Anglian WaterAnglian Water:

Health on Tap – Reducing dehydration in older people
in residential care

Health on Tap


We were commissioned to design and deliver part of the utility companys' CSR programme over 3 years. Having successfully delivered two schools' campaigns, we turned our attention to older people and health.


Earlier research by the Royal Institute for the Promotion of Health revealed the majority of older people in residential care were not drinking enough water and this could adversely affect their health.

Target audience

  • Care home staff
  • Older people in residential care
  • Care home providers

Health on Tap


Methodist Homes for the Aged, Royal Institute of Public Health, Commission for Social Care Inspection, Suffolk PCT, Norfolk County Council, Water UK, English Community Care Association, National Association of Care Caterers, National
Care Association, National Patient
Safety Association.


Two stage primary research process over
18 months

Seven week trial with care home residents and staff


  • One care home achieved a 50% reduction in falls and laxative prescriptions by improving
    hydration levels
  • Hydration is not part of staff training and induction
  • Over half of care staff did not have English as a first language
  • Staff and residents’ feared increased toilet trips as a result of increased water intake
  • Elderly people are more susceptible to dehydration due to impaired feelings of thirst, medications that increase water loss, and raised room temperatures
  • Routine was the backbone of a care home’s regime


Trial results indicated that a proactive policy of increasing water intake resulted in a range of health and wellbeing benefits including a reduction in falls, decrease in urinary infections, more than 50 per cent reduction in use of laxatives, improved sleeping patterns, greater daytime energy levels and less agitation in residents
with dementia.

This provided us with a case for support; Health on Tap was launched to all East Anglian Care homes, promoting simple and cost-effective hydration methods to combat a range of ailments and indignities, some of which prove fatal.

Participating homes received promotional materials, a training DVD and mains fed water coolers. In return, they signed up to
the Good Hydration Charter; a voluntary
code of practice in the current absence
of mandatory regulation; it required three simple commitments:

  • A drinking water regime to be established as daily routine, and matched to the ability of every care resident
  • Fresh tap water to be constantly available, accessible and palatable
  • Good hydration to be part of staff induction and training, and to be promoted to residents and visitors


Over 215 care homes have signed up to the Charter, including every care home in Suffolk. Due to demand, the campaign rolled out nationally. It made headlines on national and regional BBC radio and television including lead item on BBC Radio 4 Today Programme and BBC 1 national lunchtime TV. Questions were raised in the House of Lords and Anglian Water joined the Care Quality Commission’s expert group on hydration in hospitals.