Medical oxygen fires: how better safety can save lives
There is a need for more training and education around the risk of medical oxygen fires, explains Richard Radford, Managing Director of medical gas control specialist BPR Medical. In 2018, an elderly man died following a blaze suspected to be caused by an oxygen cylinder explosion at a Stevenage residential care home. The resident, in his 80s, was in the room where the fire started and later died in hospital. Six other people were injured, including one resident whose condition was reported to be critical. Not only did the incident affect these individuals directly, many other residents had to be evacuated. In fact, twenty-one were displaced, fourteen were relocated to alternative care homes nearby and seven moved to a different area of the care home. Although the origin of the fire was not disclosed, it was almost certainly caused by a naked flame and fuelled by oxygen from the cylinder. In isolation oxygen is not flammable, but its presence in increased concentrations will enable fires to start much more easily and burn more fiercely. Birthday candles, gas stoves, or – the biggest risk factor – smoking, all pose a serious risk, as can sparks from electronic devices, and even static from clothes. Once a fire has started in the patient’s nasal cannula or tubing it will rapidly track back towards the oxygen source. This can lead to serious injury or death, especially among elderly patients. If the fire is not stopped, it can easily spread to the surrounding premises. In fact, reports from the US suggest that around a quarter of incidents in residential home oxygen fires result in whole house fires. This danger is heightened by the presence of oxygen cylinders. Even a limited fire can create the conditions that increase gas pressure and weaken cylinder strength sufficiently to trigger an explosion. This fuels the existing fire, increasing the risk to patients and third parties, including firefighters. The risk is particularly acute in care homes where a number of factors can exacerbate the issue. First, there is the high number of staff – permanent and agency – as well as visitors, who may inadvertently put a patient at risk through lack of awareness, and who need to be aware of the risks associated with medical oxygen. What’s more, while some patients benefit from the NHS Home Oxygen Service, in some cases care homes use their own equipment, or offer back-up cylinders to residents. As a result, patients can miss out on essential safety advice, and accessories (cannulae and tubing) can sometimes be sourced privately. This means that firebreaks – small, inexpensive devices that are inserted into the oxygen tubing to stop the flow of oxygen in the event of a fire – may not be fitted. Firebreaks have been fitted as standard to oxygen supplies under the NHS Home Oxygen Service since 2006, and can be vital in preventing fire from spreading, limiting injuries, or avoiding death. Untrained staff have even been known to remove firebreaks from tubing, or to cut tubing to insert a firebreak, both of which pose a serious risk to the patient. So, what can be done? Firstly, a greater emphasis on staff training is needed. While there are excellent examples of care homes ensuring all staff are aware of the risks, oxygen safety training is by no means universal. For example, in the Stevenage event, a member of staff claimed to have received no communication “about oxygen or fire since the incident”. The episode also flagged the importance of evacuation training for staff. Two months following the fatal fire, an inspection by the Care Quality Commission (CQC) found no staff knew the fire procedure policy. In fact, in a visit by the local Fire Authority, one member of staff reported that they “never saw” the personal emergency evacuation procedures. Considering the high concentration of vulnerable and often immobile patients, the potential consequences of a fire are much more severe than in a residential home, making proper evacuation procedures absolutely essential. Furthermore, despite the warnings of the associated fire risk, as many as half of all patients continue to smoke while on oxygen therapy. It is therefore critical that staff are trained to understand that patients should never – under any circumstances – smoke while on oxygen, even if they are outside. Visitor awareness is also a priority. Oxygen hazard signs should be prominently displayed, especially if the home has a dedicated smoking area. Furthermore, care homes should ensure they use the right accessories. This includes appropriate soft tubing and cannulae fitted with firebreaks to minimise the impact of a fire. To this end, in conjunction with the residential care sector, BPR Medical has designed a single use kit that addresses the issue. In 2017, the Care Quality Commission (CQC) called for all care homes to review their fire safety procedures. Better oxygen safety training and awareness should therefore be high on the list of priorities. For more information about firebreaks visit www.firebreaks.info or www.bprmedical.com or contact BPR Medical on 01623 628281. Contact your local Fire Prevention Officer at the Fire & Rescue Service for advice on fire safety in general.
Titan by Jackloc Launch!
Leading window restrictor company Jackloc, announce the launch of the strongest restrictor in the market, the Titan by Jackloc ® Queen’s Award-winning window restrictor manufacturer, Jackloc, announces the launch of the new Titan by Jackloc® folding restrictor for care homes and hospitals. The Titan by Jackloc®, is the strongest restrictor on the market, tested to withstand a force of 4,800 newtons, or the equivalent of five adult males. Following the amendment to the Department of Health guidelines in 2014, after a fatal window accident, this exceeds all standard requirements by nearly 10 times. Jackloc wanted a name that personified the strength and support that the restrictor provides, so the Titan by Jackloc was born. The restrictor can be retrofitted, fitted to side or top hung windows, and as with all Jackloc products, it can be fitted to uPVC, timber and aluminium frames. The product comes with hardened and zinc coated, grade 4 security clutch screws and comes with a 10 year guarantee.And with the risk of burglaries in care sites, the Titan by Jackloc® can provide extra security for open windows. The product is fully metal, with reinforced steel hinges, meaning there is no cable that could potentially be cut. Eric Collins, Managing Director at Jackloc said “Since joining Jackloc earlier this year, I’ve been incredibly impressed with the Titan by Jackloc. It’s a fantastic product – it’s sleek, streamlined and more importantly it’s extraordinarily strong. To have such a compelling product in our portfolio allows us to offer a wide range of possibilities to the market.” Jackloc offer a risk assessment service to ascertain the right restrictor for the site, and also a maintenance service once installed. For more information, visit www.jackloc.comsales@jackloc.com | 01455 220616
What to look for in a window restrictor in a care home
Since starting with Jackloc in January, I have been to a number care sites and acute mental patient hospitals, talking to directors and managers about window safety. The care market for Jackloc is a busy one, sites have 100+ windows and often many locations around the country. Personally, I feel it is essential for me to understand through these meetings, what our client objectives are regarding window safety in their individual settings. I want to know why Jackloc products are selected, used and what the users and staff feel about their operation, and to establish if there is scope for better understanding or improvement. Window safety in Care In the care sector, guidelines for the use of window restrictors have been issued by the Department of Health to help reduce the risk of falls from windows. To achieve this, window restrictors must comply with BS EN 13126-5:2011 standards to withstand a force of up to 500N being applied to the window in a forced opening test. In addition, an Estates and Facilities Alert was issued in 2014, following an incident where a fatality occurred when a care home resident fell from a window that had been restricted with a brand of restrictor that would now be considered as not fit for purpose. This alert suggested that within the health and care sector, window restrictors should be capable of withstanding forces in excess of 500N mentioned in the above BS EN standard, or that two restrictors may be required if one alone is considered in sufficient. It’s also worth noting that it’s not just falls from windows which a restricted window can help reduce. If a vulnerable resident is able to leave a ground floor window, then they may wander without care in confusion. My own mother lived with Dementia in a care home seven years ago, and would often revert back to childhood saying that she wanted to go outside to play on the swing. She had a ground floor room with a window that opened straight out to the garden, so would’ve been quite likely to try to use the window had she been alone and the window had the ability to open. So, in a market where restrictors are recommended by the Department of Health, what more can a window restrictor manufacturer do? With an already captive market, will waving a few restrictors around mean that people will come flocking to purchase them? In a competitive market it is key to stand out and be present, but what is most important is not preaching to the converted – there’s clearly a requirement for restrictors in this environment; but more importantly talking about HOW to maintain them properly and that’s where relationships with clients is essential. Engaging messages In this market, the environment, testing and maintenance are the some of the most important areas to consider. Installation of window restrictors are included in the guidelines, however, they need to be regularly maintained and assessed. Just having restrictors in place doesn’t mean that they will remain working effectively, only regular testing and updating, if required, will achieve this aim. During meetings with care providers, I want to create an open dialogue to listen to their needs and identify what The Jackloc Company can bring to make things work as well as they can, and to provide peace of mind to resident’s families and care providers on an on-going basis. Maintenance Organising site visits and risk assessments takes time out of everyone’s day, but it’s important to have a regular maintenance plan in place to ensure that the restrictors are doing their job. Regular wear to both the window and the restrictor will occur over time, and the window opening can flex and widen when under that pressure. Jackloc are hoping, to shortly be in a position to announce a partnership agreement that will provide a network of skilled installers and technicians who will be able to fit new Jackloc products. They will also be able to test window restrictors that are already installed, to ensure they are still achieving pass levels under load test. This will demonstrate to CQC assessors that maintenance regimes are being adequately adhered to. The future We recently attended the NASHiCS Health and Safety Conference for Social Care and continued discussions directly with care providers on how to improve window safety. At the event we demonstrated our folding restrictor, which can hold a force of 4800 Newtons, or 74 stone. In fact, under test conditions the window failed before the restrictor, which remained intact still attached to what was left of the window frame. We built the folding restrictor intentionally for the care market as it’s the strongest available. Since joining Jackloc earlier this year, I’ve been incredibly impressed with it. It’s been very well received by the trade and customers alike and we have big plans to promote the product over the Autumn. If you would like to hear more about our maintenance plans and see the folding restrictor demonstrated in action, then let’s arrange a meeting to discuss how we can work together and how Jackloc can help with your window safety requirements. #windowrestrictors #windowsafety #preventingfalls Eric.collins@jackloc.com
4 top tips for electrical appliance safety in your care home
Staff in the care sector need all sorts of electrical appliances to help them do their job, but these tools bring their own unique set of hazards. Here, Beckie Hatton from Home Appliance Care shares her tips for keeping the electricals in your care home running smoothly and safely. Whether you’re making residents a cup of tea in the morning, or keeping them warm throughout the winter, nursing and care homes depend on a wide range of electrical appliances to provide a high level of care. But, if left unchecked, this equipment can develop faults or fall into disrepair — and poorly maintained appliances can present a serious safety hazard for both your staff and residents. The good news is that regular checks, maintenance, and a few common-sense procedures can help keep everyone safe. Here, I’ll share the electrical maintenance tips that all care home owners and managers should know. Electrical safety and the law Under the Health and Safety at Work Act 1974 and the Electricity at Work Regulations 1989, all employers are obligated to safeguard their employees and members of the public (in this care, the residents) from harm. It’s also the duty of the business owner to ensure that electrical appliances are well-maintained and fit for purpose. To meet the regulations, you should carry out a risk assessment that looks at all the potential electrical hazards in your business and sets out measures to prevent injuries and accidents. This action plan should include a schedule for safety inspections, as well as training procedures for your staff to help them minimise risks when using appliances on a day to day basis. Inspections and testing As with any commercial business that uses electrical appliances, portable appliance testing (PAT) is a legal requirement in care homes. Inspections must be carried out by a competent person: this is someone who has the right training and sufficient knowledge of electrical work and safety, usually backed up by a formal qualification. Most businesses outsource PAT testing to a professional. There are two types of testing: physical and visual. Different types of equipment will have different timescales for testing: It’s helpful to label each appliance with the date of the last test, so you can keep track of what needs to be checked when. What staff and carers can do While regular inspections are a legal requirement, that doesn’t mean you can just forget about checking your appliances for the rest of the year. This is particularly true for residential or nursing environments as, unlike with a typical 9 to 5 business, your electrical goods will often be needed 24 hours a day, 7 days a week. While employers are responsible for maintaining appliances, staff and carers can also play a vital part in helping to reduce the risk of an accident or fault. Staff should make sure that appliances are unplugged when not in use, which will help to stop residents from attempting to use them. Residents shouldn’t be left alone with potentially dangerous equipment for any length of time, either. Staff should also take a quick look at the condition of the flex before they use a particular appliance, and never try to use something if the plug, cord, or appliance appear damaged in any way. Overloaded plug sockets are also a major cause of electrical faults and fires, so staff should be careful to use adaptors and extension cords safely. Employers can help encourage staff to do this by offering training and encouraging staff to report faults to a supervisor or manager whenever they notice a problem. By following a simple, regular system of looking for visible signs of damage or faults, most of the risks presented by electrical goods can be controlled. When to call an engineer Even with good maintenance and a rigorous system of checks in place, it’s likely that you’ll need to deal with electrical faults from time to time. You should contact an appliance service engineer if you or your staff notice any of the following: Depending on the size of your care home, it may be safer and more cost-efficient to schedule regular maintenance visits with a service engineer. By maintaining your appliances in this way, you can help to prevent potentially hazardous faults from happening, and extend the lifespan of your equipment, too. Given the number of appliances in the average care home, electrical safety should always be a priority. Follow the advice I’ve outlined here, and you should be able to keep your staff and residents safe from harm. Please note that this isn’t intended as a comprehensive guide, so refer to the HSE’s electrical safety at work resource for more information.
PolyCoversDirect
PolyCoversDirect is a UK based manufacturer of High Impact PVC radiator covers. Established in 2006 and now part of the Oadby Plastics Group of companies, PolyCoversDirect provide a range of cost effective, easy to install, low surface temperature radiator covers. Designed to be used in a variety of environments such as Care Homes, Hospital, Schools, Nurseries and Doctors Surgeries the PolyCovers product offers a commercially viable solution to the protection of both the service user and service provider. Manufactured here in the UK, each cover is bespoke to each customer’s requirements and can be easily retrofitted over existing radiators. Made from High Impact PVC our covers are easy to clean, impact absorbing, low maintenance, Class 1 fire rated and resistant to rusting, bending, denting and scratching. All our cover designs ensure no individual can be exposed to a surface temperature greater than 43°c in line with NHS and HSE guidelines and also protect against impact injuries from falls. By completing a simple survey sheet, which can be downloaded from our website, we can provide customers with quick and easy quotations. Alternatively, PolyCoversDirect staff are very happy to attend site and survey to establish the required size of your covers. If you have any further questions regarding our product and services or would like any further information please do not hesitate in contacting us on the details below. PolyCoversDirect Gallan Park Watling Street Cannock Staffordshire WS11 0XG Tel: 0800 246 5704 E-mail: sales@polycoversdirect.co.uk Website: www.polycoversdirect.co.uk
