Nursing / Care Homes

[jasper]

Hi all,
I am new to the forum and have a question that I am finding difficult to resolve. Basically, I am looking into the relevant fire safety legislation for various resudential care homes. Some of the homes are for the elderly and some are for mentally disabled people. I would like to know if possible what fire legislation is relevant to homes with 1-4 residents, homes with 5 and above residents, and full blown nursing homes (and what deems a full blown). I am aware of the workplace regs and the fire precautions act,  but is is the other regs that are relevant is confusing, as this is a minefield. So, any of you who have had experience of these, your answers would be greatfully received.
Regards
Jasp

[Colin Newman]

You may refer to "Health Technical Memorandum (HTM) 88 - Fire precautions in housing providing NHS supported living in the community" for premises accommodation those with mental illness or learning difficulties.  

The document provides guidance in respect of fire precautions for premises with accommodation upto 2 floors above ground or access level, and accommodating upto 6 residents.

It is quite prescriptive, but does include a basic risk assessment process and a checklist for those involved in aquiring premises for the purpose of providing such accommodation.

[Peter Wilkinson]

For residential care homes, you may find these two documents useful...

'Fire Safety in Residential Care Premises' published by the then Institute of Building Control in 1997

'Draft guide to Fire Precautions in existing residential care premises' published by the Home Office in 1983.

The first document was published to give an English and Welsh version of the Northern Ireland HTM84. The second document, although a bit long in the tooth now, is not a bad starting point.

[colin todd]

The latest thinking is in the scottish version of HTMN 84 which is published as SHTM 84

[jasper]

Thanks for your replies guys.
The main areas of confusion is the relevant legislation i.e. between the Registered Homes Act 184 + (amendement act 1991) and the Care Standards Act 200. Please help as I have no idea which is relevant to which i.e. small, medium, large care homes etc.
Jasp

[Colin Newman]

In terms of fire safety the Care Standards Act 2000 doesn't say a lot.  

The Act states that bodies providing care should make provision as to the fitness of premises to be used as an establishment or for the purposes of an agency.

Under the section regarding the granting/refusal or withdrawal of a licence, it cites that grounds for withdrawal of a liense would be an offense under the  Registered Homes Act 1984

Under the Care Standards Act the Secretary of State may set minimum standards which will be inspected by the National Care Standards Commission (Now either the Commission for Social Care Inspection CSCI or Commission for Healthcare Audit and Insprection CHAI - depending upon whether the registered home is providing social care or health care).  

The National Minimum Standards for Sicial care can be downloaded from:

http://www.csci.org.uk/information_for_service_providers/national_minimum_standards/default.htm

The following are the only references to fire in the National Minimum Standards for Care Homes for Older People

19.5 The building complies with the requirements of the local fire service and
environmental health department.

38.2 The registered manager ensures safe working practices including:
· fire safety: understanding and implementation of appropriate fire
procedures;

I haven't been able to find similar documents for healthcare standards, the CHAI website merely cite the Care Standards Act 2000 for the minimum standards to which it audits and inspects.  Their website is http://www.chai.org.uk/

Hope this helps

[wee brian]

Which, like all good government standards, is no help at all.

In practice you need to convince everybody that you have done things properly. the SHTM is by far the best avilable guidance but some brigades may have their own ideas.

[jasper]

All these regulations seem to identify the basic need, but no detailed requirements.
Example of problem:
I have visited two care homes today - one was a two-storey domestic dwelling with 3 residents with learning difficuilties (not too severe) and had only mains wired battery backup interlinked smoke alarms, adequate extinguishers, but no door leading to the staircase enclosure was fire resisting, no strips seals or door closers. Under the fire service advice note this is ok as to comply with the care standards act 2000, as regard to detection and all bedrooms were directly onto staircase.
The second premises was a single storey dwelling with 3 residents (all severe mental / physical disabilities). This had full automatic detection, fire doors with automatic closers etc. and was very well designed as regard to fire safety.
Which standards do you guys think each of these examples complie with, as in my opinion, the stairway on the 1st premises should be protected?
Also, the 1st has just had a partial refurb and all the 1st floor windows were specified as being upvc emergency escape windows, this was even though each room lead directly onto the staircase, can this be right or is it just a smart salesman?your opinions would be appreciated on this

[jasper]

Anyone?

[Colin Newman]

For the first premises the descision as to what guidance to use is really dependent upon which body if any has responsibility or a duty of care to the residents.  

Since you state that the residents have learning difficulties the premises fit within the scope of HTM 88.  However, that guidance was written specifically for the provision of NHS supported living.

Whilst I beleive the guidance contained in that document would be appropriate for both premises you describe, your problem will be convincing a landlord or non-NHS body of their need to comply.

[Ken Taylor]

In HSG220 'Health and Safety in Care Homes' the HSE still refer to the 1983 Draft Guide - which is obtainable at http://www.odpm.gov.uk/stellent/groups/odpm_buildreg/documents/page/odpm_breg_035369.hcsp

[ianjones]

Hi, I have just joined up today and would like to know if anyone else has heard or applied the term "Stay put Policy" for residents in residential care or nursing homes. Apparently it has been mentioned by staff and its thought to have originated from some fire authorities. I have only seen it applied in one large sheltered accommodation containing 41 flats with a member of staff on duty 24 hours a day.Any comments please

[wee brian]

Sheletered accom is very different from a care homes. Its basicly a block of flats, which are designed with a stay put philosophy.

The only differences are some shared facilities and a warden, who may not always be on site.

Its not a "recognised" opton for res care, as far as I am ware, but it could be more effective when you consider the practicalities of progressive evacuation of old folk.

[colin todd]

Stay put is often talked about ofr res care, and has even been accepted by some fire authorities. Personally, I do not agree with it.

[BobDoc]

Stay put is Ok as well as partial evacuation to a different zone (if the place is zoned) it all depends on staff training, and you have to weigh up in the assessment if the probability of surviving inside the building is greater than trying to get the residents outside, especially in temperatures/weather like we are having at the moment.   SHTM 84 is only for Scotland, doesn't apply England, Wales or NI and in fact started life as a copy out from HTM84 which was purely for NI. and, it is only the latest thinking if you live/work in Scotland.  Wales has also recently published a guide based on HTM 84 but ditto re Scotland. I am led to believe, and I have a copy, that everyones favourite organisation BSI have a document giving guidance called 'Fire Safety in Care Homes for Older People and Children', its worth a look along wiith all the other guides.  As for the draft HO guide 1983/green guide I think that is really old hat.  I always find a visit to the relevant NHS Firecode documents helpful.
Hope that helps in some way
Cheers
Bob Doc