In this guest post, London Fire Brigade deputy commissioner Rita Dexter explains what social care staff can do to help reduce the risk of fire deaths among older people at home and in residential care.Last year, half of the 33 people who died in fires across London were aged over 60.
What is most unsettling about these deaths is that they are absolutely not an inevitable consequence of being elderly and a large number of those who died were in regular contact with at least one public agency. Whether receiving a full package of care or something less intensive, many of the older people who die in fires are known to the authorities. That means advice and practical help could have been offered, and, potentially, those lives could have been saved.
Mr E is typical of many of the deaths we see each year. He was 95 years old and lived alone in sheltered accommodation. He was unable to walk on his own and spent the majority of his day sitting in a chair. Part of his care package included meals on wheels and domiciliary care support four times a day, including lunchtimes. Mr E enjoyed smoking and would do so when his carer was out of the room or after they had visited.
Early one afternoon, Mr E was trying to refill his lighter, and while doing so triggered a small explosion on his lap. A fire quickly took hold and, unable to stand independently, we believe Mr E was either unable or didn't have time to put out the flames. When firefighters found him, Mr E was very badly burnt, the room had completely filled with smoke and he was beyond help. The watch on Mr E's wrist had stopped just two hours after the time his carer reported having left him.
A disturbing number of people die in similar circumstances and often there is evidence that they had sustained smoking related burns for some time before their eventual death.
The warning signs were clear - Mr E smoked, but was frail. In the event of a fire, he would find it very difficult to escape. Despite living in a residential unit for older people the property was not fitted with a sprinkler suppression system.
In order to confront the challenge of preventing deaths like Mr E's, our battle in the fire and rescue service is on two fronts. Firstly, preventing people from having fires in the first place and secondly, protecting people when fires do occur.
Many older people affected by fires have mobility issues and live on their own. They are often confined to living in one room of their home and are ill-equipped to escape a fire. Those visiting, assessing or caring for older people are vital in the battle to reduce fire deaths and injuries and can make the difference needed simply by knowing what to look for or how to ask for our help. The London Fire Brigade also believes many deaths involving older people could be avoided if sprinklers were fitted. In our view, all residential care homes and sheltered accommodation should have sprinklers to protect those who are most at risk in the event of a fire. This is already the case for newly built care homes in Scotland and it is time England followed suit. But we also believe that there is a strong case for the installation of domestic sprinklers where the risk factors and evidence support it.
The London Fire Brigade is also doing more to identify those most at risk. In 32 of London's boroughs, we now have a borough commander who sits on the adult safeguarding board. This has been hugely beneficial in getting fire safety on the agenda and raising awareness of the risk to which vulnerable adults are exposed. It has highlighted how joined up interventions can result in better outcomes for older people and how, by working in partnership, the brigade can prevent fires among older people and better protect them when they do occur.
Mr E's story is sadly common, and the impact of actions taken by
different authorities can always be debated in terms of what may or may
not have saved a life. But right now we know that the agencies and
support networks providing services to the elderly can do more.
To prevent fires happening in the first place, we want to tap into the knowledge and expertise of the people who most regularly come into contact with older people. Social care providers and carers are in a unique position to help the fire and rescue service identify those who are most at risk from fire and to work with us to stop people dying or losing their homes unnecessarily.
There are five fire risk areas for those providing care to note:
1) Smoke alarms - smoke alarms help alert people to a fire and everyone should have one.
2) Mobility issues - someone who cannot move freely will struggle to escape in the event of a fire. When considering other factors, think about fire escape.
3) Smoking and smoking materials - people who smoke are at an increased risk as cigarettes are a ready-made source of ignition. What support might you give to ensure their choice to smoke is as safe as possible?
4) Scorch marks - for example on bedding or the carpet, or worse still burns on a person, are a sign of a near miss. Next time, the person might not be so lucky.
5) Rubbish and hoarding - if someone has lots of clutter around their home a fire may spread more rapidly. It will be harder for the person to escape and easier for the fire to spread. This has the potential not only to affect their life chances, but maybe those of their neighbours as well.
By keeping these things in mind when you visit older people and by informing your local fire and rescue service when you see these tell tales signs, together we can help prevent fires occurring and better protect our most vulnerable older people when fires do happen.
To prevent fires happening in the first place, we want to tap into the knowledge and expertise of the people who most regularly come into contact with older people. Social care providers and carers are in a unique position to help the fire and rescue service identify those who are most at risk from fire and to work with us to stop people dying or losing their homes unnecessarily.
There are five fire risk areas for those providing care to note:
1) Smoke alarms - smoke alarms help alert people to a fire and everyone should have one.
2) Mobility issues - someone who cannot move freely will struggle to escape in the event of a fire. When considering other factors, think about fire escape.
3) Smoking and smoking materials - people who smoke are at an increased risk as cigarettes are a ready-made source of ignition. What support might you give to ensure their choice to smoke is as safe as possible?
4) Scorch marks - for example on bedding or the carpet, or worse still burns on a person, are a sign of a near miss. Next time, the person might not be so lucky.
5) Rubbish and hoarding - if someone has lots of clutter around their home a fire may spread more rapidly. It will be harder for the person to escape and easier for the fire to spread. This has the potential not only to affect their life chances, but maybe those of their neighbours as well.
By keeping these things in mind when you visit older people and by informing your local fire and rescue service when you see these tell tales signs, together we can help prevent fires occurring and better protect our most vulnerable older people when fires do happen.
Mears care for over 20,000 people a week in their own homes so we are very familiar with the hazards faced by older and vulnerable people. We are just about to start an innovative new contract with Cumbria Fire Service, delivering fire safety audits in 6,000 homes per year. This audit will examine appliances, heating and other factors that could be a fire hazard - we will provide advice to the resident and feedback to the Fire Service. We will also fit a smoke alarm if there is not already one in the property.
This contract is one of the first of it's kind in the UK and we hope other councils and Fire Services will follow Cumbria's example - these 45 minute audits will make a big difference in communities.
This is a critical area. We are doing some work with a few Councils on improving their risk and safety management processes, procedures and tools. What is clear is that everyone risk assesses based on their own subjective assessment of the situation they see. Fire risk (and health and safety) are down to what training the individual social worker has had in previous roles or their own personal experience. We are looking at any ways in which this can be made more subjective so thank you for the identified risk areas and we would welcome any other ideas.