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Extinguishing risk

Are care home providers doing enough to ensure correct fire safety procedures are implemented? Dawn Foster finds out

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Stock pic of smoke detector

In 2010, Paula Parle died after her nightdress came into contact with a naked flame in Rose Court, an Anchor care home in Bermondsey, south London. Her son told BBC Radio 4 that her family had raised concerns with the staff about her smoking at her home previously, and asked that Ms Parle, who had been diagnosed with dementia, be supervised when smoking, and have her lighter and cigarettes kept safe by a member of staff. The staff prepared a policy to deal with Ms Parle’s smoking, but admitted to Woolwich Crown Court in September 2010 they had not followed the procedure, so her smoking was effectively unsupervised.

Anchor, which runs Rose Court in Bermondsey, south London, was fined £120,000 and ordered to pay £50,622 to the London Fire Brigade after pleading guilty to contravening fire safety laws.

‘The care industry needs to work with us to prevent fires by training staff to pick up on the early warning signs that residents could be at risk from fire and then acting quickly to put measures in place to protect them. We have made significant changes since the tragic fire almost five years ago and the Care Quality Commission’s most recent inspection found the home, which has new managers in place, is fully compliant,’ Rob Martin, Anchor’s National Care Quality Manager tells Inside Housing. ‘Robust smoking and fire safety policies were put in place shortly after this incident and are followed. All staff undergo dementia, fire and health and safety training. Residents are no longer allowed to smoke inside the care home.’

The incident led Anchor to strive to make vast improvements in the implementation of its safety policies. ‘At the last inspection, inspectors said care at Rose Court was delivered in a way that ensured people’s safety and welfare. They highlighted the positive feedback from our residents and their relatives about the new personal care plans,’ Rob Martin, Anchor’s National Care Quality Manager, tells Inside Housing.

‘We have made significant changes since the tragic fire almost five years ago and the Care Quality Commission’s most recent inspection found the home, which has new managers in place, is fully compliant.

‘Robust smoking and fire safety policies were put in place shortly after this incident and are followed. All staff undergo dementia, fire and health and safety training. Residents are no longer allowed to smoke inside the care home,’ adds Mr Martin.

One of the balances to be struck in securing safety of tenants is that of maintaining individual liberty, and care responsibilities. Many older people smoke, and still rightly expect to make their own choices about their life even when receiving a high level of care. At the same time, staff have a duty of care to residents and finding a happy medium that doesn’t jeopardise safety can be difficult. ‘We have worked hard to foster the right person-centred culture in all our homes and there is a balance to be struck between ensuring people are safe and enabling them to be as independent as possible,’ Mr Martin says. ‘While we always have room for improvement, our above-average score in the Your Care Rating survey of residents, which is administered by Ipsos MORI, provides welcome reassurance that we are achieving that.’

Ramped up risk

With a rapidly aging population (see feature, ‘Spotting the Signs’) the pressures on care services and homes will increase, as will individual vulnerability. While smoking is still one of the main causes of fires, smoking rates amongst the population are falling, which could decrease the number of fires nationwide. However, increasing frailty as the population ages ramps up the risk of fatalities and serious injury when things do go wrong.

PAULA_PARLE

Tragic accident: Paula Parle

London Fire Brigade Deputy Commissioner Rita Dexter explains: ‘Older people, as well as people with mental health problems and those with mobility issues, are the group most at risk from fire and it is one of our priorities to reduce fires in care homes and sheltered accommodation. It is shocking that so many people are still dying in places where they should be safe and the sad fact is that many of the deaths that we see could be easily prevented.’

During 2013/14 there were 527 fires in London’s care homes and sheltered accommodation, with two people dying and 34 people being injured. One in three people who died in accidental fires in London lived in care homes or sheltered accommodation. Eight of the 31 victims of accidental fires had a home care package and a further two died in care home fires, the research found.

‘It is absolutely shocking that some of the most vulnerable people in our society are still dying from fires in places where they should be safe,’ Ms Dexter said in a statement after the Anchor court case. ‘Every care home needs to look at their fire risk assessments and tailor them to meet the real needs of the individual residents in their care.’

‘We want the care industry to work with us to notice the warning signs and act quickly so that these fires and their tragic consequences are stopped from happening in the first place,’ Ms Dexter told Inside Housing. ‘Care homes should be regularly updating the fire risk assessments of everyone in their care and tailoring them to meet the individual needs of those same residents.’

One small change could reduce the number of casualties and fatalities, Ms Dexter believes: ‘We want to see all care homes fitted with sprinklers. They are a potentially life-saving device and the number and regularity of care home fires that we attend is clear evidence that builders, developers, local authorities and private providers need to stop ignoring their benefits.’

As of January 2014, all new homes and converted care homes in Wales are required to fit sprinkler systems, under legislation put forward by then housing minister Carl Sargeant and Labour assembly member Ann Jones. Prompted by deaths in Quebec care homes, Mr Sargeant pushed the legislation through the Welsh assembly in spite of opposition from numerous politicians including the communities secretary Eric Pickles, and the Welsh secretary, David Jones.

Mr Pickles claimed the legislation would drive up housebuilding costs and was quoted as saying, ‘The growing distance in relative building costs between England and Wales will place Wales at a competitive disadvantage, diverting housing investment away from Wales. Whatever the intentions, I fear this burden of red tape will mean less housebuilding, fewer first-time buyers and more expensive rents and mortgages in Wales.’

Examining legislation

The Welsh secretary David Jones told the Conservative party conference in September 2013, ‘Regulations on builders are considerably more onerous than in England - including the bizarre proposal to fit every new house with a sprinkler system. The consequence of this over-regulation is that fewer houses are being built in Wales.’

But Labour assembly member Ms Jones accused Mr Pickles of hypocrisy, after the discovery of a press release in which the communities secretary encouraged councils and housing associations in his Brentwood and Ongar constituency ‘to save the lives of their tenants by including domestic sprinkler systems in the specifications for new properties to rent.’

Welsh ministers commissioned statisticians to examine the impact the legislation will have, and say it will save a predicted 36 lives and prevent an estimated 800 injuries between 2013 and 2022. The legislation was prompted by similar legislation being introduced in Quebec, after a blaze in an older people’s residential home killed 32 people. An inquest ruled that the deaths could have been prevented if the home had been fitted with a sprinkler system.

Croydon is one council that has acted - sheltered housing blocks in the borough have recently been fitted with sprinkler systems which could save lives in the event of a fire.

London Fire Brigade presented the council with a certificate on 28 November after it installed sprinkler systems in two special sheltered housing schemes at Truscott House in West Croydon and Brookhurst Court in South Norwood, with four more to follow in the next month. Special sheltered housing blocks accommodate residents with care and support needs.

The sprinklers will help protect people who would not be able to evacuate by themselves in the event of a fire within their own flat.

Alison Butler, cabinet member for homes and regeneration with the council, was clear about its reason for acting: ‘It’s really important that we ensure our more vulnerable residents are safe in the event of a fire,’ she states.

At the end of the day, that has to be the most important consideration for all landlords.

Fire deaths and injuries in London care homes

YearIncidentsFire deathsFire-related injuries
2008/09541352
2009/10500433
2010/11   477440
2011/12476147
2012/13540226

Source: London Fire Brigade

Factfile: Care home fire deaths

Morven House, a private care home in Croydon, was handed a £70,000 fine in May 2014 after a successful prosecution by London Fire Brigade.

The brigade’s fire safety inspecting officers visited Morven House after concerns were raised about the home by the Care Quality Commission.

When they visited the home in February last year, which at the time housed 17 residents, including elderly people with dementia and disabilities, the brigade’s inspectors immediately found a number of major fire safety failings.

The most serious related to blocked fire escape routes on the ground floor which would have seriously hampered any attempt to evacuate residents safely in the event of a fire. The property was undergoing building work at the time and the front door of the home had been boarded up, while an alternative fire exit was entirely blocked with bricks and cement, leaving the only escape route through the lounge door at the back of the home.

Elsewhere, on the home’s second floor another fire exit – an external staircase – was completely inaccessible because of scaffolding and unsuitable for use by residents because it was so steep. Another external staircase on the first floor was also blocked by scaffolding.

Other fire safety failings discovered by the brigade’s inspectors included the failure to keep an up to date fire risk assessment, the lack of any emergency plan in the event of a fire and an inadequate fire detection system.

Source: London Fire Brigade

Keeping control

Smoking control measures - things to be considered

  • Residents should not be permitted to smoke in bedrooms unless the risk is identified as ‘low’ and the bedroom is suitably equipped
  • Do residents smoke in bed or a chair?  Location of smoke detector and flammability of clothing, bed linen and furniture need to be considered.  Do they have fire retardant bedding?
  • Are cigarettes lit with a match or a lighter?  How do residents access their lighters?
  • How is access to cigarettes and lighters controlled?  Have the family been informed of arrangements if they are not to be given directly to the residents?
  • Supervision – will someone else light the cigarette?  Will anyone stay with the resident while they smoke (health and safety at work will need to sign a form to say they agree to this), how often is the resident checked if they smoke alone and is it enough?  Do the arrangements change at night?
  • Are sprinklers or some alternative fire suppression arrangements required?
  • Is there portable fire extinguishing media nearby and if so, are staff trained to use it?
  • Are there appropriate deep ashtrays?  Are they emptied regularly?

Source: London Fire Brigade

 


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MORVEN HOUSE 1
MORVEN HOUSE 2
PAULA PARLE
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