How can we improve life safety in care homes?

Over the last 12 months, the country has watched COVID-19 tear through care homes and leave devastation in its wake. With the sector experiencing the first major escalation in fatalities due to the close knit and closed off nature of homes, the importance of protecting society’s most vulnerable has been thrust firmly to the top of the nation’s agenda.

As well as the threat of the virus though, care home residents still face the risks they did pre-pandemic from a variety of other factors, including fire. And when it comes to making, installing, maintaining and supplying life safety technology, the care home environment presents a range of unique challenges.

In April 2021, Hochiki Europe hosted a roundtable made up of industry experts focused on the requirements and opportunities around life safety in care homes. The virtual conversation explored how the people responsible for keeping residents and care givers safe can work together, sharing knowledge and ideas to improve standards and best practice.


The Panel

  • Paul Adams, Marketing Manager, Hochiki Europe (Chair)
  • Martin Green, Regional Sales Manager, Hochiki Europe
  • Ian Hill, Emergency Lighting Manager, Hochiki Europe
  • Andy Hollingshead, Health and Safety Manager, Barchester Healthcare & Vice Chair NASHiCS
  • Simon Titley, National Account Manager – Healthcare, Churches Fire & Security
  • Ian Watts, Business Development Manager, Llumarlite Lighting Solutions


How has the pandemic affected the provision of fire safety in the care environment?

The discussion began with a reflection of the last year and how COVID-19 has impacted the delivery of fire safety services within care homes – taking into consideration the battle of controlling infection and reducing visitors, while observing stringent safety standards and maintenance requirements.

“It’s obviously been a very difficult time within the industry, particularly in March and early April last year when people were being discharged from hospital without a test, as testing wasn’t the norm at that time,’ stated Andy Hollingshead – who is part of the H&S Team for one of the country’s largest independent care providers. Like any other business, he stressed that those within the care sector had faced no choice but to adapt almost overnight.

“Fire and evacuation drills are a vital part of any fire safety strategy, but they encourage people to gather together, which is a challenge in the current climate. To combat this, we turned drills into desktop training where scenarios were given and staff had to describe the actions they’d take. This has been extremely well received and we’ll be continuing to run these exercises even after restrictions are lifted.

“We also had a number of fire and rescue crews that were concerned about how they’d know which residents had tested positive/suspected if they arrived to support with an emergency. We overcame this by putting red letter Cs on PEEPS to identify who was high risk, which made things immediately clear to fire fighters.”

On the topic of maintenance, all parties agreed that the legal requirement to inspect and test systems over the last 12 months has been challenging. Simon Titley shared his experience: “By law, risk assessment and method statements (RAMs) must be updated regularly, so we had no choice but to continue. We altered our approach to offer more virtual appointments via WhatsApp video calls to maintenance staff or care home managers to ascertain whether or not a site visit was necessary.

“When they are, all appointments are pre booked and technicians are instructed not to enter a care home until they’ve called from the vehicle to ensure it’s still appropriate to visit. We have put certain protocol in place where contractors can’t enter bedrooms and with smaller properties, we’ve prearranged for the carer to take the patient out into the garden while we are on site. We’ve also produced a letter for staff which states that they provide an essential service to support them with accessing the vaccine as a priority.”

Everyone agreed that new processes are key and looking to how life safety technology itself can support, Hochiki’s Martin Green expanded – “hybrid wireless systems are a great fit as they are designed to reduce installation time, which minimises the time installers need to spend in people’s rooms. The wireless technology that’s on offer now is so much more robust than it was a few years ago – it’s ideal for the care environment.”


Working alongside vulnerable individuals

Albeit obvious, one of the most challenging considerations of providing life safety systems to the care sector is the fact that many residents have poor sight, mobility issues, are hard of hearing or living with dementia – all adding to the complexity of ensuring systems are appropriately designed.

Hollingshead explained that protecting those with bariatric care requirements and reduced mental capacity causes the most issues and in response, Green went on to offer his insight into the technology designed specifically with vulnerable individuals in mind. He said, “In the event of a fire alarm being activated, visual alarm devices – or VADs – complying to BS EN54-23 are required in locations where they are considered to be the primary source of warning to building occupants.

“Within care homes, this is extremely common so we offer devices which flash brightly to serve as a primary indicator of a fire occurrence for those with impairments. More innovative control panels which enable a programmed phased evacuation are also perfectly suited to care environments, as they help to control the evacuation process and minimise confusion and chaos – a must when dealing with people who may not have any comprehension of the danger they’re facing.”

Hollingshead agreed – “People believe the concept of fire evacuation is total evacuation but in the care industry, it’s progressive horizontal evacuation (PHE). Getting people away from the point of a fire and moving them into a point of safety (minimum 2 fires doors away) is the best approach.”

When questioned on the recommended two and a half minute evacuation time, Hollingshead shared some interesting trivia – “the story goes that this originates over 100 years ago from theatres playing the national anthem in the event of a fire, as it typically signalled the end of a performance and encouraged audiences to leave. Whether this is true or not, it makes very little sense to a care worker in an emergency who’s trying to assist a resident that requires a hoist to get out of bed, for example. That’s why we take the simple approach of ‘you do whatever it takes to save a life.’”


Minimising false alarms

Next, the panel discussed the importance of reducing occurrences of false alarms – due to the reoccurring issue of the frailty of care home residents. Simon Titley reminded the group that this can be supported by regular, planned preventative maintenance programmes which extend the life expectancy of equipment, in particular sensors. In addition, visual checks of electrical equipment that come into a premises are vital to monitor for scorched plugs or broken cables.

Andy Hollingshead commented – “Toasters are a huge issue – they usually cause smoke rather than fires, which cause activation of alarms. Halogen floor lights have recently cause problems too, so we only use LED bulbs across our homes now. It’s so important to be smart in order to avoid bad relationships with local fire brigade, as the work they do is incredible and it’s vital to keep them on side.”

Turning to how technology can help avoid false alarms, Hochiki’s Martin Green said: “Investigation delays can be set to give staff a few minutes to respond before the fire brigade is alerted and cause and effect programming in multi-sensors can also help, particularly with common causes such as toasters. For example, you can program the multi-sensor to provide an initial alert at the fire control panel to inform a manager that there is smoke present and then, while also monitoring for the presence of heat, begin to determine whether it’s a real fire and whether a full alarm condition should be initiated.”

When asked what companies can do to improve system design and engineering, Simon Titley stressed that every design should be built around a fire risk assessment (FRA) provided by the owner of the care home – “creating a robust fire safety strategy relies on a partnership between contractor and operator”, he said.

Picking up on a potential design flaw, Hollingshead explained that people living with dementia often set off call points. “We do everything we can to try and stop this with covers and howlers and it still happens. Within BS 5839-1, there’s a proviso that all manual call points are fitted with covers to reduce false alarms but when you’re dealing with people living with dementia, it’s almost impossible to avoid them completely,” he said.

The group were in agreement and FIA trainer, Ian Watts, advised that it’s possible to write something into the care home’s risk assessment to override this issue. He commented – “There’s so much ability to create variations to the BS and this is something that I’m always keen to stress during training courses. Of late, there has been a real uplift in the take-up for training, which is wonderful to see. People are taking their knowledge and applying it to individual buildings successfully – it’s a lovely movement.”


The role of regular risk assessments

Expanding on the subject of risk assessments, all parties agreed that they don’t just offer an understanding of fire safety, but also the people that use a home and the unique difficulties of each care home. “This isn’t often appreciated within the industry. An ex-fire officer isn’t necessarily a risk assessor,” said Hollingshead. “We have a full survey every three years and an additional review annually that looks at the people and the environment, not just the system.”

Under the Regulatory Reform (Fire Safety) Order 2005, the responsible person is required to – following a risk assessment – implement appropriate fire safety measures to minimise the risk to life from fire, and to keep the assessment up to date. However, within the industry, there is often confusion around how a responsible person is defined. Andy continued: “Under legislation, it’s officially the CEO but typically it’s down to managers to make sure remedial work from assessments are carried out.”


Energy efficiency

While it’s clear that fire safety must not be disregarded in the quest for energy efficiency, there is a clear link between the two. The panel discussed ways that new build homes are more energy efficient and fire safe by design – through the use of products such as LED bulbs and USB charger ports. However, when it comes to older buildings it can be more challenging, as it’s hard to put demands on people regarding their own belongings.

Hollingshead said: “We wouldn’t like people to come into our bedrooms and start altering things, so it can be tricky! There are ways to overcome this though, for example, we’ll quite often replace the halogen bulbs in residents’ reading lamps for cooler running LEDs, so you’re not taking someone’s belongings away, just changing them to make them safer and more efficient.”


The benefits of wayfinding technology

At this point, Hochiki’s emergency lighting manager, Ian Hill, raised the topic of wayfinding technology and emergency lighting, which is also now designed to use LED – not only more efficient but also long-lasting, meaning products are much more reliable, reducing the chance of failure and simplifying maintenance.

Ian explained: “The majority of fire risks in care homes are at night, when there’s substantially less staff than during the day and it’s dark, which highlights the importance of designing a fire system with emergency lighting in mind.

“Design is vital here. It’s extremely important to communicate an exit plan right the first time to minimise confusion – especially when dealing with people with dementia. In care homes, there tends to be corridors with lighting signs at each end, so blocking off exits to take choice away makes evacuations safer and quicker. With some intelligent life safety systems that combine emergency lighting and fire detection, at the first instance of a fire, the nearby exit signs will change from a green running man to a red cross to show the exit is compromised. In these instances, there’s no room for ambiguity and it must be totally clear to residents and staff alike.”

Closing the discussion, Paul Adams asked the group for any final advise they’d offer those within the care industry, as well as where they can access support or technical guidance.

Ian Watts suggested the FIA, while Andy Hollingshead praised the HSE and NASHiCS websites. He also urged them to always consider the ‘three c’s’ – communicate, command and control. “We use this motto to train care sector staff and believe that if all these are in place, nobody will lose their life.” Watts echoed this sentiment – “in a similar vein, we use ‘review, refresh, replace’ when referring to the importance of maintaining risk assessments.”

In conclusion, Ian Hill stressed that reading the guidance and keeping abreast of evolving standards and requirement is important, a robust life safety strategy comes down to a successful initial design and the quality of products installed. By working with industry experts, those within the care sector can rest assured that every possible measure is in place to protect residents and staff.