Failure in Care Homes

Every year there are around 800 fires in homes providing care for older persons in the UK. On average 5 people die each year and a further 90 are injured.Over the past 10 years 45 people have died and 1000 have been injured. Added to this is the true cost of pain,suffering and impact on families and careworkers. Primary causes of fires in care homes are faulty electrical appliances or wiring, cooking facilities, smoking related combustion, misuse of equipment and deliberate arson. Standards of England’s care homes are putting thousands of elderly and disabled at risk. Homes are routinely breaking fire regulations, with 135 homes branded fire hazards by fire inspectors. It is also important to remember most of the deaths in care homes are as a result of the smoke inhalation rather than burning.

The worst case of fire in a care home was at Rosepark Nursing Home in Scotland in 2004 in which 14 people died. Rosepark is known as the worst care home fire in UK ever.

Rosepark is a prime example of failure in care. Everyone has the right to be safe and it was easy avoidable according to investigations following the fire. The staff at Rosepark did not act quickly enough. The fire started in an upstairs electrical cupboard on 31st January 2004 (dodgy wiring was to blame). The fire safety at the home was seriously defective. This was pointed out to Thomas Balmer owner of the care home a year before in January 2003. James Reid carried out an audit and recommended key changes, these were there were not any suitable and sufficient health and safety policies in place, fire drills were overdue a fire drill and full evacuation should take place every six months. He found that some of the fire exits were blocked with day to day items. The lift room had flammable paint tins stored. Some of the night staff did not know what to do in the event of a fire.

The fire and deaths could have been avoided if
1-regular electrical testing had taken place.
2-The electric cupboard where the fire started should have had fire doors. It was also on a critical escape route. 3-There were aerosol cans stored in the cupboard where the fire started. 4-The bedroom doors did not have devices to close them in the event of fire. This would have made a significant difference to the resident’s time to evacuate. 5-There were too many rooms in one corridor to allow for effective evacuation. 6-A fire alarm panel should have been installed where staff could see it and trained to see where the fire started. 7-None of staff on duty except the senior in charge had fire training. 8-There was a nine minute delay between fire alarm sounding and emergency services being called because of the homes policy of locating fire before dialling 999. 9-When emergency services arrived they failed to independently check information given to them by the nursing home regarding fire location. 10-A proper fire risk assessment had not been carried out. This is an important document which would identify worst case scenario’s, such as night fires, means of escape and emergency. 11.An additional 4 minutes were added when the fire brigade went to the wrong entrance of the Care home.

The homes construction also came into question which was managed by the manager of the care home Thomas Balmer who had no experience of construction, the care home required knowledge of structural fire precautions. Following this tragedy improvements to the home were made. The electrical system is inspected every three months. fuse boxes are contained in separate locked cupboards, automatic door closers are fitted with smoke seals to bedroom doors, aerosol cans and other hazardous materials are kept away from heat sources, a new fire alarm system has been installed and improvements to staff training have been brought in. It was felt that 4 people died in the fire as a direct result of not calling the fire brigade immediately (This could have been though lack of training in the fire procedures).

Following this tragedy fire services started regularly visiting care homes in Scotland offering safety advice. New legislation in Scotland following public uproar over how these circumstances were allowed to occur in a care home, they were angry and could not understand why checks on public buildings, staff training etc had not been carried out at Rosepark and that for a little extra cost lives could have been saved, the result of the findings meant all new care homes and extensions to existing ones required a sprinkler system to be fitted. There has been no multiple deaths in homes fitted with a sprinkler system.

From my own personal experience working in care homes we had fire alarm drills but they were at the same time on a Friday but never involved the night staff. Which was fine as long as there was a fire during the day would be fine. It was a surprise to me after researching this subject just how many fires occurred in Care homes each year and the loss of life and injuries. It has also made me aware of the potential for me to spot problems when visiting people in their own homes whilst doing my rounds. As it is just as likely to occur in those situations. Most commonly in the bedroom or with nightclothes catching fire. I have included some handouts on fire equipment such as ski sheets, evacuation chairs and ski pads which are useful in the evacuation of patients in the event of a fire who are unable to be mobile and therefore speed up the evacuation. In April this year the Care Quality Commission was forced to abandon 580 planned visits on Hospitals and Care homes in favour of carrying out spot checks on doctors who were carrying out wrong sex abortions. They Claimed it had used up £1 million on resource’s. In 2011/12 it had spent 1.6 million on communications and £417,000 on marketing a total of £2 million.

To summarize it appears whether it is the Care Quality Commission, the care home owners or the staff it all comes down to the money available and prioritizing what is most important. It is about striking a balance and improving over time the way we do things and learn from experience, a serious fire in a care home has highlighted the need for stricter controls to be in place like staff training, the installation of sprinklers and regular checks. Like most jobs there are lots of new legislations which take time to bring forward and implement into the workplace and come from learning experiences collected from for example accident records.