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Healthcare premises

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Paul1979
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Healthcare premises

Post by Paul1979 »

Hello All,

Hope you are well.

Please can I have your thoughts / share experiences on the following scenario... .scratch
  • Healthcare premises with an In Patient Unit / Ward.
    Progressive Horizontal Evacuation Procedure.
    Bedrooms and 5 bed bays found along central walkway / corridor.
    Two exits at opposing ends of central corridor.
    Each bedroom and bay also has a separate exit directly to fresh air if needed.
    L1 fire alarm system in place.
Within the central walkway/corridor there is an open Nurses Station (including all the usual computer / IT equipment) and also a small kitchenette / tea point for beverage making and food warming only. There is also a small domestic dishwasher in there. The kitchenette is not enclosed though.

We have just had a fire service audit carried out - the fire officer has said that the Nurses Station and Kitchenette (in particular the dishwasher) should be removed as these are "significant fire risks along the escape route"....

We have had over the years many FRA's and visits from Fire Officers and none have made remarks on the Nurses Station and Kitchenette before. We also need the Nurses Station to remain where it is for working practices.

I know plenty of Hospitals and other healthcare premises which have similar set-ups so am assuming this is not uncommon??

Any thoughts or experience on this scenario would be much appreciated! .salut
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Re: Healthcare premises

Post by witsd »

Write a very clear email to the FRS station, stating that you are surprised by their comments, as you have many alternate routes and that your current fire risk assessment has not raised this as an issue.

I would be very surprised if they didn't back down (while also not admitting they made an error).

Unless they actually give you some kind of improvement notice in writing, pay (almost) no attention.
We often think that when we have completed our study of one we know all about two, because 'two' is 'one and one.' We forget that we still have to make a study of 'and.'
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Re: Healthcare premises

Post by 1804 »

There is no need for the nursing station to be removed- that is frankly ridiculous and smacks of a fire service officer who knows nothing about the NHS. As long as the portable electrical equipment has been tested and maintained at the nursing station is in date there are no reasons why the station should be questioned, as long as staff have received their statutory and mandatory fire training and have not brought in any items that have not been PAT tested.
The area with the dishwasher and whatever is used to heat food - guessing a microwave- needs to be fitted with a 30fds fire door and needs to be fitted with 30 minute compartmentation. Not listed as a fire hazard room as such in HTM 05-02 and I know it has been superceded but they are the things which are most likely to cause a fire - and smoke. These rooms are always, in a ward, on a fire escape route and that is what the fire service bod will be looking at, rightly.
Worked in fire in the NHS since 2009 (no longer)and have had fire service peeps give erroneous advice loads of times as they are not aware of the existence of HTMs. Do the room compartmentation and ensure that the room has the correct fire door and ignore the nonsense about the nursing station. Challenge the person giving the instruction. Reach out to any fire bod in any NHS Trust and they will back you.
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Re: Healthcare premises

Post by Messy »

I agree with 1804. This advice is most certainly worth challenging

It does appear that this inspecting officer is applying the rules of a protected route to an area where an NHS progressive horizontal evacuation (PHE)procedures has been adopted. They are totally different strategies that are incompatible to each other.

In a protected route situation, once in the escape route, the environment you are deemed to be in a place of relative safety and the area would be largely fire resistant with for example no soft furnishings, and it would be kept free of significant ignition sources such as dishwashers and kitchens. Once you are in a protected route, you stay in one until you reach a place of ultimate safety - outside!

In a PHE environment, very basically speaking, you leave the area affected by fire into a neighbouring area which acts as a refuge. The areas are separated by significant fire resisting walls and doors. This is effectively a holding area where you stay until the fire is dealt with or you need to move again to another place. The holding area is often an identical ward so definitely not a protected route, it doesnt need to be.

In the OP's example, the usual horizontal linear route is supplemented by final exit doors from each bay - so for the life of me I cannot see the risk is worth moving the dishwasher or closing up the kitchen - although I accept I havent seen it so cannot be 100% certain

Like 1804, I have had experience with applying fire safety across the NHS in five Trusts - mainly, but not confined to mental health units. We also had a few problems with over enthusiastic but woefully under trained F&RS inspecting staff - many of whom have never heard of HTMs or Firecode (NHS fire safety guidance).

Further information on PHE here on page 7 and 18

https://www.england.nhs.uk/wp-content/u ... 2_2015.pdf
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Re: Healthcare premises

Post by Paul1979 »

Hello All

I just wanted to say a massive 'thank you' to everyone that took the time to reply to my question...especially with such detail and obvious experience!

Truly appreciated.
"If life were predictable it would cease to be life and be without flavor." ../.
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Healthcare premises

Post by 1804 »

I am sure that Messy will have a thousand stories to tell regarding findings at NHS sites but I have some experience with mental health trusts too, which I found were a bit unsafe in terns of my personal safety - repeatedly, especially the forensic units. I don't want to sound like Ronnie Corbett sitting in a chair with a Pringle golfing jumper so I will keep this to two of my memories from that time.
1) Young woman, slight build, about five foot four, who when wanted to go for a cigarette, asked politely and was escorted into the security fenced garden to have a cigarette. On one occasion, another of the section 136 residents(!) was kicking off, requiring all of the staff to assist, meaning that there was no-one to escort her to the rear garden so that she could have a smoke. She was not happy. The doors to the rooms were the same as on police cells (my former job) which means that they were ridiculously durable and strong. She had ripped the whole doorset off within fifteen minutes of expressing her frustration. This is why the soft furnishings on the wards Edited now have furniture filled with sand to stop anyone throwing these heavy items at others. Absolutely phenomenal strength.
2) Another resident kept absconding for short periods of time. Bear in mind that if this happens, it is an immediate high priority call to the local woodentops(as we in the police were referred to by some) as the absconder posed potentially a massive and immediate threat to others and themselves. He kept scaling a 16 foot wire fence topped with inward facing barbed wire - standard Stalag stuff - then legged it. But he always returned about an hour later. When asked why he kept doing it, his reason was simple - somebody he was scared of wanted to watch something on TV that conflicted with his choice so when he got out, he watched Eastenders in a local pub then came back.
Funny old world.
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Messy
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Re: Healthcare premises

Post by Messy »

First of all, 1804 - I can see you in a Ronnie Corbett chair (and jumper) enthralling your grandchildren of tales from the mental health unit around an open fire :lol:

To be honest, most of the 'events' I witnessed had an element of poor staffing and/or management associated with them.

I worked mostly in a well known forensic mental health establishment. Part old Victorian buildings and part fabulous new buildings. The staff were fairly good here and I rarely saw any staff alarms operated despite the very severe mental health issues that some clients presented with. The new build had a central 'High Street' with communal facilities such a cafe, shop and even a hairdressers (with the usual scissors etc you would find anywhere). This was an excellent place for staff and clients - and their relatives

But I also worked in my local MH Unit attached to a General Hospital. It was also in a new building that was a cheap and cheerful PFI effort. They installed a wireless fire detection system, ignorant that the dry walling in the unit was strengthened by steel mesh thereby screening multiple heads. That took weeks to fix. Door holders were overheating regularly and door closers were Chinese rubbish. But the PFI contract meant the NHS paid for repairs. There was hardly any natural light and no independent staircase for those upstairs to reach smoking areas outside, so an a

The staff and management here were shocking. So much so, I reported one guy - a senior nurse who was in a nurses station (separate room) reading a newspaper and ignoring a female client who wanted to talk to him in the most undignified manner that I wont go into here. Many of the staff where openly confrontational and rather than de-escalate events - their attitude tended to intentionally escalate issues in a way that wasnt needed

But the worse thing there was the over use of the staff alarms. In one two hour training session, I lost staff three times who responded to such alarms. That was never the case in the 6 other hospitals I worked at

I loved working in Mental Health as the challenges would certainly keep you on your feet. I worked with some amazing people (including 1804), but also witnessed poor staffing behaviour. With a shortage of MH Nurses in the UK, management seem very reluctant to discipline


One last thing, when a firefighter with a huge mental health hospital on our patch, one of the other shifts attended a fire there only to be turned away by a Doctor in a white coat and Porter at the gates who told the arriving crews it was a fire drill. Er......... it wasnt!!! The crews were called back after staff saw them leaving......whoops! There was plenty of Mickey taking of that crew after - but we all learned a valuable lesson about trust
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