-conduct.co.uk/

http://www.legionella-conduct.co.uk/


6.2.4 The Personal Protective Equipment (PPE) regulations 2002

The Personal Protective Equipment (PPE) regulations 2002 place a duty not only on all managers to provide the necessary PPE but also for all staff to wear and comply with reasonable instructions.

Where centres have multiple staff, managers must monitor and ensure compliance to CHA Quality Standards and Code of Practice is adhered to by all operatives.

Managers and operators should be aware of the idiosyncrasies that some equipment contain and would be

reasonably expected to ensure adequate protocols are in place to deal with these. For example, on some aquatic treadmills the water contained in the treadmill chamber may not be fully drained, leaving some residue under the treadmill belt. During a normal working day this may be acceptable, but it may pose an increased hazard if left whilst the centre is not operational, i.e. closed for a number of days.

6.2.5 Safe storage of Chemicals

The chemical store should have enough space and be well organised, well lit and well ventilated. The floor should be impervious and resistant to the chemicals used and easy to clean.

Containers should be stored upright and all be clearly labelled and stored as per the MSDS sheet. All cabinets must be waterproof and stored at room temperature in a locked cabinet. Health & Safety Chemical warning stickers should be on the cabinet to ensure individuals are aware of the dangers.

All chemical storage units should be locked and clearly labelled as a chemical storage facility. All centres must comply with Control of Substances Hazardous to Health Regulations 2002 (COSHH)

Access to the chemical store must be restricted.

6.3 Emergency Procedures – Action Plan

All CHA centres should ensure they have an emergency action plan covering all foreseeable emergencies which could affect any service user or staff members and ensure that this is reviewed regularly. Where appropriate

staff should complete an incident form and consider whether it is a "notifiable incident" to the relevant authority.

Centres should also have a list of chemicals on site (this may be in the form of the MSDS), where they are stored (in diagrammatic form, i.e. a site plan) and ensure this is made available to any emergency services where required. This is a legal requirement.

6.4 Water Testing

Water used for hydrotherapy treatment must be sanitised using a CHA approved sanitiser. Testing must be done using a CHA approved method and must be kept within CHA approved levels. Testing must be carried out a minimum of twice a day, although 3 times a day or more is recommended especially in busy centres. Photometers are the preferred method of testing water as opposed to comparators as they are more accurate.

Water test records must be kept with all tests and remedial actions recorded. Test records must be retained on file and available for inspection for a minimum of 5 years.


As a minimum water test records must be handwritten, so acceptable if ever needed in court, and include, but

not be limited to:

⮚ Date & Time of Test.

⮚ Tester's Name.

⮚ Sanitiser Levels.

⮚ Alkalinity.

⮚ pH.

⮚ Temperature.

⮚ Number of dogs treated between each test.

⮚ Remedial action taken.

6.4.1 Sanitisers:

Acceptable sanitisers are:

⮚ Chlorine.

⮚ Bromine.

6.4.2 Water Testing Equipment:

Acceptable testing equipment is:

⮚ Photometer (preferred).

⮚ Comparator.

6.4.3 Water Quality Levels & Ranges

FREE CHLORINE - Recommended range 2ppm to 4ppm. Levels higher than 4ppm are permitted for short period 4-6 hours. However, where levels rise above 6ppm the source of chlorine should be removed or chlorine production ceased until the level falls below 4ppm. If the level rises above 10ppm treatments must stop until the

level falls back below 4ppm. Free chlorine levels should not fall below 1ppm.

CHLORAMINES (COMBINE CHLORINE) - The ideal level is zero. In practice, levels should be kept as low as is feasibly possible and should never exceed 50% of the Free Chlorine. However, levels above 2ppm should be treated with super-chlorination (shocking) with levels over 4ppm addressed by dilution.

FREE ACTIVE BROMINE - Recommended range 4ppm to 6ppm. Levels higher than 6ppm are permitted for short periods 4-6 hours. However, where levels rise above 8ppm the source of bromine should be removed or bromine production ceased until the level falls below 6ppm. If the level rises above 10ppm treatments must stop until the level falls back below 6ppm.

BROMAMINES - There is no recommended level since these act as an active sanitiser.

SUPER-CHLORINATION (shocking) - There is much confusion surrounding shocking. CHA general guidance is that it should only be carried out when necessary; for example when water quality is poor, bacteria has shown up on your bacteria test report or upon the recommendation of your own pool water engineer who will be familiar with your centre's water quality management protocols.

This link to PWTAG's website http://pwtag.org/technicalnotes/superchlorination-of-swimming-pool-water

gives examples of when shocking is required and exactly what process you need to go through for a number of different circumstances. It is well written, extremely clear and highly informative. We would strongly urge you to take a look.

pH - recommended range 7.2 to 7.6.

http://pwtag.org/technicalnotes/superchlorination-of-swimming-pool-water/


Alkalinity - recommended range generally 80-120ppm or within parameters set by your own pool engineer with

such discussions documented for reference.

6.5 Water temperatures

Water used for hydrotherapy treatment must be heated within the temperature ranges shown below:

Pools & Underwater Treadmills 28ºC to 32ºC - operating pools outside of this recommended temperature range should be done with the utmost care and all physiological parameters such as fitness, size, age, duration

of activity and clinical conditions should be considered. Any such deviation should be recorded in writing and retained on the records.

Spas 35ºC to 40ºC.

Water in pools and underwater treadmills must be filtered in accordance with the manufacturer's instructions and in a manner appropriate to ensure compliance with the Quality Standards parameters laid down regarding sanitisation. Spas should ideally be permanently filtered but where this is not possible the water must be changed after each patient. In either instance the water parameters are the same as pools.

6.6 Monthly UKAS Testing

Microbial testing should be carried out by a UKAS accredited laboratory. A monthly bacterial test must be carried out as a minimum on each piece of equipment (pool, treadmill and spa) and should include the following as a minimum

⮚ Pseudomonas aeruginosa (confirmed viable colony counts).

⮚ E.Coli (confirmed viable colony counts).

⮚ Coliforms.

⮚ TVC result (Total Viable Count) - Optional

Some labs also report presumptive Pseudomonas counts and the TVC result (Total Viable Count). Pools/Treadmill are routinely tested for TVCs at 37c, the results for TVCs provide a general guide on the water quality and how well the treatment system is controlling bacteria growth; high TVCs are not necessarily harmful like E.Coli or Pseudomonas may be. There would not be any value in obtaining the presumptive Pseudomonas

counts and these are not normally tested or required under the PWTAG guidance for commercial leisure pools.

It is strongly recommend that if the additional measure of TVC result (Total Viable Count) is not already listed on your reports that you ask your UKAS laboratory to include it as this will give you an early indication on a potential water management issue. With regard to presumptive Pseudomonas aeruginosa counts members should decide whether they feel this is something they would like to be tested. .

Each month a copy of the test report must be uploaded on receipt onto Skills+ by the 15th of the following month

and we will endorse. Fines will be imposed for any centre failing to ensure a test is carried out when they are open. If a test is missing due to deep cleaning being in operation the centre must be closed for that entire month and be able to evidence it for a missing test to be acceptable.

It is the responsibility of the centre to ensure the UKAS laboratory is aware of holiday periods and operational opening hours to ensure no monthly test is missed.

This satisfies part of the centres obligations under COSHH to assess and minimise exposure to hazardous substances. Centres would be well advised to ensure all personnel responsible for pool testing are appropriately trained/qualified and a register maintained to record their qualifications/training.


7. Equipment Specification & Safety

Purpose

Equipment used is suitable for purpose and safe to use.

7.1 Requirements

⮚ Hoists and other equipment used for the lifting of dogs must be designed & built for purpose, with a tested weight loading of at least 100 kg. All hoist slings must have a four point pick up.

⮚ Hoists must be fixed in accordance with the manufacturer’s instructions and specification and maintained in a good, serviceable condition.

⮚ Tracked hoists must either use tracking supplied by the hoist manufacturer for that purpose, or to the specifications defined by the hoist manufacturer.

⮚ A means of restraint must be worn by the dog undergoing hydrotherapy at all times. This is to facilitate removal of the dog from the pool/aquatic treadmill in the event of an emergency. It is unacceptable for dogs to be in the pool or aquatic treadmill without a means of restraint. Treatment records must include clinical reasoning

as to why any patient may not be wearing a restraint harness in the pool or aquatic treadmill.

There are to be three categories of restraint:

⮚ Floatation device.

⮚ Hoist sling.

⮚ Restraint harness.

Hoist Slings must be specifically designed for the lifting of dogs thereby fit for purpose and safe. They must have a tested weight loading of at least 100kg and hold the dog in a safe and balanced way with a 4 point pick up providing adequate contact to support the dog.

Flotation devices and restraint harnesses must be designed and manufactured specifically for their purpose.

7.2 CHA Recommended Equipment

7.2.1 HOIST SLINGS

⮚ Westcoast - Dog Sling.

⮚ Catac - Canine Hydrotherapy Sling.

7.2.2 FLOATATION JACKETS

⮚ Baltic pet buoyancy aid.

⮚ Crewsaver Petfloat.

⮚ Ruffwear float coat

⮚ Westcoast - dog sling.

⮚ Outward Hound – petsaver.

⮚ Hurtta life jacket.

⮚ Non-stop Dogwear - safe life jacket.

⮚ Ezydog buoyancy jacket.

7.2.3 RESTRAINT HARNESSES

⮚ Ruffwear webmaster.

⮚ Activate your dog.

⮚ Orthopets Help 'em Up.

⮚ Akela Harness.


8. Normal Operating Procedures

8.1 Health and Safety

⮚ The environment at centres is safe for the dogs, clients and operators.

⮚ Members should be familiar and fully compliant with current legislation for all aspects of Health and Safety requirements at all times.

Particular attention should be taken with regard to:

⮚ Equipment and any electrical appliances, especially in or near to wet areas.

⮚ It is recommended that electrical installations and subsequent periodic testing is carried out by a person or persons recognised by the Electrical Safety Council in England or the Electro Technical Council for Ireland.

⮚ Safe storage and handling of chemicals, see 6.2.5 above

8.2 Emergency Procedures

Not applicable if the centre is run as part of a veterinary practice

A formal procedure is in place to deal with an incident occurring to a dog, whilst at the centre, in a timely and professional manner.

Veterinary back up is available to provide the best and most timely assistance should an incident occur to a dog whilst at the centre.

8.2.1 Requirements

⮚ There must be a telephone in the treatment area at all time with the number of that phone prominently displayed.

⮚ If the main means of communication is by mobile telephone, then the centre must ensure that the service is reliable and continuous.

⮚ During treatment times there must be at least one person in attendance that has attended a CHA L3 approved first aid course within the last 2 years.

⮚ There must be an emergency procedure agreed with a veterinary practice where a vet can be contacted by phone to give advice should an incident occur to a dog whilst at a centre.

⮚ All clients should be briefed on the emergency procedure as part of the initial session.

⮚ The emergency procedure should be displayed in a prominent place in the centre at all times.

⮚ An incident form must be easily accessible in the treatment room for all dogs undergoing hydrotherapy.

The form must include the following details but not be limited to: -

⮚ Name, sex, breed & age of dog.

⮚ Condition being treated.

⮚ Current medication.

The incident form must also have space to record the following details:-

⮚ Nature of Injury.

⮚ Severity.

⮚ Time of Incident.

⮚ Whether the dog is breathing or not.

⮚ Whether the dog is conscious.

⮚ Pulse rate.

⮚ Whether the dog is improving or not.


9. Centre Insurance

Purpose

Adequate insurance is in place to provide protection and benefit for the client, operator and staff.

9.1 Requirements

Centres must have valid insurance, which provides cover for, but is not limited to:

⮚ Employer’s liability - The Employers Liability (Compulsory Insurance) Act 1969 makes Employers Liability Insurance a legal requirement for any company that has employees or contractors whether full or part time. http://www.legislation.gov.uk/ukpga/1969/57/contents

⮚ Public liability - This protects you if someone makes a claim against you for injury or damage to property suffered because of your business.

⮚ Professional Indemnity; this must include cover for animals whilst at the centre and whilst being treated

as covers financial loss and injury resulting from your negligent act, error or omission while you're working for a client.

This must be uploaded to the CAT A’s Skills+ profile.

10. Inspection & Certification

Purpose

CHA member centres and those individuals seeking registration to the CHA conform to the latest version of the CHA Quality Standards.

10.1 Inspections

⮚ Centres must have passed a valid centre inspection in order to join or retain membership of the CHA.

⮚ Centres will be audited from time to time by either a physical or paper audit as requested by the Board with appropriate notice unless we have cause for concern or investigating a complaint about the centre where no notice will be provided.

⮚ The Canine Hydrotherapy Association reserves the right to require inspection of all its member centres

at any reasonable time.

⮚ Re-inspections in the event of a failed audit or inspection will be chargeable at the current rate and payable before the inspection takes place to ensure membership is not suspended.

10.2 Membership Certificates

All centres must display a valid CHA Membership Certificate in a prominent and public place within their centre as this lists all staff working within the centre and at what level they are permitted to work. The certificates are nontransferable. Current First aid certificates may also be displayed but are not essential as the CHA certificate is evidence that all is in place.

10.2.1 Staff working within the centre

All staff working within the centre must be identified unless on work experience and are not on payroll.

10.3 Adding an additional member to the team

Where you need to inform us of a new member to the team, you must go into the members area of the CHA website and download an “Application to add new member” form. Once completed email this to

http://www.legislation.gov.uk/ukpga/1969/57/contents


[email protected]. A membership number will be allocated and Skills+ account set up to

enable the appropriate evidence to be uploaded:

⮚ Valid First Aid Certificate

⮚ Awarding body hydrotherapy qualification and transcripts

⮚ Development plan

⮚ First Aid exemption form – where applies

10.4 Reporting a long-term absence

Where a member of the team is on long term sick or is due to start maternity leave, you must go into the members area of the CHA website and download a “Member CPD Pro Rata notification form”. Once completed email this to [email protected] and this will be loaded onto the members CPD log and a note of leave date added to the members log. This will ensure a pro rata CPD allowance is applied otherwise a full 25 hours will be requested at renewal.

10.5 Member returning to work or leaving the centre

Where a member returns or leaves it is important to email to advise this at the time to ensure your centre member list can be updated and where needed Skills+ accounts suspended.

11. Website and Social Media

All centres websites and social media posts and content must show hydrotherapy practice in line with the CHA Quality standards and must not in any way damage the reputation of the CHA. All centre website and social media accounts will be monitored periodically and where it is found to damage the reputation of CHA copies will be made and held on centres file, centre will be asked to remove immediately and may be dealt with under the Complaints and Disciplinary procedure depending on the severity of the case.

12. Renewal Procedure

The CHA renewal year is October to September. Subject to 25 hours CPD being completed centres can submit their renewal by downloading the “Yearly Renewals T&C” form from the members area, completing it and then uploading on Skills+ on the CAT A profile, Centre tab. All forms required for renewal are held in the members area on the Canine Hydrotherapy Association Website.

Centres will be able to upload this form from the 1st September subject to all members in the team having the following on Skills+:

Centre Details – CAT A only

⮚ Valid Centre insurance

⮚ Bacteria tests from October to September are already loaded

Qualifications ⮚ Valid FA certificate

Or confirmed as

⮚ RVN/RSN

⮚ Student

⮚ Associate member

CPD ⮚ 12 hours external CPD evidence uploaded for period October to September

⮚ Reflective learning uploaded covering all 25 hours of CPD

⮚ Development plan for the next 12 months

Once the CAT A has ensured all team members have correctly added the documents to Skills+, the ’Yearly Renewals T&C’ form can be uploaded and sent for endorsement, this will then start the centres renewal process.




Version Control

Version Date Details of Change

V2 December 2019 Addition of application and renewal requirements Insert of CPD Policy agreed at AGM April 2019

V2.1 January 2020 Clarification on Individual Assessment Day (IAD) for new centre

membership applications

V2.2 October 2020 Update to wording within: 5.1 - Due Care & attention 6.6 - Monthly UKAS Testing 12 - Renewal Procedure

V2.3 June 2021

Inclusion on new Physiotherapy Qualification within:

2.1.1 Qualified Animal Physiotherapist, Veterinary Surgeon or Veterinary Nurse.

V2.4 October 2021 Addition of CPD for Student and Associate members. Clarification on bacteria test uploads. Updated wording for insurance document.

CANINE HYDROTHERAPY ASSOCIATION

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