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Mark-W  
#1 Posted : 25 September 2019 12:02:45(UTC)
Rank: Super forum user
Mark-W

I have a client who I haven't been with for very long and I'm just getting to grasps with the way they do work.

Like another client they have a day care facility. All the clients have learning difficultys, some minor, some very major.

I recently reviewed their FRA and procedures in place for these vulnerable people. Some have an aversion to noise. So when the fire alarm is tested they panic, some hide, some take flight and will aim for the nearest door and will will do everything in their power to go through it. Wether that means injuring staff or not.

So fire evac drills haven't been high on the list of jobs to do.

I've informed them that they have a legal obligation to conduct at least 1 drill a year, possibly more depending on the results. They are reluctant to have a full evac because it then puts 10-15 vulnerable clients into the public domain with to many distractions.

Anyone have any advice on the best course of action?

A Kurdziel  
#2 Posted : 25 September 2019 13:33:14(UTC)
Rank: Super forum user
A Kurdziel

Ideally you have system that alerts staff only and then they can gently usher the patients out of the building

thanks 1 user thanked A Kurdziel for this useful post.
Mark-W on 25/09/2019(UTC)
Mark-W  
#3 Posted : 25 September 2019 13:39:35(UTC)
Rank: Super forum user
Mark-W

After a chat today with the inhouse H&S bloke, it seems that they have buildings with minimal rooms and ALL internal doors are fire doors. I think they are doing as much as possible, I'm hoping to conduct a fire drill in the near future but will have to get staff from other teams to attend incase any client gets out of hand.

Dave5705  
#4 Posted : 25 September 2019 20:36:32(UTC)
Rank: Super forum user
Dave5705

This is a very interesting one. Do you put staff at risk of injury caused by a service user in fight mode caused by a fire alarm when it is just a drill? Do you not let the service user know there is a drill (or a fire) so the staff don't get hurt and can gently usher the service user out of the building? How about staff not having their personal warning device on them, or faulty? Is it acceptable to increase the risk to staff in order to reduce the risk to service users? Is it ever acceptable to place care staff in danger when it can be avoided at a cost? Where does reasonable practicability go then?

Many staff, in many care environments, already endure a level of risk of assault that in just about every other industry would be controlled without question. In this case, raised by the OP, the facility avoid fire drills because of the risk to staff and the trauma it causes the service users. It's a balancing question that's for sure!

In one such place I know of, the staff always know when a drill is due, and each new service user is exposed to their first drill in a normal operating routine, but their reaction is noted and included in a PEEP such that if they react violently, or drop and refuse to be moved (no lifting policy), then that service user will be moved to a safer location or out of the building immediately prior to any future fire drills. Staff are also trained and practice re-deployment to be close to known 'violent responders' as soon as a fire alarm sounds, and before all fire drills so they are where they can provide most assistance. That all takes some organising and helps keep the violent assault count down, but it's still hell on earth when the alarm goes and staff are definitely put in danger trying to get service users out. To have enough staff to do it safely would mean having staff with nothing to do the rest of the time, just waiting for such a situation, which is not reasonably practicable.

It's a dilemma.

thanks 2 users thanked Dave5705 for this useful post.
Mark-W on 27/09/2019(UTC), SJP on 02/10/2019(UTC)
Messey  
#5 Posted : 26 September 2019 03:55:37(UTC)
Rank: Forum user
Messey

It seems to me that doing nothing here is not an option. The title of the post uses the word vunerable and this term could be used to describe the risk this group face during a fire - ie a much risk than the 1000s of offices and shops etc that routinely carry out drills.

So lets go back to basics. Why do the fire drill in the first place?

Its obviously to test procedures and in most buildings, its to audit staff awareness and remind all involved of what they are expected to do in a fire. In essense, a training actvity. In a supermarket, customers wouldnt really gain much from a drill, but the staff would. However in this care type environment, surely its all about staff and procedures and very little to do with the clients.

So why not exclude the clients from the process? A series of table top exercises where staff are faced with different scenarios may, if designed and recorded well, replace the need for a traditional drill. After all article 15 of the Fire Safety Order states:

-------------------------------------------

5.—(1) The responsible person must—

(a)establish and, where necessary, give effect to appropriate procedures, including safety drills, to be followed in the event of serious and imminent danger to relevant persons;

--------------------------------------------

OK the 'where necessary' part ususally applies to flats where drills are rarely carried out, but IMO it does allow a degree of flexibility. So a table top could be a sufficient alternative. I have used the following table top shape in Mental Health establishments where drills are problematic:

  • Produce a simple but large large single line drawing of the premises (or part of if the building is large). One sheet/plan per floor.
  • Talk through the features of the plan to those who are not familiar with drawings (doors, stairs etc) and get staff to 'walk' through the building showing where they arrive and their route to the office.
  • When satified all understand the drawing, you explain everyone's roles in an evacuation via a briefing. Manager does this, receptionist does that etc
  • Then by placing a coin in a room, you say the fire alarm is sounding and the head is in this room, the door to the room is open. Talk through what should happen
  • Then do it again by asking those present to take on their roles and talk through their actions
  • Do it again, different room, different staff and mix the staff roles up. The manager becomes the receptionist - this way they all get an idea of what each other should be doing
  • The next scenario add a small of smoke in the area with door closed
  • Try a fire in an electrical riser or plant area
  • Maybe a strong smell of smoke where its not possible to determine the origin
  • Keep building the scenario until you reach a significant fire, minimal staff numbers (at night?), persons trapped

You may wish to discuss key clients, their needs and expected difficulties. Staff can be reluctant at first, or shy as this more inclusive type training might be new to them. Keep numbers to a minimum - 10 at most. For bigger establishments, a literal walk around the building may be useful prior to the scenarios so everyone gets an idea of what other floors look like and a reminder of RVPs etc

Record the table top, who is present and scenarios covered and time spent. Plus get a signing in sheet as evidence of who was there

This is just an idea of how to apply the 'where necessary' part of the requirement to test procedures. The actual system you use would be wholly down to a RA and may involve discussions with enforcing agencies.

The use of the table top training allowed us to cut a requirement of fire drills from 4 per annum to two and avoid night drills which upset clients the most.  But with a carefully recorded RA and business case and involvement of the local fire enforcing teams, I cannot see why this system woulnt be acceptable. 

thanks 4 users thanked Messey for this useful post.
Dave5705 on 26/09/2019(UTC), Mark-W on 27/09/2019(UTC), SJP on 02/10/2019(UTC), lorna on 03/10/2019(UTC)
Dave5705  
#6 Posted : 26 September 2019 05:35:34(UTC)
Rank: Super forum user
Dave5705

Messey thanks for that. I agree. Blindly going through the motions of drills just because that is how it has always been done is not a sensible option. With some service users, no amount of drills will ever 'desensitise' them to the process, every occurrence is just as traumatic. 

There is the problem of making sure the staff do what is expected in the event of a real evacuation. Experience shows some staff, once presented with it, behave differently and are not as confident dealing with the stressed out or violent users, (sometimes due to lack of training in physical handling if it's not something they are used to, it's very expensive to train ALL the staff in such as Team Teach or similar). It is not just the users who find it traumatic.

Some of the users get worse with exposure, as they learn more ways to avoid leaving and better ways to prevent being handled out. The answer certainly is not to just do drills because 'thats what we do'. Out of the box thinking.

thanks 2 users thanked Dave5705 for this useful post.
Mark-W on 27/09/2019(UTC), SJP on 02/10/2019(UTC)
stevedm  
#7 Posted : 26 September 2019 07:51:55(UTC)
Rank: Super forum user
stevedm

I have only dealt with autistic PT..but similar reaction and scale of reaction...disgree that stopping fire drills is the way forward it is the exact opposite of that...you need to normalise the activity, the sound (or remove it)...they need to know that this is ok...(I can't even use the blue lights and sirens and that is really the best bit of the job! :))...it also sounds like the staff need a dose of understanding the PT conditions...

HTM-05-02 gives guidance that 'appropriate' warning signals should be given...

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/473012/HTM_05-02_2015.pdf

Guys please..understand what you are dealing with first before reacting and saying the process is wrong..

thanks 2 users thanked stevedm for this useful post.
Mark-W on 27/09/2019(UTC), Dave5705 on 27/09/2019(UTC)
stevedm  
#8 Posted : 26 September 2019 07:58:01(UTC)
Rank: Super forum user
stevedm

Each service user should have a care plan....you will not be able to, but the staff can discuss this with the HCP and update the care plan accordingly...which also may help you/them find a solution that fits with the HTM and Fire guidance..might mean some extra training for them...some options will include leaving people in place so the protection of those people will be paramount..

thanks 1 user thanked stevedm for this useful post.
Mark-W on 27/09/2019(UTC)
Dave5705  
#9 Posted : 27 September 2019 13:55:08(UTC)
Rank: Super forum user
Dave5705

Thanks Steve,

2.46 pg 12 

stevedm  
#10 Posted : 27 September 2019 14:49:38(UTC)
Rank: Super forum user
stevedm

Yeah! Result!

off to soak my battered brain in some red wine... :)

have a good weekend

FadzilF  
#11 Posted : 03 October 2019 09:01:34(UTC)
Rank: New forum user
FadzilF

Maybe a simplified poster with a diagram / flowchart on the emergency preparedness and what to do can educate all patron and visitors included, how to respond and know where to go. People passing by and looking to that poster, they'll memorise it.

lorna  
#12 Posted : 03 October 2019 09:21:19(UTC)
Rank: Forum user
lorna

I've done the same as Messey & steve in a number of social care settings from secure mental health to children with complex needs. One child's care plan basically said that the child thought that the fire drill was the signal to play on the trampoline in the garden - well, it was one way of getting them out without too much trauma!

Hsquared14  
#13 Posted : 03 October 2019 11:59:49(UTC)
Rank: Super forum user
Hsquared14

I have audited quite a number of facilities for children and adults who react in much the same way as you describe.  They moved away from traditional loud sounders opting for alternative alter systems based on things like lights, signals to staff radios, mobile phones, pagers etc and one where the sounder played a tune rather than the traditional wailing noise.  I think you have to be a flexible in these situations.  Its all about keeping everyone safe in an emergency and that could need a different approach to the alert system and also to how everyone is trained to react when the signal is given.

thanks 1 user thanked Hsquared14 for this useful post.
Mark-W on 07/10/2019(UTC)
Mark-W  
#14 Posted : 07 October 2019 07:34:41(UTC)
Rank: Super forum user
Mark-W

HSquared14

Thanks for the info. I think I need to be thinking more outside the box here and not the normal conventions

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