Fire Safety in Care Settings: Why Vulnerability Matters

Research shows that vulnerability significantly increases fire risk. In care settings, residents may have reduced ability to escape, limited awareness of fire danger, or combinations of factors that together create serious risk. Understanding these vulnerabilities is essential for effective fire safety management.

Daedon has worked with Devon and Somerset Fire and Rescue Service guidance to identify nine key risk factors found in care settings. This audit guide helps managers and staff recognise and address these risks.

Nine Key Risk Factors in Care Settings

1. Reduced Ability to Escape

Risk factors include:

• Limited mobility due to frailty, disability or physical impairment
• Residents who are bed-bound or chair-dependent
• Reliance on walking aids (frames, sticks, wheelchairs)
• Visual impairment or blindness
• Hearing loss or deafness
• Lack of capacity to understand fire procedures or follow instructions
• Blocked or cluttered escape routes
• Inability to unlock or open doors independently

Audit check: Are escape routes clear and accessible? Can residents with mobility issues reach exits safely? Are locks and doors operable by residents with limited strength?

2. Less Able to React to Alarms or Fire

Risk factors include:

• Memory loss or cognitive impairment (dementia, confusion)
• Mental illness affecting decision-making or understanding
• Medication that causes drowsiness or impaired alertness
• Alcohol or drug dependency affecting awareness
• Sensory impairments (hearing loss, vision problems) affecting ability to notice fire or understand alarms
• Sleep or unconsciousness at time of fire

Audit check: Are alarm systems adequate for residents with hearing or sensory impairments? Do residents understand evacuation procedures? Are staff trained to recognise when residents may not respond to alarms?

3. Smoking

Risk factors include:

• Unsafe cigarette disposal
• Smoking in bed or while drowsy
• Smoking combined with medications that cause drowsiness
• Smoking in prohibited areas (near oxygen, fuel sources, flammable materials)
• Burn or scorch marks visible on furnishings, bedding or fabrics

Audit check: Are smoking areas clearly designated? Is supervision adequate for residents at higher risk? Are staff trained to identify signs of unsafe smoking (scorch marks, smouldering fabrics)?

4. Lack of Alarm Detection Systems

Risk factors include:

• No smoke alarms, or alarms not on every floor
• No heat alarms in kitchens or cooking areas
• No carbon monoxide alarms in rooms with fuel-burning appliances
• Alarms not audible to residents with hearing impairment (missing visual alarms, vibrating pads, call-centre monitored systems)
• Alarms with dead or missing batteries
• Alarms disabled or covered

Audit check: Are alarms present on every floor and outside sleeping areas? Do alarms work? Are they tested regularly? Do residents with hearing difficulties have visual or vibrating alarm systems?

5. Unsafe Heater Use

Risk factors include:

• Electric or gas heaters placed too close to flammable materials (bedding, curtains, clothing)
• Old halogen heaters or bar heaters with high burn/fire risk
• Non-standard heating sources: ovens left on for warmth, open flames, candles
• Portable heaters with damaged cords or faulty thermostats
• Heaters with no tip-over protection

Audit check: Are portable heaters positioned safely (at least 1 metre from combustible materials)? Are residents supervised when using heaters? Are non-standard heat sources (candles, ovens) prohibited?

6. Emollient Creams

Risk factors include:

• Both aqua-based and paraffin-based emollients are flammable
• High fire risk when residents using emollients smoke or are near naked flames, candles, or heat sources
• Emollient remains on fabrics even after high-temperature washing
• Research indicates approximately 50 fatal fires yearly involve emollient creams (NFCC data)
• Risk increases significantly if smoking, naked flames, or heat sources are present

Audit check: Are residents using emollients identified? Are they supervised closely if they smoke? Are combustible heat sources, candles or naked flames prohibited in their vicinity? Is staff aware of emollient fire risk?

7. Previous Fire Signs or Near Misses

Risk factors include:

• Scorch marks on carpets, curtains, walls or furnishings near plug sockets, heaters or candles
• Burn marks on fabrics or furniture
• Evidence of previous fires or fire incidents in the premises
• Previous near misses (e.g. smoking in bed, heating appliance malfunction, electrical fault that nearly caused fire)

Audit check: Are there visible signs of previous fires or near misses? Has the cause been addressed? Has the hazard source been removed or the behaviour changed?

8. Hoarding and Clutter

Risk factors include:

• Cluttered or blocked escape routes (corridors, doorways, stairs)
• Items stored in exit routes or stairwells
• Excessive personal possessions in bedrooms affecting escape and fire spread
• Faster fire spread through accumulated items
• Items in contact with heat sources (hobs, candles, extension cords, heaters)

Audit check: Are escape routes clear? Are common areas uncluttered? Do residents hoard items in rooms? Are items stored away from heat sources?

9. Electrical Dangers

Risk factors include:

• Daisy-chained extension leads (leads plugged into leads)
• Overloaded sockets with multiple high-power appliances
• Visible scorching around plug sockets or chargers
• Unsafe chargers purchased cheaply online (low safety standards)
• Tumble dryers or dishwashers run when residents are asleep or away from the premises
• Damaged cords or frayed wiring on personal appliances

Audit check: Are electrical sockets overloaded? Do residents use cheap online chargers? Are high-heat appliances supervised? Are appliance cords in good condition?

Specific Vulnerabilities and Care Considerations

Dementia and Memory Loss

Residents with dementia or memory loss may:

• Leave cooking unattended on the hob
• Misunderstand the meaning of smoke alarm sounds
• Become disoriented and unable to find exits
• Forget evacuation procedures or safety rules
• Forget to turn off heaters or electrical appliances

Support needed: Close supervision in kitchen and cooking areas. Clear, simple evacuation procedures. Regular prompting and reminders. Consideration of locked kitchen access if safe to do so. Staff trained to recognise signs of confusion.

Learning Disabilities

Residents with learning disabilities may:

• Not understand fire risk or the need to evacuate quickly
• Struggle to follow complex instructions or navigate unfamiliar exits
• Require tailored, simple communication about fire safety

Support needed: Simple, pictorial evacuation procedures. Regular, repeated training and rehearsal. Clear verbal and physical guidance during drills. Staff trained in communication and de-escalation.

Sensory Impairments

Hearing loss or deafness: Visual alarms (flashing lights), vibrating pads or bed shakers, personal alert devices, call-centre monitored systems.

Vision loss or blindness: Clear, uncluttered escape routes. Handrails and tactile guidance. Audible alarms. Verbal guidance from staff. Familiarity with room layout and exits (repetition and familiarity).

Medical Oxygen

Medical oxygen is highly flammable. Fire risk is significantly increased if residents using oxygen also:

• Smoke or use smoking materials
• Are near naked flames or candles
• Use emollient creams

Support needed: Close supervision. Prohibition of smoking or open flames in vicinity of oxygen. Clear labelling and safe storage of oxygen cylinders. Staff training on oxygen fire risk. Home Safety Visit assessment recommended by fire service.

Airflow Mattresses and Cushions

Airflow mattresses, pressure-relief overlays and cushions carry fire risk:

• Can be punctured easily, increasing airflow that fans flames from cigarettes
• Electrical components may overload if bedside power strips are overloaded
• Residents may not evacuate quickly if dependent on powered mobility aids

Support needed: Prohibition of smoking or open flames near airflow mattresses. Electrical safety checks. Specific evacuation planning for residents dependent on equipment.

Incontinence Products

Bulk storage of incontinence pads in care facilities presents fire risk:

• Pads are highly flammable
• Large quantities store quickly in small spaces
• Combined risk with smoking or heat sources

Support needed: Safe storage away from heat sources and smoking areas. Regular inventory turnover. Awareness of product flammability among staff.

Fire Safety Audit Checklist for Care Homes

Use this checklist to audit the nine risk factors in your care setting:

Risk Factor	Status	Action Needed?
Reduced ability to escape
Less able to react to alarms
Smoking
Lack of alarm detection
Unsafe heater use
Emollient creams
Previous fire signs
Hoarding and clutter
Electrical dangers

Working with Fire Services

Devon and Somerset Fire and Rescue Service offers Home Safety Visits to support organisations working with vulnerable people. These visits are free and can help identify risks, provide practical recommendations, and build staff confidence in fire safety.

Daedon can support care home managers in preparing for these visits, interpreting assessments, and implementing recommendations.

Key Takeaway

Fire risk in care settings is not inevitable, but it requires understanding vulnerabilities and taking proportionate action. By recognising the nine key risk factors and supporting residents with specific needs, care home managers can significantly reduce fire risk while maintaining dignity and quality of life for residents.