Care Home Fire , Quebec

[dalnaskhl]

http://www.cbc.ca/news/canada

tragic

[Mike Buckley]

tragic yes, but too familiar.

[Kelsall]

The potential for something like this to happen here is still too high i feel. I think there is an absolute acceptance by many involved in care home fire safety that if a fire happens in the middle of the night when staffing levels are low; there is a very good chance that there will be multifatalities.

Thankfully there are not that many fires, but there should be no excuses from the care home operators; if the evacuation strategy isn't possible at night, then they need to invest in something that will work.

[Paul2886]

What do you suggest as they won't increase staffing levels for that reason. The brigade where I live won't turn out to a fire alarm sounding so staff have to confirm a fire or signs of a fire which can be tricky for some. Recall to duty (snowball system) is probably the best that we can come up with. Of course the chances of a fire starting can be reduced by a good FRA and staff training. Look forward to views on this

[Mike Buckley]

Unfortunately there is not a lot that can be done, everybody is minding the pennies hence the staffing levels at the homes are kept as low as possible and the brigades are trying to save money by cutting back on turnouts.

Yes the safety of the residents is the responsibility of the care home but they will push the boundaries until either a brigade takes action and makes them do something (expect wails and moans in the press) or there is another tragedy in this country (expect wails and moans in parliament).

Just to add to the mix we have "Call me Dave"'s push to reduce the red tape (regulations) on small businesses.

I think we can all see the train wreck coming and there is not alot we can do except sit and wait.

[kurnal]

I have not seen anything in the red tape challenge (full list of proposals available for download on the cabinet office website) that would affect standards of fire safety in care homes.

Or fire safety in general- there are proposals relating to furniture and furnishings, repeals of some old strands of the factories act and OSRP and would you believe the old workplace fire safety regs where they were incorporated into the H&S Management Regs, proposals to allow children aged 12 to buy Christmas crackers and a few issues relating to marine fire safety.

[Kelsall]

Next week is National Sprinkler Week www.cfoa.org.uk/16352

On a risk basis (as every care facility is different) the use of sprinklers should be explored as an option for life protection. I don't believe they need to be retro fitted in every care facility in the UK but when an enforcing authority visits a care premise and the risk profile strongly suggests there may be an issue with the escape strategy at night. I think they should have the courage of their conviction and serve a notice. There are hundreds and hundreds of care homes in the UK that haven’t a snowballs chance in hell of getting all their residents out of the compartment of origin at night never mind out of the building if needed. I recall a care home a friend of mine worked in who moved their residents higher up the floors as they became less mobile and less coherent. The residents least able to self-evacuate being on the third and highest floor.
I think there are a lot of things that need to be done before we get to the point where enforcers and risk assessors are able to say this just won’t work with the numbers of staff you have on at night; but let’s make sure we do them before we have a fire like the one in Canada. The care sector need to be engaged the enforcers and risk assessors need guidance and the government needs to help care operators make the change to operate safely 24 hours a day.
We absolutely need care facilities in the UK but that need should not make the authorities turn a blind eye. The care sector know there is an issue, the fire service know there is an issue I even believe that fire risk assessors know there is an issue. If home operators are not staffing because of cost but that reduction in staff means the escape strategy is not going to do the job, something needs to be put in place to compensate for the reduction in staff.  I know sprinklers may not save the resident in the room of origin but they will buy time for the management to get the rest out safely.

[kurnal]

Yes serve a notice by all means but the notice could only identify the installation of sprinklers as one possible way of improving safety standards. You could not REQUIRE a system to be retrofitted as part of a notice- it would not be enforceable.

The other problem that might be encountered is the difficulty of installing such a system in an existing operating care home. I have a care home client who is having a new addressable fire alarm system installed at the moment and even that is a nightmare for staff and service users alike.

[Kelsall]

Fully agree but I believe notices are not being served because the answers are just too difficult or too expensive and that isn’t right.

The biggest issue is the notice being served and unless there is a key shift away from acceptance that the escape strategy just won't work with two staff on then we will end up with a fire that kills many more residents than it should.

At the end of the day I feel it is reasonable to protect residents 24 hours a day, if you can not staff it there needs to be something else that does the job. The enforcers can enforce that!

[nearlythere]

From what I can make out the building and those surrounding are timber frame. The vast majority in UK are bricks and mortar. Perhaps there is a lesson there?

[Dinnertime Dave]

Unfortunately there is not a lot that can be done, everybody is minding the pennies hence the staffing levels at the homes are kept as low as possible and the brigades are trying to save money by cutting back on turnouts.

Yes the safety of the residents is the responsibility of the care home but they will push the boundaries until either a brigade takes action and makes them do something (expect wails and moans in the press) or there is another tragedy in this country (expect wails and moans in parliament).

Just to add to the mix we have "Call me Dave"'s push to reduce the red tape (regulations) on small businesses.

I think we can all see the train wreck coming and there is not alot we can do except sit and wait.

Sorry Mike I think there is plenty that can be done. Reduce the size of protected areas, have an addressable alarm, link it to an ARC and have your fire risk assessment done by a 3rd party accredited risk assessor, in return I can let you reduce your staffing from 3 to 2. As the saying goes " spend a little save a lot"

I have also experienced CQC preventing a care home opening following an informal notice, this alone had the potential to cost the operator £30k per week. They had the work done in three days!

Call me Dave - Dinnertime Dave 

[Paul2886]

Hi Dave, I trhink the point being made originally by Kelsall was a total evacuation at night. We know the benefits of additional compartmentation which will of course assist in the first stages of evacuation. Yes an addressable system will help derrtimine the precise location of a fire but not how 2 night staff will evacuate the premises totally. The real world is that you can't evacuate any person with problems of dementia, leave them outside then spend another 15 minutes retreiving the next resident. You are of course absolutely correct in mentioning a fire risk assessment is undertaken by a professional but one heck of a lot is down to staff training both to help reduce the risk of a fire and responding effectively to the fire alarm. There are so many people providing training that have no concept of care homes and the protection offered by the building layout and alarm systems. Too much emphasis often on pretty colourful pointless videos and death by powerpoint presentations splashed on the nearest convenient wall that have nothing or little to do with the home/
My thoughts are that only a 'snowball' system of recalling staff to duty will work. I recently experience a fire authority inspector suggesting a dormitory on the premises where off duty care staff can sleep in case off a fire.......I give up.

[Dinnertime Dave]

The problem is that the HM Guides don't give guidance on numbers of staff needed to evacuate, they choose a time of two and a half minutes then back tracked in the additional guidance, that incidentally ends this month. Anybody know if it is reviewed?

For any worthwhile guidance you have to look at HTM 84 which at least puts numbers of awake staff against numbers of residents in protected area. There is some other guidance that gives numbers needed based on clinical needs and this Paul allows as you state "snowball" arrangements.

I agree that very often staff training is poor and is based on theory - I often ask staff when auditing what their actions will be when they investigate an area. They all say that they will check doors for heat before opening. Great in theory put not a realistic situation based on a system based predominantly on smoke detection. Many staff don't have practical extinguisher training, surely it would be easier to extinguish a small fire than move up to 10 residents - A manual handling nightmare.

[nearlythere]

The problem is that the HM Guides don't give guidance on numbers of staff needed to evacuate, they choose a time of two and a half minutes then back tracked in the additional guidance, that incidentally ends this month. Anybody know if it is reviewed?

For any worthwhile guidance you have to look at HTM 84 which at least puts numbers of awake staff against numbers of residents in protected area. There is some other guidance that gives numbers needed based on clinical needs and this Paul allows as you state "snowball" arrangements.

I agree that very often staff training is poor and is based on theory - I often ask staff when auditing what their actions will be when they investigate an area. They all say that they will check doors for heat before opening. Great in theory put not a realistic situation based on a system based predominantly on smoke detection. Many staff don't have practical extinguisher training, surely it would be easier to extinguish a small fire than move up to 10 residents - A manual handling nightmare.

Thats the big question.
Do you ignore the fire provided it is contained and commence evacuation or try to deal with the fire and if it goes pear shaped and the fire has developed or lost it's containment, then commence evacuation with the possibility that time has been lost through ineffective action by staff.?
How much training would staff need to undergo so enabling them to make important strategic decisions in a fire situation?
How do you teach staff to be able to recognise different fire situations so that they can make a judgment calls on the course of action to take to deal with the situation - successfully?
The course of action must be dead simple so as to be easily understood by all.

[Paul2886]

Hi NT, absolutely agree and so we decide that trained fire wardens are always on duty only for them to have left after a few weeks and so we start again. My belief is that all staff in the care home should be trained to a fire warden standard. It's s massive problem exerbated by: the unpredictabilty of elderly residents, the bloody hoist not being the effected floor and we can't use the lift to get it, the residents evacuated into a horizontal safer position being left wondering off and falling down the stairs. I've been conducting fire evacuation drills in care homes for years now and even under controlled conditions its a nightmare. My training thoughts are: more emphasis on preventing fires, all staff being able to effectively use the time an activated detector gives them and the importance of good fire doors for containment.