Number of Residents in a compartment

[GB]

SHTM 84 provided good guidance in relation to the ratio of staff to residents in each compartment with a caveat of dependency which should be considered during the assessment.
This particularly was useful when assessing whether the number of staff in a care home was adequate at night time when some care home providers want to keep staff numbers as low as possible (please note I say some and not all!)

I have had a look at the Practical Fire Safety Guides for both North & South of the border and guidance in relation to night time staffing is a bit scarce which is allowing some providers to go on the bare minimum.

This week I have seen one provider have 1 night time staff member with 30 people in one building with a similar number 20m away with the action that the staff member will leave the building that is not affected and support the other staff member. They are justifying this stating a 'stay put' policy in the care home with residents being left in their bedrooms due to the presence of sprinklers.

I love sprinklers - I have them fitted in my house - but I think sacrificing adequate staff numbers to carry out PHE is folly and the reliance on sprinklers too heavy.

Does anyone know of further / more recent guidance similar to SHTM 84 which I can use as a topic of conversation with the care home provider?

[John Webb]

I would have thought that a minimum of two people would be needed. What happens if the single carer is taken ill or is in the middle of carrying out urgent work on a resident when the alarm actuates? (I have to say this is a purely pragmatic viewpoint and not based on any guidance that I've seen.)

[kml]

I agree with you and dont think that the intention when sprinklers were made compulsary was to initiate a system of horse trading over other safety measures such as staff numbers. I would draw the owners attention to the Rosepark FAI in relation to the sections dealing with staff actions  - it would also be worth getting the opinions of the regulatory authority and/ or the FRS, if they are not happy with the arrangements they usually sort things out fairly quickly.

[wee brian]

Sprinklers are unlikely to help somebody directly involved in the fire. this is common in care homes.

https://www.bre.co.uk/filelibrary/pdf/rpts/partb/Sprinkler_Effectiveness_in_Care_Homes.pdf

[kurnal]

Most common advice to care staff is, in the event of a fire in a bedroom compartment, to evacuate the unaffected rooms in the  bedroom compartment involved using PHE before even considering opening the door of the room involved in fire. This is because  as the potential leakage of smoke and risk of flashover may otherwise prevent safe evacuation of the rooms unaffected by fire.

My advice in respect of staff numbers, notwithstanding guidance talking about 2.5 minutes etc is that in the event of a fire if you have not evacuated the bedroom compartment involved before the arrival of the fire service then the RP is going to be in big trouble. So that's always been my starting point when taking on new clients in this sector  and the RP needs take account of compartment size, peeps, staff numbers and capability and equipment needed in order to achieve this, then review your provision and in particular hone your staff's skills through drills etc to seek continuous improvement. And record what you have done.

My question is whether the provision of sprinklers would lead to a change in the advice - would sprinklers make it safe for staff, using appropriate door procedures of course, to investigate the room of origin before evacuating other rooms? Bear in mind in England the provision of sprinklers allows relaxation on door closers? In the light of the BRE report referred to in Wee Brian's posting and with both sprinklers and comprehensive L1 detection there may a chance to save a life in the room of origin without putting others at risk?

Your opinions would be welcome.

[wee brian]

If you're responding to a smoke detector in the bedroom then the fire could be very small and it would seem a shame to leave the resident in there.

Might even be able to put it out before having to do anything else.

[kurnal]

Yes that is a good point and in an ideal world would be my preferred choice of action too-  if staff were trained to firefighter standard and could be relied on to carry out proper door procedure and competent to make a judgement on priorities and risks.

 Generally, with a few exceptions, I do not have confidence in the staff of most average care homes to make the right judgement.  I think it's best to save as many people as you can as quickly as you can without increasing the level of risk in doing so. With zoned alarms of course we are looking at a scenario where there is a smell of smoke in the corridor or signs of fire in the room apparent from outside.

In addition to training courses I always ran timed exercises and set off the fire alarm - it was always surprising and dissapointing to see the red mist descend and staff go to the wrong  zone- addressable alarms can be  a big help but age fairly few and far between due to the 80s building boom, upgrades can be incredibly difficult in an existing operational care home.

We must remember the challenges of the sector- large ongoing turnover of staff, many of whom do not have a good command of English so you never really know how much of the training is fully  understood, widespread use of and standard of the on line courses widely used, massive use of agency staff who move between homes and do not receive meaningful site specific fire training or adequate handover of peeps.
 

Is it better to hand over a fully evacuated bedroom compartment to the fire service on arrival with the room of origin not checked or a potential smoke logged corridor and vulnerable people still at risk? Would sprinklers make a difference?

I am being deliberately controversial but I know realistic scenarios such as this are rarely discussed on training courses. I would be particularly interested in hearing the views of fire officers

[Dinnertime Dave]

I agree with Brian, I used to get fed up with staff telling me that they would feel the door handle and if it was hot not open the door. The likelihood of the door handle being hot in a room where the alarm has been raised by smoke detection is remote to say the least.

Fortunately, I only went to one bedroom fire in a care home, the elderly lady was still in the room and was rescued by the fire service without BA. Staff had been trained not to enter any room, so did nothing. I would estimate that from time of discovery(detection) to rescue was 10-15 minutes. Very little smoke logging.

I always worry about theoretical training as it doesn't account for human behaviour and moral duty on staff. They will nearly always try and do something. I have always been an advocate of giving staff the skills they need to make judgement. Money spent on extinguisher training in care homes is money well spent - It is easier to put a small fire out that move 4/5 residents, sometimes up to 9 in a zone.

[Golden]

Another incident that I discovered while making case studies for my MSc highlights some of the issues is the Woodlands Psychiatric Unit, Ipswich where the AFA system at the hospital detected a fire in ?Poppy Bed 19? and CCTV footage obtained by the fire service as part of the fire investigation demonstrated a lack of care by the staff. Staff members on the ward did not respond immediately to the fire alarm and check the incident location as was the procedures but carried on their routine tasks. The fire was still burning and the patient was still locked in the room. Over five minutes passed, during which time the staff silenced and reset the alarm several times, before anybody went to check the source of the alarm .
As a consequence of the delay the patient was unconscious and unresponsive and due to deteriorating conditions in the room the staff were unable to rescue the patient who was left until they were rescued by Suffolk fire and rescue. As crews commenced their operations difficulties were experienced as they had to force their way through a manually locked fire exit.  The patient underwent resuscitation and further hospital treatment but recovered and was returned to the unit.
A post fire audit was carried out by the fire service who found a series of failings including failure to provide adequate staff training, no fire drills carried out since the unit had been opened and a previous ?notice of deficiencies? had not been fully addressed. Several other fire exit doors were found to be manually locked. The fire service were deciding whether to prosecute they found that liability for criminal acts had not been successfully transferred to the new trust that had been set up some months before and the investigations were ceased.

http://www.suffolk.gov.uk/assets/suffolk.gov.uk/Emergency%20and%20Safety/Fire%20and%20Rescue/Workplace%20Fire%20Safety/2012_12_20%20Report%20of%20Investigation%20Final.pdf

For good measure many years ago I attended a fire in a secure unit where the patient had deliberately set the fire and the staff investigated immediately, implemented their emergency plan and called the fire service; the fire was quickly extinguished but the patient was nowhere to be found having made a successful escape under the cover of the emergency operations!!

[kurnal]

The fire service were deciding whether to prosecute they found that liability for criminal acts had not been successfully transferred to the new trust that had been set up some months before and the investigations were ceased.

That seems a very bizarre decision with echoes of  RosePark?

Have a serious fire and dissolve the organisation in order to wash your hands of responsibility?

I have recently dissolved my business but my Solicitor advices me that despite the limited company no longer existing I personally remain liable for decisions I made as director.  The fire service report states that the RP nominated by the Policy was an individual manager and not the employer, why did they not peruse the employer at the time of the fire? Public sector looking after its own?

[Davo]

I trust you have checked your Articles, Prof

[kurnal]

Hi Davo No not in any great detail I am getting increasingly hit and miss at this game, my wife says I have turned into a grumpy old man. I blame the chemo for a lot of the errors, it's doing my head in  and it's probably time to call it a day and hand over to someone else.

I would be very surprised and dissapointed if UK legislation is so flimsy as to allow  RPs to walk away from their responsibilities by winding up the company in between  having a serious fire and the due process of the Law running its course. If I recall the statistics correctly, 40% of businesses go bankrupt as a result of a serious fire. 

[Dinnertime Dave]

I would be very surprised and dissapointed if UK legislation is so flimsy as to allow  RPs to walk away from their responsibilities by winding up the company in between  having a serious fire and the due process of the Law running its course. If I recall the statistics correctly, 40% of businesses go bankrupt as a result of a serious fire. 

I don't think it is UK law being so flimsy rather 'Public interest' Prosecutions tend to be have to be a nailed on certainty for the fire service to take it on. Blame austerity or what ever you want, Authorities haven't the money to take a chance.

Even the CPS have a view is that the chance of conviction has to be better than 50/50 based on the evidence supplied by the police, if the police don't see it as a priority then the the evidence is likely to fall down.

[Davo]

Retirement's a bu**er, my brain is shrinking due to lack of stimulation............

[colin todd]

Suppers, it never ceases to amaze me what sense you talk.  I wholeheartedly agree with both your posts on this topic.  In fact, I wish I had written them myself (obviously with minor improvements in punctuation). Are you sure you were ever in the FRS?