Care home help please

[Adam Jackson]

Hi,

I've been asked by a mate to advise him on a fire issue in the care home in which he works. To be clear, this isn't a paid job and is not a type of industry I have looked at before, hence I need some pointers.

The home is not a hospice but is the kind of care home where the residents are not expected to leave once they're in. There are about 25 residents, over two floors in various states - some are fine mentally but are wheelchair bound or can only walk with difficulty, while others are fine physically but have exceptionally severe altzheimers, etc., with all shades of problems in between.

They've been told by their provider of fire extinguishers, alarms, etc. that they need to sound the alarm weekly as a test and need a training programme which involves drills as part of it. The home has automatically-releasing internal fire doors which close when the alarm is activated. The problem is, a weekly test causes severe distress in some of the residents (some have a mental age of a small child, others just panic at the noise as they don't know what it is, while others recognise it as an alarm but don't understand the concept of a test and panic that they're trapped, etc.). Also, the doors release which isn't great when an unsteady old dear with brittle bones is shuffling through them.

So, the question is, in a situation like this, what are their options for routine soundings of the alarm and importantly, what about drills / staff training? The staff can see that they need to be able to respond well and get people out, but regular drills involving the residents cause a huge amount of distress and carry a not-insignificant risk of physical injury. My quandry is that unless you test an evacuation procedure, while it may be great in theory you can't be sure it works for real, but practicing it in a place like this is risky.

Any pointers from your practical experience gratefully received. I've downloaded the fire risk assessment guide for residential care premises but I'm keen to see what anyone's come across that worked in practice.

[PhilB]

This needs a common sense approach...there is no point distressing the guests with a weekly alarm test or by evacuating them all to the car park every six months.

That is the beauty of this risk appropriate approach...there should be no prescription. But as you correctly identify the responsible person must ensure that emergency procedures are adequate  and that will probably involve some form of rehersal but it could be a desk top exercise.

A tricky one I know but talk to your local FRS I'm sure they'll be happy to assist.

[kurnal]

If the residents are distressed by the alarm but are entirely dependent on the staff in an emergency there is little to be gained by having general area fire alarm sounders. A staff alarm system, with conventional sounders in staff only areas plus some coded system or pager with very subdued levels in other areas may be more appropriate. Dont overlook the needs of visitors though.

Staffing levels are critical in these situations.
The exercise need not involve the residents, but evacuation procedures should be tested using volunteers or other staff members playing the role of residents.

[PhilB]

Good points Kurnal. These premises will be subject to the Care Home Regulations and they state that you must.........

"(e) to ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home and, so far as practicable, service users, are aware of the procedure to be followed in case of fire, including the procedure for saving life."


...note the so far as practicable, service users......in your case it is not practicabe or desirable.

[johno67]

I agree with Phil and Kurnal's comments, a couple of other things to bear in mind are:

If the service users get agitated when the alarm sounds for a short interval during a test, how are they likely to react in a real fire situation?

I have come across a small number of res care premises in the past who use the service users as an excuse for doing very little in relation to fire safety - 'we can't evacuate the residents because we have a no lift policy, so we leave them in their rooms' is a typical example, I'm not saying that this is the case here but be aware.

I think the home may have to get the permission of the service users next of kin for them to take part in drills, but as mentioned you can simulate that using other members of staff acting as patients. A table top exercise may be good as a refresher but I think they need to practice it to make sure they can actually do it.

It may be worth having a chat with the Care Standards inspector for the home to get their thoughts on it.

[stevew]

Hi

Agree with all of the previous comments.

I would however offer a word of caution.  Firstly to contact your local FRS without having already carried out a FRA would ONLY gain general advice NOT specific to the premises.  Of the fire authorities I deal with the general attitude  is to offer specific premises related advice ONLY once a FRA is in place.  Out of interest they dont put anything in writing anymore until deficiencies notice stage.

All of the points previously raised would form part of a FRA so I suggest thats where you start.  The information you have provided would suggest that the person responsible for the FRA obtain the services of a competent fire risk assessor.  Such a person would be capable of setting an appropriate standard taking into account your concerns even though it may deviate from the recognised guides and British Standards.  Any such assessor should also be happy in justifying the FRA not only to his/her client but also a FA inspecting officer and  the courts.

[Adam Jackson]

Thanks everyone - some useful stuff there.

Cheers

[Ken Taylor]

For the type of premises under discussion, I go with the approach described above by Kurnal. For others with general sounders throughout, a quick activation for a few seconds at a set (and appropriate) time each week should soon become familiar to the residents as part of the routine and enable staff to ensure that the sounders all remain operational. However, when it comes to evacuation practice, volunteer staff members acting as residents requiring assistance is often advisable.

[Adam Jackson]

should soon become familiar to the residents as part of the routine

Sadly it doesn't - they've got people in there who keep asking when their parents are coming to pick them up as they think they've been in the 'home' for a weekend-away, without remembering that they themselves are in their 80s and have been there for 5 years. There are a lot for whom a weekly test comes with as much surprise and panic each week as to them it something strange, new and stress-inducing every time. One was stood in her room last weekend crying her eyes out because she couldn't understand why she'd been locked in an empty room, respite the room being fully furnished with all her own furniture and the door help open to try and stop her getting distressed. No matter how patiently a fire alarm test is explained, in a week's time they've forgotten again. Very sad really.

[Ken Taylor]

I do appreciate your situation, Adam, having come across this situation before. I was just referring to weekly alarm tests for some other residential care premises (the type of which I also have experience) where there is no real difficulty. It's always a matter of doing what's suitable for the situation with which you are presented in the best interest of the occupants on a risk-assessed basis and by reference to the guidance available.