Care home evacuation

[Paul2886]

Interested in any views on the following:
With the current thinking that there has to be an evacuation procedure to secure the safety of residents in care homes without the reliance on arriving fire crews, how can the staff remove residents vertically following any horizontal movement. It seems its not enough to move them two fire doors away from the fire then rely on fire crews.
I'm particularly interested where there are service users with severe physical and mental disabilities that can only be moved in heavy electric wheelchairs. Many of these service users can be fairly heavy and cannot be lifted of dragged by staff members. It is not as simple as housing them on the ground floor as occasionally suggested. The lifts cannot be used (or can they) in a fire situation, but is often the only way. Often the phased horizontal movement is towards on external fire escape which would prove a nightmare for staff and even fire crews for these catagory of residents.
It seems different FSO's say different things on this issue so interested in your views. Thanks in advance

[jokar]

Easy to say but difficult to complete is to change the lifts to evac lifts.  Alternatively, risk assess the use of a normal passenger lift.  This may include whether it grounds on operation of the FA, where the power supply comes from and a dynamic RS when the evacuation takes place.

Evacuation has always been the responsibility of those in charge but not taken seriously.  FRS role is rescue not evacuation, as  a provider the RP has to make suitable arrangements to get people out.

[kurnal]

Agree with Jokar but I would say that once the residents are two doors from the fire then the need for speed has usually gone.  (Unless its a lightning strike with multiple seats of fire etc )
In my evacuation plans I usually expect  the duty staff to evacuate to two doors away and include a telephone tree to bring in off duty staff for the next stage of evacuation.

For some persons the risk assessment at the time of rescue will balance the risks of staying put with the risks of moving them vertically ( for example critically ill) and then I am quite happy to wait for the arrival of the fire service for them to advise on the operational need for further evacuation taking account of the nature and expected further development of the fire.

[jokar]

Good call and therefore the important role is the liaison between the FRS and the care facility which means both the FRS and the faciliyt being aware of the plan and how it is being implemented.

[AFD]

It would be interesting to hear from someone who has consulted with the FRS and agreed to be part of their evacuation strategy, since the RRfsO came in ? My present experience is that they insist we must be totally responsible for our own evacuation to complete safety, as they may not be available for quite a long time, which is more likely as the IRMP develops.  

What time period are you taking into consideration for off duty staff to come in ? Are they paid a standby fee ? How many must be available ?  During holiday periods eg. Christmas are there different precautions, to ensure the required number of staff are available ?  Must all staff be able to drive ?

[kurnal]

Hi AFD
1- Not specified a time scale not all will be available or sober but of a staff of 42 there should be a reasonable chance of getting half a dozen within 15-30 minutes.

2- No fee no pressure but its their home and if they wont help out should a crisis occur its a poor show. They would be paid at the overtime rate if they did come in. Many will and dont have a problem with the idea. Theres enough prepared to help out in an emergency to make it worthwhile.

3- Many fire services are now publishing standards of service under IRMP. I just dont accept it when they say we have to make arrangements for very long delays. Are they fit for purpose or not? Do we have to keep the fire going till they arrive?  Do they want to give their jobs away to people like Falk in Denmark?

[AFD]

Sorry been away !

I do not think that in a coroners court ( or a fire service audit ) if the so called evacuations strategy team ie. those not on duty, didn't turn up because they were all away on a members of staffs hen party, that he or she would accept;  it was a 'poor show' ! as a justified case for the defence.

You cannot base a strategy on a 'reasonable chance ' that some staff would show in 15-30 minutes !

And yes the fire and rescue service are now in the business of cutting back, the emphasis is on community prevention, business looks after the buildings not them, and RTA's killing more than fires.

[kurnal]

Sorry been away !

I do not think that in a coroners court ( or a fire service audit ) if the so called evacuations strategy team ie. those not on duty, didn't turn up because they were all away on a members of staffs hen party, that he or she would accept;  it was a 'poor show' ! as a justified case for the defence.

You cannot base a strategy on a 'reasonable chance ' that some staff would show in 15-30 minutes !

And yes the fire and rescue service are now in the business of cutting back, the emphasis is on community prevention, business looks after the buildings not them, and RTA's killing more than fires.

Well AFD for a minute I had to stop and think whether you were desribing the British Fire and rescue Service with its reliance on the retained duty system.

Why do you say the british fire services are cutting back- certaily locally in the East midlands most appear to have above inflation setllements.  RTAs have always killed more than fires. I am glad you are addressing education and supporting initiatives to reduce carnage on the roads. I proposed exactly that in the early 90s where many of our stations were attending more RTAs than fires but the powers that be decided it was not the fire services role.

If you dont like my ideas for evacuation plans in care homes please share your alternative ideas. All I know is that everywhere that I have implemented my proposals and trained staff to work them the local fire officers have been over the moon and in one case put the reinspection cycle back to 5 years- low risk.

[Redone]

At a care home yesterday, resident smoking in room caused a fire, home policy is no smoking, specific smoking room provided, couple of residents do as they please.

Anyway, the room is off a dead-end corridor, five rooms off.  Occupant at far end weighs in at 42 stone, so the staff placed towels across the base of the door to stop smoke entering his room, whilst they evacuated the other 4 high dependancy residents.  Fire officer gave the senior a dressing down for leaving the big guy, now the staff have a grudge against the fire service, they feel they are stuck between a rock and a hard place, which in truth they are.

Why did this officer not take up the issue with the management, the policy makers, point out the various guides available, be constructive, give some help, put his observations in writing to the people that can improve the situation?

Now we still have a home with residents that smoke, fire panel showing two zones on actuation (which the fire officer should have observed and questioned) and owner(s) at arms length not being brought to heel.

Fire officers please note, the care home staff are more than aware of the problems they face in a crisis, and in this case if they voice there concern are told they can work elsewhere.

In my county I'm dismayed at the lack of attention the fire service is giving to life risk premises, care homes, guest houses, hotels... to me, it indicates a policy to choose the easy life.

[AFD]

Redone,
the term fire officer in the UK fire service covers a plethora of 'abilities, training , experience and qualifications' from 'whole time, retained, operational, civilian, trainers, fire safety etc.etc. I agree with your points and I hope you and the home owner have written to the CFO of the brigade to pout their shortfall, because we don't  let the FRS know they are faulty, they will not mend it.

Kurnal,
A good standard of fire precautions in residential care 'may' be provided by good standards of enclosure, detection, management, staff training, testing amd maintenance procedures, short travel distances, high staff to resident ratio ( straight away) even possibly suppression etc etc. .  
It may be that if we believe you, that the homes you are invoved with,  and are the second coming to the local fire authorities.  May actually have those things in them as well ( but was not mentioned ),   and you have done a good job, but the point in question that I think of as 'a bit silly' is that as a main part of an evcuation strategy, there is a telephone tree and 15-30 minutes 'possibly ' - ' damned good show'  staff input !

If you go and loiter around any fire service headquarters ( whatever floats your boat ) you will see that any finances are going into community fire safety eg. 500 vans and 500 civilian advisors !  Many brigades are down grading the number of ariel appliance, whole time stations to retained or day manned and cross jumping appliances.  Their role is now 'containment' not 'fire fighting' ( this admission upsets a lot of long serving firefifghters, but ask the senior management who have targets to hit ), their rescue role is (as mentioned by both of us)  now mainly RTA , or urban search and rescue etc.,  The role of safety in buildings is down to business, not the fire service, go and ask CFOA or the CLG, don't believe me.  

Also, I believe many CFO's of FRS's are stating there is a reduction in funding from this year, read the journals.

Finally, which home are you in ?

[Clevelandfire]

Redone,
the term fire officer in the UK fire service covers a plethora of 'abilities, training , experience and qualifications' from 'whole time, retained, operational, civilian, trainers, fire safety etc.etc. I agree with your points and I hope you and the home owner have written to the CFO of the brigade to pout their shortfall, because we don't  let the FRS know they are faulty, they will not mend it.

Kurnal,
A good standard of fire precautions in residential care 'may' be provided by good standards of enclosure, detection, management, staff training, testing amd maintenance procedures, short travel distances, high staff to resident ratio ( straight away) even possibly suppression etc etc. .  
It may be that if we believe you, that the homes you are invoved with,  and are the second coming to the local fire authorities.  May actually have those things in them as well ( but was not mentioned ),   and you have done a good job, but the point in question that I think of as 'a bit silly' is that as a main part of an evcuation strategy, there is a telephone tree and 15-30 minutes 'possibly ' - ' damned good show'  staff input !

If you go and loiter around any fire service headquarters ( whatever floats your boat ) you will see that any finances are going into community fire safety eg. 500 vans and 500 civilian advisors !  Many brigades are down grading the number of ariel appliance, whole time stations to retained or day manned and cross jumping appliances.  Their role is now 'containment' not 'fire fighting' ( this admission upsets a lot of long serving firefifghters, but ask the senior management who have targets to hit ), their rescue role is (as mentioned by both of us)  now mainly RTA , or urban search and rescue etc.,  The role of safety in buildings is down to business, not the fire service, go and ask CFOA or the CLG, don't believe me.  

Also, I believe many CFO's of FRS's are stating there is a reduction in funding from this year, read the journals.

Finally, which home are you in ?

I think that you are being very rude. Surely Kurnal is trying to devise a procedure to get more staff into play during an incident by using the "telephone tree" arangement. This is to help take the pressure off responding FRS crews that sometimes get roped into assistin with evacuation.

I have seen "on call" or "off duty" staff being brought in during incidents at many care homes. Do you actually understand how a care home is run? If not let me give you an insight. The owners employ careres often on minimum wage rates, put in the bear minumum staff they can get away with to cut down on overheads / staff wages leaving just two welll intentioned careres in charge of perhaps 30 or 40 residents at night. Do you honestly think that is enough to cope with a full scale evacuation? Yes the care industry should take up some of the slack by actually taking responsibility for evacuating residents and not leaving it to fire crews, but in the real world the only way you will get more help on hand quickly is by bringing in off duty staff. You try and get care home owners to employ more staff. Not even CSCI can do that easily. The FRS can't comment on staff patient ratios either.

Now bring in the minimum wage factor and some staff being reluctant to come in when off duty because they wont get paiud or the money isnt good enough to warrant the hassle you will get some staff that will make excuses and not come to help. So Kurnal is right in the real world trying to motivate staff who's morale is often quite low (poor wages, having to do lets face it what is sometimes a very horrible job cleaning up poor folk and the like) Until you change the care home owners attitude and get them to fork out cask to provide more staff on at night this problem will be compounded.

But it seems like you have all the answers AFD so you tell us how you would address this extremely difficult scenario. You show me how 2 careres can 1) investigate cause of a fire alarm activation, 2) call the fire brigade, 3) begin evacuation 4) meet fire service on arrival all on their own. You tell us how you would get care owners to spend more money on staff.

[kurnal]

This one for AFD
http://www.derbyshire-fire-service.co.uk/pdf/Welcome_News_on_Fire_and_Rescue_Service_Budget_2007.pdf

I am delighted to see that in some areas things are easing after so many years of real cutbacks. If the Brigades choose to spend their money in different ways then that is a matter for the CFO and Authority and Government to determine. But what you describe is restructuring not cutbacks.

How many staff do you suggest for a nursing home with 40 residents at night- assume a modern home with protected areas of 10 beds? For care needs the CSCI would require 2 carers and 1 qualified nurse. How many additional staff would you recommend on standby to assist in evacuation in case of fire?

[AFD]

If my flippant attitude as offended any one I apologise, and to kurnal I apologise, because following your link, I then looked into the situation that it appears has been resolved in December ( see  extract below) although I only received a journal with the the shortfall being announced two weeks ago.
"FUNDING VICTORY – A GREAT JOINT EFFORT
West Yorkshire’s fire chief, Phil Toase, has described yesterday’s Government grant settlement as ‘a great victory for all the metropolitan brigades.’ Proposed changes to the formula used to allocate Government grant had threatened to take away £30m. in aid from the seven metropolitan fire and rescue services, including up to £1.3m. from West Yorkshire. “Thankfully Whitehall has appreciated that a knock-on effect of these changes would have seen money flow away from the large urban centres,” CFO Toase explained. “All seven brigades have been engaged in an intensive lobbying campaign over recent weeks to try and persuade ministers to think again and yesterday’s announcement appears that, at least in part, we have been successful ""-

So on those points I snivvel and say sorry, but in relation to the evacuation .

I still do not believe a fire authority will accept on the primary evacuation strategy a phone tree and 15-30 mins. yes for an immediate business continuity following a full evcuation of the building requiring emptying and other accomodation being required for residents.

I know of one brigade who is asking homes to demonstrate their evacuation of a sub compartment and timing it, because they say the staffing is insufficient for the number in a protected area.

I have seen 'notices of deficiencies' quoting the 2.5 minutes evacuation time to be achieved.

The critical time is for the initial protected area and if you cannot do that with the staff available you will have to get more staff or decrease the sub compartment size or suppression etc..  I have an action plan telling me to do this.

To be near to the guidance for high dependency residents ( or even medium, and don't mention bariatric , because no one does !) you would not have a 10 bed sub compartment.

Please tell me the names of brigades who accept telephone trees for the primary evacuation strategy and I will contact them for confirmation and will tell the others ( I wont really tell the others because I don't agree with it, but please name them).

Your faithfully and ever so politely,
AFD
ps
they may be getting the funds but not for evacuation purposes.
pps
Is there any serving fire officers out there who will state there brigade accept phone trees for primary evacuation ?

[kurnal]

Hi AFD

My telephone tree aint perfect it was never intended to be for primary evacuation of the sub compartment because the guidance that we use for a target recommends that this should be achieved within 2.5 minutes???

Now we know from drills and exercises that for an invalid bedridden person it will in the real world take two staff about 3 minutes per person and if they are on ripple matresses probably 3-4 minutes. Thats after they have responded to the alarm- (1 minute), identified the zone involved- (15 secs), one has stopped behind to call the fire service- (2-4 minutes), proceeded to the zone (1 minute), intercepted Mrs Miggins  on a nocturnal wandering on the way and sent her off in a safe direction ( 1 minute) , and checked for the location within the zone (1 minute). Thats about 5-7 minutes and we have got one person  to a place of relative safety with a bit of luck.

Thats the real world as I see it and thats my starting point for improvement. I dont think we can realistically expect an increase in staffing levels over and above the numbers required to deliver the care standards. To put two extra staff on nights for 365 days would take at very least 8 extra staff at an estimated annual cost of about £4000 per resident. Thats ongoing revenue costs at around about £20k per employee- about £12k for salaries and the rest employment overheads.  To hit the 2.5minute time we would still need a maximum sub compartment size of two bedrooms. Can you see Social services - who fund most places footing the bill?
The care home owners are currently making some money but not to that extent and are being hit for capital investment in many other areas apart from fire at the moment. Of course capital expenditure isnt such aproblem as revenue- you can spread the cost over a number of years.

Its a real problem. I believe sprinklers are the long term answer to it but for existing homes it is almost unsolvable. My plans are simply a small step towards an improvement for most care homes, the local fire officers are only pleased with them because compared to what went before  they are a very significant move in the right direction.  

My telephone tree will bring in staff albeit fairly slowly. But it is not too far removed from the fire service - indeed for recall to duty for flexi officers they run on exactly the same lines.

I know many homes and give training in fire, health and safety, risk assessment, moving and handling and coshh as well as fire risk assessments. In my experience care workers tend to be a special bunch of people who despite lousy pay, poor conditions and long hours really do care about the people they look after.

[nearlythere]

Hi AFD
1- Not specified a time scale not all will be available or sober but of a staff of 42 there should be a reasonable chance of getting half a dozen within 15-30 minutes.

2- No fee no pressure but its their home and if they wont help out should a crisis occur its a poor show. They would be paid at the overtime rate if they did come in. Many will and dont have a problem with the idea. Theres enough prepared to help out in an emergency to make it worthwhile.

3- Many fire services are now publishing standards of service under IRMP. I just dont accept it when they say we have to make arrangements for very long delays. Are they fit for purpose or not? Do we have to keep the fire going till they arrive?  Do they want to give their jobs away to people like Falk in Denmark?

Hello Kurnal et al and welcome to the "Modernisation" of the UK Fire & Rescue Service. If you voted Labour at the last election you voted for this.
As long as the politicians get their dodgy expenses and taxpayer funded holiday villas they will never give a monkeys for those they supposedly represent.