Safety advice for professionals and carers

Fire safety advice for professionals and carers who work with people with care and support needs.

health_and_safety

Safety

As part of the West Midlands Fire Service's (WMFS) strategic vision to make the West Midlands safer, stronger and healthier, we have produced a series of initiatives, training packages and guidance aimed at those working with and or supporting members of the community with care and support needs.

There is documented evidence following Safeguarding Adult Reviews (SAR) highlighting that following fatal accidental fires in the home, adults with care and support needs may be at an increased risk of fire. However, these traits are not always recognised by their care provider and are not shared with fire and rescue services who are best placed to offer advice guidance and support.

Public sector organisations have a duty under the Care Act 2014 to work effectively and in partnership to ensure that individuals can continue living independently, safely in their own home for as long as possible.

Fire service data analysis concludes that casualties of accidental dwelling fires who are in receipt of care and support, are more likely to be severely injured or die as a result of the fire.

Additionally, West Midlands Fire Service Serious Incident reviews (SIR), have identified a need for the risk and vulnerability to fire to be integral to the initial and ongoing individuals care plan, this should also include a responsibility to monitor and review any change of circumstance that affects that risk.

In assessing and providing for someone’s needs to live independently, a variety of health care agencies and professionals may be involved, so our guidance can assist those who are:

  • Commissioners
  • adult social care staff
  • social workers
  • occupational therapists
  • those providing domiciliary and home support
  • continuing health care professionals
  • community nursing teams.
  • Staff in organisations or agencies involved in the care of people in their own home
  • Those providing unpaid care and support voluntarily to a family member or friend.

The aims and objectives of our guidance and associated learning provide information in the following areas:

  • Identifying risk and vulnerability to fire
  • the importance to include the risk of fire in the initial assessment and care plan design
  • when and how to refer to WMFS including what support and services are available
  • ongoing training and workforce development.

We trust our guidance will help raise awareness to the correlation of those living independently in their own home with care and support needs and any potential fire risk that may pose. The term ‘own home’ includes those people who live in sheltered housing with care and housing with extra care schemes

The e-learn package

As part of the West Midlands Fire Service's strategic vision to make the West Midlands safer, stronger and healthier, we have produced an e-learn package designed to help those who work within a care environment. This will help you to identify potential fire hazards and risks you may find whilst caring out your care role.

The following link will take you to the registration page, where you will find a short video clip explaining how to register to complete the course. Please use the enrolment code '999' when prompted.
Partners and carers learning portal

Identifying vulnerability and risk to fire

The following are characteristics and vulnerability to fire that you may see or become aware of during the course of your work. 

While individually, these can increase risk to an individual, combinations of these characteristics will escalate the risk and make it even more vital to ensure appropriate support and mitigation is considered. 

Where risk and vulnerability to fire is identified, a Safe and Well visit should be requested, even where the individual may not meet eligibility/thresholds for care provision. Although consent is preferable for best engagement, we are able to act on referrals made without consent where risk and vulnerability have been identified. You can do this via the button below
Book a Safe and Well visit
A professional carer talking to an elderly gentleman

Smoking within the property

A high percentage of injuries and fire deaths are from fires caused by smoking. Indicators of risk to fire associated with smoking include:

  • Burns on carpets, furniture, bedding and clothing
  • evidence of smoking in bed
  • carelessly discarded cigarettes or matches
  • overflowing ashtrays
  • lighters or matches within the reach of children.

Information on smoking safety can be found on our smoking safety advice page.

Physical Impairment/Limited Mobility/Reduced Manual Dexterity

A person with a physical impairment or limited mobility is not necessarily at greater risk of fire. However, if a fire should occur, they may be slow or unable to vacate the property in a safe and timely manner.

Reduced manual dexterity may increase the likelihood of a fire, particularly from smoking or other household activities.

For individuals who are bed dependent or bariatric, in the event of a fire, escape will not be an option. The biggest risk to these individuals is smoking.

Drug and alcohol dependency / misuse

May increase the likelihood of a fire, particularly from smoking, or other household activities, such as cooking because its effects inhibit the ability to make safe decisions. It also affects the ability to recognise and respond appropriately in case of a fire.

Use of prescribed medication

Prescription medication can increase the risk of a fire starting particularly if the individual is a smoker. It can inhibit the ability to vacate the property in a safe and timely manner. This is because it is either designed to, or has side effects, that relax or create calmness, and help people to sleep.

Mental ill heath

Mild mental illness with minimal medical intervention does not necessarily increase the risk of fire. More serious diagnosed conditions may lead to stronger medication, and more propensity to consume alcohol, non-prescription drugs and smoking.

In some more serious conditions symptoms can include fire setting behaviours.

Dementia

Dementia is a progressive brain disease that means a person’s ability to make rational cognitive decisions will become more challenging the further along the journey they are. Some of the specific risks and vulnerabilities to fire that the condition creates are:

  • Leaving cooking unattended or putting things on cookers or in microwaves that shouldn’t be there
  • understanding the sound of the smoke detector in the event of a fire and taking appropriate action
  • not recognising the property they live in, can inhibit their ability to exit in a safe and timely manner, in the event of a fire.

Disorganised living - hoarding behaviours

Hoards generally increase fire loading within a property.

The hoard can block exit routes which would reduce the ability to exit in a safe and timely manner, in the event of a fire. It can also affect firefighters' ability to tackle the fire because it makes the fire more intense and makes it more difficult to make a rescue.

The content of the hoard may include hazardous or highly inflammable materials and the hoard may be located close to ignition sources such as gas fires or cookers.

Heaters and open fires

West Midlands Fire Service is aware of a number of injuries and fire deaths relating to inappropriate use of portable heaters and/or poor regard for being in close proximity to an open fire, (gas, electric or solid fuel). More information on open fire safety can be found on our chimneys and open fires safety advice page.

Learning disability

The risk factors are similar to those who live with dementia:

  • The disability may inhibit their ability to make safe decisions
  • they may not remember or retain safety information which could affect their ability to respond to fire and exit in a safe and timely manner
  • due to their vulnerability, they may be inappropriately befriended by individuals who undertake risky activities such as taking drugs, smoking and fire setting in their homes.

Sensory impairment

A persons hearing impairment does not in isolation make them more at risk of fire. Should there be a fire without the correct type of smoke detection they are more likely to die or be injured.

Smoke detection should include flashing strobes and vibrating pillow pads.

Where the individual resides in sheltered type accommodation consideration should be given to how the alarm system links to the individual’s smoke detector.

Visual impairment in isolation does not make an individual more at risk of fire. With appropriate adaptations, everyday household tasks can be carried out safely. For a person with visual impairment, because they cannot see smoke, a working smoke detector and escape plans are particularly important as is the need for clear escape routes.

Our Safe and Well visit request form allows you to specify if a person has an impairment that may mean they need specialist fire or smoke detection and alarm equipment and if so, we can fit this equipment free of charge. 

Inappropriate use of or unsafe electrical appliances

The biggest risk of fire comes from damaged or overloaded electrical sockets.

Risk is also associated with combustibles such as clothing or newspapers/magazines being placed over or too close to electrical equipment and sockets.

Faulty electric blankets are also a common cause of fire, as is the use of electrical chargers and appliances which do not comply with British/European safety standards.

Always use the correct charger for the equipment/appliance.

Air flow mattresses overlays and cushions

Dynamic-flow pressure relieving mattresses (and overlays placed on top of standard mattresses) are provided for the prevention and treatment of pressure
ulcers to people who spend extended periods of time in bed.

The mattresses/ overlays are filled with air via a pump. These systems use dynamic controlled air pressure cells to constantly adjust the mattress/overlay in response to the person’s needs.

If the mattress is punctured and loses air, the pump reacts by increasing the flow of air produced, fuelling a fire. The mattress pump also contains a battery back- up so if the electricity supply fails, the pump continues to discharge compressed air.

Emollient creams

Emollient creams are applied to the skin to treat conditions such as eczema / psoriasis. Their use is common for people who spend extended periods of time in bed due to illness or impaired mobility.

Many emollient creams are paraffin-based and the use of such creams can result in bedding, dressings and clothing becoming impregnated with paraffin.

These items can easily ignite when bought into contact with naked flames i.e. smoking, candles, gas fires and cookers

Incontinence pads

Older people and those with severely reduced mobility are at greater risk due to the flammability of incontinence care products.

Use of medical oxygen

Oxygen is highly explosive when exposed to naked flame or dirt and grease. Medical oxygen use is often associated with smoking-related lung diseases and users often continue to smoke.

The oxygen-rich atmosphere stays within clothing and furnishings creating an increased risk of rapid-fire spread which is a particular risk for smokers.

The presence of medical oxygen cylinders poses a risk to firefighters and the user in the event of a fire because the heat from the fire may cause the cylinders to explode.

We strongly recommend those who have medical oxygen in their property receive a Safe and Well visit as soon as possible.

Living alone

Analysis of accidental house fires shows that people who live alone are more at risk from fire.

This is likely to be because one or more of the risk and vulnerability factors above are present.

No working smoke detectors

Smoke detectors do not prevent a fire from occurring. But they provide the earliest possible warning, in the event of a fire, to give the best possible
chance of exiting the property safely.

Fire and rescue services recommend that all homes have a working smoke detector on each level of the property. More information on smoke detectors is available on our smoke alarms safety advice page 

Book a Safe and Well visit

If you're a partner, carer or professional and want to submit the details of a client or property you're responsible for, please complete the form below.

Fire risk assessment and care planning

Assessment and review

West Midlands Fire Service (WMFS) recognises that there are many variations across agencies and sectors in the types of assessments and reviews of care and support needs to be undertaken. Therefore the term assessment and review is used in this guidance to cover:

  • Assessment and review processes as defined in the Care Act 2014
  • continuing health care assessments and reviews
  • domiciliary and home support planning and reviewing processes
  • hospital discharge planning processes
  • occupational therapy assessments/reviews

Where risk and vulnerability to fire have been identified, with service user consent, professionals and carers should make Safe and Well visit referrals to us even if the person being assessed does not meet eligibility/thresholds criteria for care and support.

We recommend that the Fire Safety Risk Assessment tool detailed in Appendix 1 of the downloadable document linked in this section is used to identify risk and vulnerability to fire. If any of the risks and vulnerabilities are present and/or the person does not have a working smoke detector then we strongly recommend that a referral for a Safe & Well Visit is made.

The Safe and Well referral form found on our website shows the information required by West Midlands Fire Service to triage and arrange the Safe & Well visit. A 'paper' copy of this form can also be found in Appendix 2 of the document linked in this section.

If it is anticipated you, or the organisation you represent will make multiple referrals to us for Safe and Well visits then please make contact with your local station before submitting a referral (unless urgent). They will then create a unique referral pathway number for your organisation/
team. The referral number is key for communication between WMFS and the referring agency.

Housing providers should consider how they can incorporate assessing risk and vulnerability to fire within their lettings processes for individuals with care and support needs. Particular consideration should be given to those who require adaptations within their properties and those who will reside in sheltered/housing with care/extra care schemes.

Fire Safety Guidance for Professionals and Carers

This document details information, which mostly can be found on our website, in a downloadable format that assists professionals and carers in identifying and assessing vulnerability and risk to fire with people they support in the course of their work.
Download
Document

Fire Safety Risk Assessment Form for Professionals and Carers

Professionals and carers can use our Fire Safety Risk Assessment form to assess levels of risk in the homes of those they care for to support requirements around fire safety intervention or risk reduction measures.
Download
Document

Community Alarm/Assistive Technology

Where it is decided that assistive technology is used to support service users to live independently, WMFS recommends that a smoke detector linked to the system is considered, in all cases, where a Community Alarm is being installed. This is particularly relevant for people with complex needs, who have limited mobility and smoke.

Activity/Behavioural Risk Assessments

Behaviours and activities such as the use of alcohol and drugs or smoking may require a more detailed activity specific assessment and management plan. This is particularly important where individuals with limited mobility smoke.

An example of good practice in assessing ‘smoking’ as a specific risk is attached as appendix 4 the downloadable document found in this section.
It includes examples of statements of:

  • The benefits the person believes they get from undertaking the activity
  • risks and hazards identified through conversations with the person to make sure that they understand the risks to
    them and others around them
  • statements explaining what actions/plans are in place to reduce/monitor the risk together with roles and responsibilities
    for these.
A carer speaking to a lady at a dining table.

Mental Capacity

Where a service user is identified as being vulnerable and at risk of fire, we require the person's consent to receive a referral for a Safe and Well Visit.

We do recognise there will be instances where the service user either, lacks capacity or has the capacity to make unwise decisions.

When a person lacks the capacity to make decisions about their fire safety, we recommend inviting us to attend any multi agency meetings, to discuss and agree on best interest decisions.

When a person has capacity to make decisions about their fire safety, but refuses to consent to a Safe & Well visit, we recommend that this is recorded in the individual’s records.

At this stage, we are available to provide professional advice and guidance. We would encourage professionals and carers to make contact in these instances using the Home Safety Centre free phone number which is 0800 389 5525.

Information sharing

We recommend that wherever possible consent is gained from the service user and for the referrer to be present, during the Safe and Well Visit. This provides the best opportunity for a coordinated and shared approach to supporting the individual to reduce or manage their risk.

Where this is not possible, following a Safe and Well visit, our firefighters will leave a booklet called ‘Keeping you safe and well’ summarising the outcome and recommendations with the service user. An electronic copy of this document, without service user recommendations, can be downloaded from our website.

Where the service user gives consent, we will also record these outcomes and recommendations in the ‘Collaborative Care Record’ when this is present.

Where the service user refuses consent for us to share information but we consider that the person is at significant risk to fire (life risk to self and others), we will, in the best interests of the service user, share all relevant information relating to the risk with the referring agency.

The flowchart available in the Fire Safety for Professionals and Carers document linked earlier in this section summarises the process of assessing, referring and mitigating risk and vulnerability to fire for people who have care and support needs.

Workforce training

In order to be able to identify, assess, refer and mitigate the risk and vulnerability to fire, the workforce that engages with people with care and support needs must be able to:

  • Understand who is at risk and vulnerable to accidental fires in the home
  • identify behavioural, health, lifestyle and environmental risks
  • understand how and why these risks increase vulnerability
  • undertake fire risk assessments
  • make a referral to WMFS for a Safe and Well Visit for service users that are at risk and vulnerable to accidental fires
    in the home
  • incorporate the recommendations from the Safe & Well Visit into care and support planning and review
    processes
  • understand the resources available to mitigate risk and vulnerability to fire.

We recommend that agencies design and deliver training to their workforce that incorporates the objectives above. The information contained in our guidance will provide the foundation to develop the content for the training session. This guidance has been written following recommendations from the Miss G SIR conducted by Coventry Safeguarding Adults Board, therefore a good practise approach to developing the training session would be to focus on Miss G or a similar individual as a case study.

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