Widths of Bedroom Fire Doors in Nursing Homes

[Geoff]

I've come across a little problem with a couple of new build nursing homes which are part of a PFI deal my lot are involved with.

Basically they are 72 bed schemes over 3 floors, 4 and 5 bedrooms to a compartment, all singing and dancing afd/alarm system and all approved under BR 2000.  The problem that has been identified (by an FSO) is with the width of the fire doors to the flats, which are compliant with Part M being a width of 850mm.  The problems comes from this being a nursing home and in nursing homes you have to use hospital/nursing beds which have a width of (wait for it!!) 900mm.  Good piece of design I'm sure you will all agree!

The Res. Care guidance indicates that all doors should be of sufficient width to accept a nursing bed which obviously these cannot.  I could go along the route of recommending delayed evacuation, but this leaves me with the problem of not having enough staff to effectively work this during the night, especially with the daft timescale expected of evacuating a compartment in 2.5 minutes! Or do I get the architect to organise the works to widen the doorways, etc.

I suppose what I am asking is would an FSO carrying out an inspection a new nursing scheme expect the doors to be of a width to enable easy and safe evacuation of non-ambulent nursing clients in their hospital beds and if they weren't would a notice be issued?

[kurnal]

How did they get the beds in the rooms? Or are the beds in the rooms narrow enough to pass through the doors or have alternative arrangements been made for the evacuation of the compartment involved?
If it aint broke....

[Geoff]

The beds were built up individually in the rooms and now being 900mm in width cannot get through the doors at all!

I hate to admit it but it was only noticed when the FSO asked the question (now don't shoot me I only got involved this week when my boss brought it up!), to my knowledge no-one has ever tried to practice evacuationg a person who is on one of those beds, or to transfer them to another means of transport like a wheelchair.  To be honest with some of the people i nthese types of scheme the only way to move them without seriously injuring them or god forbid killing them is to use the bed!

So I suppose I have to say it is already broken!

[kurnal]

Looks like transfer from the bed to a skid sheet or matress straps or similar will be the most practicable solution.
At least your compartment sizes are small so the time taken to evacuate should not be too much greater than usual for a 10-12 bed compartment.

[Mike Buckley]

If you are saying that the only way to safely move some of these people is in their bed, then the doorways have to be widened. I cannot see any way round it. Should a fire occur and people die because you cannot get them out of the rooms because the beds won't fit through the door or they die because you have to transfer them because of the doors then I would think the official bodies will descend like a ton of bricks closely followed by the litigation lawyers.

Perhaps there could be a halfway house to widen the doors to a number of rooms and keep the bed bound residents in these rooms.

At the end of the day someone messed up either by not giving a full brief or by missing it in the brief.

[wee brian]

That's the big "if" - do they have to be moved in their beds or can you use a wheelchair (how do they get about during the day?)

[johno67]

Have to agree with Mike on this.

You will certainly be putting them at unacceptable risk by doing nothing or trying to use a stay put policy.

If you are also putting them at risk by moving them from the bed onto a mattress etc. then I think you have no alternative but to have the doorways widened.

You don't want to end up having a situation like the Redcar incident, that has been highlighted on this forum.

[William 29]

You could go for the delayed evacuation, I note your point regarding staff/resident ratios but are the bedrooms and escape routes 60 mins FR (page 71 HM Res care guide)

It may seem obvious but can they not introduce smaller beds!?

[johno67]

I believe that the delayed evacuation is there primarily for those people that really are so ill that it is a danger to move them. I don't think you could use the cost of widening the doorways as an excuse for implementing delayed evacuation.

Surely a delayed evacuation is simply that, delayed. You would still be required to get them out if conditions worsened in a fire. I don't think we can look at it as a fire proof box in which they will be safe until the fire has burnt itself out or the fire service have put the fire out.

The staffing implications could be huge, the Res Care Guide recommends that there should be one member of staff to each resident using delayed evacuation. And as we know this is very rarely the case. I have only come across it with people with very severe learning difficulties.

The narrower beds is a good idea, but I would imagine it would be more expensive to replace the beds than have the building work carried out. (I should imagine the beds are a standard size anyway thinking about it)

[kurnal]

Yes widening the doors may be a good solution assuming that bed based evacuation is required in the circumstances. It could be the quickest way to evacuate the protected area.  

But before considering this is there room to stack 5 beds in the adjoining protected areas and how far can we proceed in this particular building before we are satisiified that we are a safe distance from the fire? Are we still going to have to tip people out of bed if we need to move them further or down a level? Do adjoining compartments have space for all these beds? Most care homes would not. In fact I dont know of many care homes where evacuation by beds is a practical option. This is not a hospital as far as I am aware.

Its only worth widening the doors if it will be a significant help in an emergency. Otherwise in my opinion the small compartment size and provision of an alternative means of evacuation may be adequate risk control measures in compensation.

[wee brian]

Care homes just aren't designed for bed evac - That's what they do in hospitals.

[nearlythere]

The RA will take into consideration the issue of the beds wider than the doors. Can't see widening doors as a resolution without huge implications especially if surrounding partitions are load bearing walls. Probably help a bit if some were stud partitions and could be relatively easily widened.
A RA will probably say that evacuation should be undertaken using the matress only. Yes, it will be the bed width but would be capable of being pulled through a gap 2 inches narrower. There is then staffing issues relevant to this method.
Bigger question is how did it happen in the first place. After all it was built as a nursing home.

[wee brian]

How do these people get to the loo and the day room to play cards???

They cant all be whizzing about in their beds!!!

[Geoff]

Apologies for not replying earlier but have just come back from some leave!

The beds are required by Health & CSCI to be 900mm wide in nursing care establishments, so I can't get those changed.

Some of the service users in the scheme are able to get themselves about quite easily during the day but do so very, very slowly so would still need help in an emergency. Plus when most people enter nursing care they tend to be losing control of their faculties and I don't just mean their mental ones!  So they also require assistance.  However the majority in this scheme do tend to be bed bound!

The architect was a muppet and so where the team involved in the brief, this was designed and finished before I joined the organisation and for some strange reason the safety/environment people do not get invited to take part in these developments!  Must think we would add to the costs!!

The corridors are all over 2m wide and have bays in where it would be possible to put a number of beds my problem would start to get worse if any situation lead to evacuation of more than one compartment!  Also since I've been to the place I've found that there is no fire lift so makes it even more difficult in a full evacuation!

I don't want to go into the rest of the stuff I found but I would really like to get the builder and the architect into a room and express my opinions in a forthright manner!

Nearlythere and Kurnal are pretty much correct it, is too problematic to get the doors widened apart from the distress it would cause already highly confused and dependant service users, many of the walls involved are load bearing.  Looks like I will have to go with the mattress idea as that is the most efficient and possibly least stressful means of evacuation (and I used that last phrase advisedly)!  Will still have to get over the manual handlling implications though!

Many thanks for your thoughts on this and please feel free to add anymore, this is one that is going to run for quite a while for me as I'm goig to have the same problems in the new ones that come on line, if I can't get the management team to get architect and builder to play ball!