Fire safety for homecare providers: Questions and Answers

There continues to be a worryingly high number of injuries and deaths from fires in people’s homes in the UK. In the year 22/23, there were 185 fatalities in accidental dwelling fires in England, of which 104 were aged 65 and over. In the same year there were 4,019 casualties, with 991 being 65 and over.

The London Fire Brigade has noticed that a significant proportion of people dying in accidental house fires have had some contact with homecare providers or social services.

This means that homecare providers have a vital role to play in helping to reduce the number of unnecessary fire deaths, for example, by completing a person-centred fire risk assessment checklist. This will alert them to a person supported by homecare services who could be more likely to have a fire, and would be less able to respond or escape if a fire occurred.

All fire services have arrangements in place to visit people at home and advise them on reducing fire risks.

Find your fire service | Fire England by entering a postcode.

The following questions and answers on fire safety, as it relates to homecare, are based on questions posed by members to the Homecare Association helpline.

We are grateful to the London Fire Brigade, who have a specialist liaison unit on social care provision, for their answers and advice for our members on this vital topic.

This is the Skills for Care’s Care Certificate Standard 13 which concerns Health and Safety:

 

This means workers should be able to explain how to prevent fires from starting or spreading, and what to do if there is a fire in a service user’s home.

Although the Care Certificate Standards are the minimum standards that should be covered as part of induction training of new careworkers in England, providers throughout the UK will want to conduct similar training for their existing staff.

Here is a link to The Care Certificate Standards (skillsforcare.org.uk).

Homecare providers and careworkers can pass on their understanding of how fires start and how to prevent fires from starting. Where risks are identified, homecare managers should work with the person and the service commissioner to put in preventative measures. These include:

• Smoking – Smoking is the biggest cause of fire deaths. London Fire Brigade are especially concerned about those that smoke in bed or in a chair and are immobile. Careworkers should look out for burn or scorch marks on bedding, furniture, carpets or clothing and report these to their manager.
  
  The London Fire Brigade promotes smoking cessation or vaping (if this can be done safely - there is information about the fire risks of vaping and e-cigarettes) as an alternative to smoking cigarettes, cigars or pipes. If a person being supported by homecare services wishes to continue smoking, advise them it is safer to use a lighter instead of matches, a deep ashtray and not to smoke in bed. They should also advise the person to keep smoking materials away from anything soaked in emollient creams (petroleum, paraffin or oil based) and stored incontinence products which are highly flammable. In addition, the service user should be advised that flame retardant bedding, throws and aprons will reduce the risk from dropped cigarettes onto bedding, furniture or clothing. The care manager can help the individual obtain these items.

 

• Cooking – More fires and fire injuries are caused by carelessness in the kitchen than anywhere else in the home. Advise the individual not to leave their cooking unattended, or cook when drowsy or after drinking alcohol. They should also take care when wearing loose clothing. If the oven, hob, cooker hood or grill have a build-up of fat and grease, this could ignite and cause a fire. Careworkers should report this to their manager.


• Candles – People supported by homecare services should be advised that candles should be put out before leaving the room or sleeping. In addition, people should be advised to use a suitable candle holder which is placed on a stable surface away from curtains, furniture and clothes.


• Portable heaters – Careworkers should advise the person being supported to secure portable heaters against a wall to stop them falling over, keep them away from clothes and furniture and never use them for drying clothes. It is recommended that heaters are turned off and allowed to cool before they are moved. People should be advised that portable heaters are placed at least one metre away from their chair or bed. Regular servicing of portable heaters is highly recommended.


• Electrics – Scorch marks, flickering lights, hot plugs and sockets and fuses tripping for no reason could all be signs of loose or dangerous wiring. Careworkers should report any of these signs to their manager. Appliances used while providing care should be clean and in good working order. The fluff from tumble dryers should be removed where a careworker’s duties include carrying out the laundry. If using a cable drum extension lead, careworkers should make sure it is completely unwound before using and must not overload electrical sockets.
  
  Careworkers should advise the person supported by homecare services to always use chargers that come with their phone, tablet, e-cigarette or mobile device and not to leave items continuously on charge. Items should not be left charging on a bed or soft furnishing, or left charging overnight.
  
  People using homecare services should be advised against using electric blankets with air flow pressure relief mattresses.
  
  People should not buy counterfeit electrical goods or use faulty items, which can increase fire risks. Check here to find out whether any electrical appliances or white goods have been recalled by the manufacturers and sign up for product email alerts: Product Recalls and Alerts - GOV.UK (www.gov.uk).

More fire safety tips can be found on the LFB website here: Safety advice from London Fire Brigade | London Fire Brigade (london-fire.gov.uk).

Where a risk has been identified, the careworker should take action by reporting it to their manager especially where, for example, there are signs of unsafe disposal of cigarettes or smoking materials, or burn and scorch marks on clothing or bedding.

The manager should then arrange for a person-centred fire risk assessment checklist to be completed. In addition, the individual should be asked if they wish to have a Home Fire Safety Visit from the local fire brigade.

Careworkers should also have an understanding of how fire can spread through a building and the purpose of fire doors. People supported by homecare services should be advised that it is good practice to keep internal doors closed - especially the kitchen door. Careworkers should ask whether they can close the doors before they leave the service users home. Where the person is living in a multi-occupied building, the flat front door should be fully closed before leaving to stop a fire spreading into the corridor and stairs.

More fire safety tips that all should be aware of can be found on the LFB website: http://www.london-fire.gov.uk/safety/the-home.

In the event of fire, careworkers must know how to raise the alarm, the evacuation instructions for the building, or if there is a ‘Stay Put’ policy in place.

Further information, including advice for those with reduced mobility, can be found here: http://www.london-fire.gov.uk/safety/the-home.

The London Fire Brigade offer free training sessions for careworkers to educate them about fire risk. Find out from your local fire service what support and training is available.

In addition, Age UK has a presentation on fire safety for family carers.

 

A person supported by homecare services asked that their gas fire is left on overnight to ensure their house was warm enough in cold weather. The care provider was not sure this was safe and asked the Homecare Association helpline if there was an alternative way of ensuring that the service user does not get hypothermia.

London Fire Brigade advised that careworkers can help the person to feel comfortable, and gave some fire safety tips that could help reduce the risk of a fire:

Ideally heaters should not be left on at night. To reduce risk, discuss with the person alternative means of heating such as a hot water bottle, extra blankets, warm night clothes or an oil fuelled radiator. If the person still wants to have a portable heater on at night, the risk of fire can be reduced by ensuring that the heater is at least one metre away from the service user, and away from bedding, clothing, soft furniture and stored incontinence products.

Further information on keeping warm is available from the Energy Saving Trust and the NHS.

Homecare providers are not directly responsible for the premises where they provide care, either because it is the person's own home, or because it might be sheltered living where another organisation looks after the property. Nevertheless, providers have a duty of care for their careworkers and are required to provide care in a safe way.

To comply with regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, registered persons must assess the risks to the health and safety of people being supported by homecare services and do all they reasonably can to mitigate any such risks. There is more about this in the CQC Provider Guidance. Fire Safety should form part of this.

The London Fire Brigade recognises that there is a limited amount of scope within a person's own home, and there may be limits, to what can be achieved. The London Fire Brigade suggest that a person-centred fire risk assessment checklist is completed and where the person receiving homecare services, is acted upon. Findings can then be incorporated into the person's care plan.

The London Fire Brigade’s person-centred fire risk assessment checklist is a short five question form to help providers assess whether there is an increased risk of fire – it will help decide if a Home Fire Safety Visit is needed. A referral to the local fire service for a Home Fire Safety Visit MUST be made where someone is assessed to be at increased risk from fire.

Any agreed fire reduction actions should be included on the individual’s care plan, for example, that electrical appliances with worn leads should be replaced or that flame retardant bedding should be used.

There is an increased risk of fire where individuals use petroleum, paraffin or oil based emollients. If clothing, bedding or dressings come into contact with an ignition source such as a candle, smoking products or cooking appliances, a fire will burn more rapidly as the fabric can act as a ‘wick’. It is important that people receiving homecare services and their carers are aware of the risks. Providers should take all reasonable steps to reduce risk such as arranging for the frequent changing of dressings and regular laundering of textiles to be added to the care plan.

The London Fire Brigade warn that emollients will also soak into flame retardant materials nullifying the flame retardant properties. Emollients should also be used with caution by Home Oxygen users because of the increased fire risk.

The London Fire Brigade is working with the Medicines and Healthcare Regulatory Authority (MHRA) regarding warnings on packaging of emollient products to alert users to any potential risks. MHRA campaign to raise awareness of fire risks of emollients: Emollients and risk of severe and fatal burns: new resources available - GOV.UK.

The London Fire Brigade is also working with pharmacists to increase awareness of the issue and ensure correct advice is being given. Where possible, the London Fire Brigade would like to see GPs and pharmacists offering non-flammable products. This will depend on the individual’s circumstances.

Homecare Association members can download the document: Skin care creams and lotions - Guidance for Homecare Providers.

The London Fire Brigade recommends that bedding and clothing should be washed regularly. Non-flammable emollients should be considered if someone has been identified to have an increased risk of fire, in consultation with the person receiving homecare services's health professionals.

The UK Cleaning Products Industry Association (UKCPI) suggest the following for cleaning bedding or clothing that have come into contact with emollients:

• Wash the clothing, bed clothes and bed linen daily to reduce the risk of sustained build-up of paraffin creams.
• Wash with a quality laundry detergent product – liquid and gel detergent products will be more effective than powder products.
• Use the detergent at the dose recommended for heavy soiling.
• Wash at the highest temperature possible allowed by the item(s) care label.
• Provide an extended wash time by either:
  • the use of a prewash product + main wash cycle (with the main wash cycle being as above), or
  • soak with prewash in the washing machine (e.g. overnight) followed by the above wash cycle.
• Turn the clothing inside out before washing.

Care Quality Commission

Regulation 12: Safe care and treatment

 

London Fire Brigade

London Fire Brigade Fire Safety in the home

London Fire Brigade Advice on caring for older people

London Fire Brigade Total Recall Campaign

London Fire Brigade Advice for careworkers using emollient creams

London Fire Brigade Fire Risk Check List

London Fire Brigade Caring for smokers

Means of escape for disabled people (HM Government)

 

Skills for Care

The Care Certificate Standards

 

Homecare Association

Skin care creams and lotions - Guidance for Homecare Providers

 

 

Whilst every effort has been made to ensure the accuracy of this guidance, it is a summary, rather than a definitive statement of the law; advice should be taken before action is implemented or refrained from in specific cases. No responsibility can be accepted for action taken or refrained from solely by reference to the contents of this guidance.