Dementia and Incontinence
Dementia is an umbrella term for a host of memory loss symptoms. As dementia becomes more prevalent with age, many sufferers are also dealing with incontinence. Why Do People With Dementia Develop Incontinence? There are a number of reasons why someone with dementia might develop incontinence. • Not recognising the bathroom – People with dementia can struggle to recognise common household objects. While they can visually ‘see’ the toilet in front of them, they might not be able to identify what it is, and what it is used for. • Getting lost and wandering – People suffering with dementia tend to get lost very easily. The pathways responsible for spatial awareness can become muddled, and ‘wandering’ aimlessly becomes common. While this might begin out in the world, it can progress to confusion and getting lost within one’s own home. • Communication issues – Dementia can cause communication to break down. A person with advanced dementia might not be able to alert their carer that they need to use the toilet before it is too late. • Mobility loss – Dementia is often accompanied by reduced mobility and other physical disabilities. Even if a person is conscious that they need to use the toilet, their physical condition might prevent them from doing so. This often results in an inability to get to the bathroom in time to prevent an accident. Incontinence Pads and Pull – Up PantsIncontinence Pads or pull up pants can give a person suffering with incontinence a sense of normality, whilst at the same time, maintaining their dignity. A wide range of Incontinence products are available from HARTMANN Direct, which provide containment for both urinary and faecal incontinence to help reduce the embarrassment that incontinence can cause. One of the best things you can do to keep life as normal as possible for someone with dementia. HARTMANN customer Adrienne recounts her experiences with husband Jeff. “Jeff’s problem was not remembering quickly enough that he needs to go to the toilet during the day and having frequent accidents during the night. We tried to manage it ourselves, to begin with by looking out for signs he needed the toilet and setting the alarm… but he was frequently soiling the bed.” She found respite and relief with HARTMANN MoliCare® pull-up pants. Adrienne continued, “the MoliCare® pull-up pants are much better for Jeff as they look like normal underwear, so he doesn’t get upset wearing them. He can pull them up and down like normal pants, which helps him maintain his dignity.” “We want him to keep his independence for as long as possible and minimise what is already a confusing world for him.” Adrienne is just one of thousands of customers around the UK who have benefitted from using MoliCare® pads and pull up pants for themselves and their loved ones. Dementia or not, no one deserves to have incontinence affect their quality of life. Reference list 1. https://www.alzheimers.org.uk/get-support/daily-living/toilet-problems-continence 2. https://www.scie.org.uk/dementia/living-with-dementia/difficult-situations/using-the-toilet.asp 3. https://www.mayoclinic.org/healthy-lifestyle/caregivers/in-depth/alzheimers/art-20046222
Care Roadshows Celebrates 10 Years
Care Roadshows returns for 2020 with five great events to celebrate its 10th year! Shows across the UK will feature exhibitors from top care brands with innovative products and services to help support and develop your care business. Visitors will also be able to take part in creative workshops and informative seminars from experts in the sector. The events continue to provide inspiration, information and a great day out for all those working in the care sector. Over the last ten years the events have seen thousands of visitors at locations in Glasgow, Liverpool, Birmingham, Cardiff and London. This year, the event is lucky to host a fantastic set of speakers. The line-up includes Gillian Anderson, Service Manager at Care Inspectorate, Issac Theophilos, Author and Director of Outstanding Care Homes, Neil Eastwood, Founder & Author of #1 bestseller ‘Saving Social Care’ and Senga Currie, Head of Care Development for Quality Compliance Systems. To see the full list of speakers, visit https://www.careroadshows.co.uk/. Event Organiser, Emma Barrett said, “Ten years ago we created Care Roadshows as a way of helping bringing the people who work in the care sector together in a positive way. Our aim was to create smaller regional events that allow more quality face-to-face time between care professionals and experts, associations and brands that can improve their businesses. It’s great that we’re still going strong after a decade and we hope to keep delivering excellent events for the next 10 years!” QCS are once more sponsoring the five events and will be running QCS User Hubs at each venue where visitors can try out new compliance platform features and tech. Save the dates: Glasgow on 28th April; Liverpool on 19th May; Birmingham on 7th July; London on 20th October and Cardiff on 17th November. Registration for the one-day events is free, so click this link to sign up! – https://careroadshows-2020.reg.buzz/pr
New approaches to hand hygiene
The importance of hand hygiene has been understood and accepted for a long time. The majority of infections – around 80 per cent according to studies – are passed by hand to hand contact or by touching a contaminated surface. This is why hand hygiene and surface disinfection are critical to infection prevention in hospitals, care homes and other settings. One would imagine that hand hygiene would be the easiest of everyday activities to get right. We all learn at an early age to wash our hands before eating and after going to the toilet. But studies have shown that relatively large numbers of people forget – or refuse – to do this. Even in settings such as hospitals, where poor hand hygiene can have serious consequences, studies suggest that processes can be improved, compliance rates increased and infection rates reduced. Despite established and robust infection prevention procedures, studies show that infection rates in hospitals run at around 10 per cent – that is one in ten – of all patients. While this is far lower than the past, many facilities have found it difficult to reduce the rate further. This is why current thinking is towards more effective hand hygiene processes and focusing on critical tasks. The recommended procedure for using hand rubs, for example, proscribes six separate steps. This is a tried and tested technique that is known to be effective at reducing infection rates when followed correctly. However, following all six steps correctly in the real world can sometimes be difficult. Researchers wanted to test if alternative, simpler techniques could be just as effective. One study compared the WHO’s current six-step hand rub method with a three-step method that involved covering the entire hand with alcohol rub and then focusing on the fingertips and thumbs. The results were significant and, to many, surprising. The three-step method was more effective at reducing the levels of bacteria on the subjects’ hands. A separate study focused on the fingertips because these are generally accepted to be the most contaminated part of the hand – this intuitively makes sense because it is quite possible to touch and hold all manner of surfaces and objects with the fingers alone. Trials of a fingertip-first method of hand hygiene demonstrated a greater reduction in the number of bacteria than the existing six-step methodology. Alongside new and improved hand hygiene techniques like these, attention has turned to when health workers should clean their hands. The World Health Organisation’s “Five Moments of Hand Hygiene” initiative has helped reduce infection rates in healthcare settings. These recommend healthcare workers wash their hands: before touching patients; before clean/aseptic procedures; after body fluid exposure; after touching patients; after touching patient surroundings. But despite progress, studies suggest between 20 and 40% of healthcare associated infections arise when a healthcare worker passes pathogens from one patient to the next. The latest thinking is for a more targeted approach that encompasses hand hygiene and surface disinfection. All areas in care settings are cleaned and disinfected daily, as before, but additional attention is paid to frequent touch and high-risk surfaces. In practice, this has been distilled into five critical points: before placing food/drink on over-bed tables; after procedures involving faeces or respiratory secretions within the patient bed-space; before/after any aseptic practice; after patient bathing (within bed-space); after any object used by/on a patient touches the floor. For its part, the cleaning and hygiene industry continues to develop innovations that help to make processes simpler, safer and more sustainable while improving performance and infection rates. Diversey offers a wide range of hand hygiene and surface disinfection products for healthcare and other settings. As a leading supplier with years of experience, the company can advise on the right combination of products for every setting and situation. Further information in the UK on 0800 525525 or http://www.diversey.com Further information in Ireland on 01 808 1808 or http://www.diversey.com
Avery launches staff well-being programme
High levels of staff transience, combined with a sometimes unattractive reputation for the adult social care sector, means it is often a challenge to attract and retain high quality permanent staff. Avery knows that investing in employees, through better training, career pathways, broader and appropriate benefits packages, flexible working and pay patterns, proactive support for staff well-being and healthy lifestyle choices, plus better information and communication leading to higher staff morale and loyalty, and thus retention. The AveryOne Programme has been designed and implemented to provide genuine value-add to employees, based upon their own feedback to Avery on those features that would enhance their working experience and career opportunity. It has also become clear that this retention platform can be an effective staff attraction tool in recruitment. Adapting its approach to person-centred care for its residents, Avery has developed and launched in December 2019 an employee-centred solution to help retain staff; to better support and reward them, to enhance their personal well-being at work, to increase their job satisfaction, to boost their benefits package, and enhance their continued professional development (CPD) and career opportunities. An App for both iPhone and Android, AveryOne’s deliverables include weekly pay (quicker access to pay based on shifts worked), vouchers and coupons (helping money go further in ways that matter), a well-being focus that supports a proactive lifestyle (with health advice on-line), plus healthcare, optical and hospital plans. AveryOne – Avery looks after the people who look after its residents. Additional information Weekly Pay In 2019, Avery Healthcare was the first major care sector provider to partner with a third party to offers its employees instant access to a proportion of money or salary already earnt within the standard monthly pay cycle. The company is keen to embrace new technology wherever possible for the benefit of residents and staff, and the instant payment system gives employees greater control of their finances, and mitigates the need for them to use high interest credit such as payday loans and credit cards for when they need quicker access to funds. Very few of the staff are desk-based with access to a computer, but virtually all staff possess a mobile phone. This led Avery to implementing a mobile phone App that is compatible with both Android or Apple devices and that is quick, simple and easy to use. Discounts AveryOne offers employees instant access to discounts with hundreds of product and service suppliers, including leading supermarkets, fashion and technology retailers, restaurants, cinemas, travel companies and hotels, experience days out such as theme parks, gyms, spas and beauty services. New retailers are being added on a weekly basis, with some offering up to 60% off their recommended retail prices. Based upon research from the employees prior to this service being implemented, such benefits were high on the list of staff preferences for how their overall rewards and remuneration package could be enhanced, making their money go further in ways that they could individually choose. Well-being A key element of the App is the focus on staff well-being. It provides access to information for on-line GP services, hospital and healthcare plans, death in service benefits and eyecare discounts. It also includes a free service called Hapi Life, which offers employees proactive life advice and guidance on such things as: • managing money more effectively • nutrition and diet • work life balance • personal productivity • spiritual and religious matters • national charity days and events The AveryOne discount platform App also offers employees access to details of other core benefits such as pension schemes, training and development opportunities, as well as uniform policies. It also provides access to Avery’s website and the company’s quarterly magazine, Welcome Home. These elements within the AveryOne Programme align with other staff retention initiatives such as: • training opportunities for all staff to support their Continuous Professional Development (CPD) – from the Avery Apprenticeship Scheme to nurse revalidation and QCF Level 5 • career pathways for all categories of staff, both care and non-care – including those who wish to change direction in their career such as a carer to a trainer, or culinary staff to housekeeping • some of the longest and most thorough new recruit inductions for the sector • competitive rates of pay, continually reviewed and updated in line with the marketplace It has been Avery’s finding that in general terms an increase in staff overall well-being levels can lead to the following organisational improvements: Increased Productivity – well-being can directly improve the mental and physical health of the workforce, with staff who are motivated to complete tasks contributing more to the organisation Decreased Absence – workplaces that value well-being will experience reduced absences thanks to better health behaviours, better stress management and greater morale Improved Retention – it is more costly to continue to replace rather than retain Positive Health Benefits – an effective well-being strategy can have physical benefits as well as mental, with staff more likely to adopt and maintain healthier habits Enhanced Communication – various ways for staff to provide feedback on their working environment and experiences; through regular meetings with their line manager, anonymous staff surveys, staff group meetings, plus annual or six-monthly Personal Development Reviews (PDRs) AveryOne – Avery looks after the people who look after its residents.
Borough Care marks International Women’s Day
Borough Care, the largest not-for-profit provider of care for older people in Stockport, is marking International Women’s Day (8 March) by celebrating the achievements of its female residents. Dr Mark Ward, CEO at Borough Care, says: “At Borough Care, we believe the amazing things our female residents have achieved during their rich and interesting lives should be celebrated not forgotten. These ladies paved the way forward for today’s women. Although gender equality is still some way off, by drawing attention to the incredible, colourful lives our female residents have led we hope to raise awareness against bias and take action to promote equality.” One such resident is Marjorie Aytoun, who lives at Borough Care’s Meadway Court in Bramhall. Born in Stretford, Greater Manchester in 1932, Marjorie’s intelligence and aptitude shone through from an early age. She secured a place at Stretford Grammar school before going to Leeds University to study the Classics, Ancient Greek and Latin. Things took an unexpected turn for Marjorie at Leeds University, when she developed Spinal TB and had to spend two years in hospital. Despite many difficulties, Marjorie continued to study for her degree throughout her illness. Marjorie had to lie on a slab and could only move her hands and head. Books were laid on her chest and the words reflected onto the ceiling so she could read. It was her determination to complete her degree that kept Marjorie going. Marjorie recovered and went on to achieve both a B.A. and M.A. in the Classics, before she began a teaching career. Marjorie’s ambition to succeed and break boundaries didn’t stop, as she decided to study for the ministry, despite some reservation towards female reverends at the time. While at Meadway Court, Marjorie has continued to enjoy being involved with the Church, regularly attending services and special events. www.boroughcare.org.uk
The team behind Castle View looks to expand
Castle Retirement Living, the team behind the new £30million Castle View retirement village in Windsor is looking to replicate its retirement living model. The envisaged future formula would blend purpose-built luxury apartments with excellent community facilities and be based in an urban area with all the benefits of connectivity, community, entertainment and activity. “We aim to design and develop high-end quality retirement living that’s a significant departure from conventional older living apartments,” says Robin Hughes, CEO of Castle Retirement Living. “The quality benchmark is that it should be good enough for my mum, and she was one of the first people to move into Castle View. “Apartments would be well built, sound-proofed and thermally efficient, and set within a building that incorporates contemporary features such as a cool café/bar, a restaurant serving good food, quiet spaces like our library and statement features as the Sky Lounge and sun deck at Windsor. Good interior design is also vital to create an environment that today’s 60 and 70 year olds aspire to live in. Adds Robin: “The huge demand on retirement housing and health care in the UK is a consequence of the changing demographics. Today’s older generation also has the wealth to demand a much higher standard of living than their parents, and as well as having a focus on peace of mind, well-being, independence and living with like-minded people, this market wants a quality experience throughout – and why not, they have worked hard for it!” The next development would comprise some 60-70 units and be fully staffed. The first project at Windsor cost approximately £30million to construct and fit out, and it is envisaged that the next one would represent a similar investment, subject to the cost of land. Castle Retirement Living comprises a small management team with an excellent pedigree led by Robin Hughes who has some 20 years’ experience in the property and care sectors – see Note to Editors below. The business is now looking to build on the success of its first scheme which will be the cornerstone for a long term investor to grow the business. To this end, CBRE has been appointed to find a partner to take it forward to the next stage.
Care Innovation Hub’s social care challenge
The upcoming Social Care Challenge is a two and a half day sprint, aimed at University students as an opportunity to consider social care as a career pathway and come up with new ideas to address some of the biggest problems in social care. Sprint Partners and supporters include Hallmark Care Homes, Home Instead, Walden Care, Royds Withy King, Quality Compliance Systems, Person Centred Software, Hilton Nursing Partners, Apetito, Greensleeves, Borough Care, WCS Care and the Department of Health and Social Care. Mentors are senior executives in social care who spend the weekend supporting students with their ideas and offer insights that could help create the next big idea for social care. Hallmark Care Homes, Home Instead and Quality Compliance systems join CIH as Sprint partners for a second year. Ram Goyal, Managing Director from Hallmark Care Homes commented: “I am incredibly excited to be supporting this event and I cannot wait to see what ideas the students come up with. The care sector is facing a lot of challenges at the moment and there is an increasing need to come up with innovative ideas and technology to support the needs of residents.” Home Instead joins CIH for a second year as Sprint Partner. Martin Jones, CEO said: “It’s incredibly exciting to support the Care Innovation Hub and to bring people together from a variety of academic backgrounds to come up with innovations which could shape the future of social care. Not only is it fantastic to encourage new ideas into the sector but it’s also a great way of showcasing to students the rewards of working in care. If you’re a student looking to make a difference to the lives of others, I’d encourage you to take part in the challenge.” Mat Whittingham, CEO of QCS has renewed their partnership with Care Innovation Hub. As a judge at the Department of Health and Social Care at last year’s final, Mat said: “The innovative, but practical solutions that were demonstrated will challenge how we think care should be delivered.” Jonathan Papworth, Founder of Person Centred Software said: “Mobile Care Monitoring was a significant innovation in how to evidence care when it was launched in 2013, and I am looking forward being part of Care Innovation Hub to help others bring to market equally valuable new solutions to the needs of the social care sector” “Whilst politicians and the media can talk about the problems in health and social care, it is refreshing that the Care Innovation Hub is standing out by focusing on new ideas to help solve the problems and improve quality of care for everyone. I am delighted to have been invited to help drive innovation in the sector” Apetito will provide participants with meals, to give them an experience of the high-quality food that is distributed throughout care homes in the UK. Neil Hargreaves, Care Home Divisional Manager said: “apetito is delighted to become a sprint partner with Care Innovation Hub. We are passionate about driving positive change in the care sector and CIH share this passion. Innovation is critically important to the future of care in the UK and supporting entrepreneurs to develop ideas is at heart of this. We are excited to attend the upcoming events in 2020 and be a part of something that is going to make a real difference to residents and carers.” Greensleeves join CIH as their latest Sprint Partner for 2020. Paul Newman, CEO of Greensleeves said: “A culture of innovation lies at the heart of Greensleeves Care’s success, as is nurturing new talent. We champion the pioneers across social care working incredibly hard to implement new ideas and technologies, ultimately to enhance the resident experience. We are delighted to partner with the Care Innovation Hub to advance this sector-wide agenda. We look forward to supporting the entrepreneurs at the Hub and adopting some of these innovations at our care homes across the country.”Previous ideas include an error proof medication system, an app focussing on culturally matched care for the BAME community, sleep monitoring devices and much more. The Social Care Challenge will be taking place in Florence’s offices in London from Friday 28th February till Sunday 1st March. For more information about the Sprint, visit www.careinnovationhub.org/what-is-it.
Keeping your care home hygienic
Keeping your care home hygienic: Making sure residents are healthy and happy Safe hygiene practices, infection control and health and wellbeing play a major role in the care of residents and is the responsibility of all staff. In 2016, in response to the implementation of the (Care Act 2014), ‘think local, act personal’ (TLAP) carried out a survey commissioned by the Department of Health (DOH). they discovered that a proportion of people in receipt of care felt they were not respected, whilst others felt that care practices amongst staff were often ‘different’ and not comparable to others. This highlights the at times inconsistent standards from individuals and service providers. Within the United Kingdom (UK), the Care Quality Commission (CQC) carry out regulation of health and social care services ensuring they meet the required standards in relation to quality of the provision. The CQC work with the service providers, staff and service users (residents) to make improvements. Cleanliness is vital within a care home environment. A clean care home not only keeps your residents, staff and visitors safe, it also impacts on how they feel both physically and mentally. This can have a huge impact on a person’s mental wellbeing, as no-one wants to live in an environment that is unclean. This is also true for visitors and people choosing a home for a loved one, they are unlikely to select a care home that does not appear clean or smell fresh. Here at the University of Northampton, we instil this knowledge into our students from the onset with skills for practice (getting them ready for practical/placement experience). This commences with the fundamentals of personal hygiene such as handwashing techniques and effective communication. Hygiene Personal hygiene for most people is a private activity. Yet for some in a care home, due to mobility or health related issues, the resident may need assistance with the most intimate of tasks. The key here is to aid with maintaining the resident’s independence, dignity, choice and privacy ensuring you are sensitive to the person’s needs, aiming to make the experience as positive and comfortable as possible. Using good personal protective equipment (PPE) is vital to ensure the spread of infection is minimised, staff play a major role in this by ensuring they use best the latest, evidenced based practice to ensure they aim to prevent the spread of infection, e.g. wear gloves whilst providing care. It is both the responsibility of the organisation and staff to ensure that infection prevention and control (IPC) is maximised, the World Health Organisation (WHO) found that IPC is a fundamental aspect for quality health care in relation to patient safety (WHO, 2019). This can be maintained by rigorous handwashing techniques or simply by participating in regular training activities for staff, residents and/or carers/relatives. (NICE, 2014). Living in such close proximity within a care home means that infections are likely to spread. The people within the care environments are likely to have weaker immunity so are susceptible to easily transmitted infections. Residents, staff and visitors should feel safe knowing that appropriate measures are taken to ensure they are in a safe, clean and comfortable environment. Home from Home The Enhancing Health and Wellbeing Module on our foundation degree very much focuses on supporting individuals to enhance their health and wellbeing. When living in a care home the resident should feel at home. Likewise, when choosing the right environment, the choice would be made based on cleanliness and odour. Encouraging the person to bring along personal possessions can aid with the transition to long term care and helps the resident to feel valued, happy and at home in their new environment (Brownie, et al, 2014). Stigma often surrounds care home environments and offensive odours, particularly in relation to older people. A good cleaning regime from the housekeeping team and staff members can aid with ensuring good practices are adhered to in relation to cleaning and removal of waste products. There are also many products available that can aid with odour elimination such as air fresheners and scented cleaning products. Staff should ensure they attend the workplace looking presentable and treat the care environment as the residents’ place of residence, this is their ‘home’ and should be treated and respected as such. Here at the University of Northampton, we teach the students the principles around professionalism. With placement modules that provide ‘hands on’ experience with support from experts in practice. Care homes very often like to offer students employment following their placement, which is testament to the quality of the student and also to the learning experiences they have received whilst here with us and on placement. Maintaining good standards of care and ensuring staff are trained adequately is vital to ensure residents are safeguarded. During 2017-18 there were 394,655 concerns of abuse raised in relation to Adult Safeguarding, an increase of 8.2% on the previous year (NHS, 2018). Within the Faculty of Health Society and Education we are dedicated to providing the message that good, quality care matters. It is vital that our students leave us as conscientious health and social care staff that are able to deliver and celebrate good practice and challenge poor practice. Age UK (2019) Age UK factsheet 29, Finding, choosing and funding a care home. [Online]https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs29_finding_choosing_and_funding_a_care_home_fcs.pdf [Accessed 03/02/20] Brownie, S. Horstmanshof, L. and Garbut, R. (2014). Factors that impact residents’ transition and psychological adjustment to long-term aged care: A systematic literature review. International Journal of Nursing Studies. 51(12) pp1654-1666. CQC, (2019) Care Quality Commission – The independent regulator of health and social care in England. What we do. [Online] https://www.cqc.org.uk/what-we-do [Accessed 03/02/20] Marsden, J (2015). Keeping patients safe: a practical guide. Community Eye Health. 28 (90) 23-25 [online] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675257/ [Accessed 02/02/20] NICE (2014) NICE Quality Standard 61: Infection prevention and control (National Institute for Health and Care Excellence). [Online] https://www.nice.org.uk/guidance/qs61 [Accessed 02/02/20] NHS (2018) Safeguarding Adults, Engalnd, 2017-18, Experimental Statistics. [Online] https://files.digital.nhs.uk/33/EF2EBD/Safeguarding%20Adults%20Collection%202017-18%20Report%20Final.pdf [Accessible 17/02/20] TLAP (2017) The Care Act (2014) Survey Results. Exploring
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.
