Agenda item

In response to Member questions and discussions at the last meeting (resolution 104/19 refers) a report was presented by the Deputy Chief Fire Officer in relation to person-centred Home Fire Safety Checks (HFSC) and the overall effectiveness of the HFSC, Safe and Well visits delivered by the Service.

Members noted that a ‘person-centred approach’ placed the Service recipient at the centre of the offer and ensured they were treated as a person first.

Lancashire Fire and Rescue Service (LFRS) had a number of prevention activities and campaigns which had been developed around this personalised approach by focussing on the importance of well-informed risk assessments, dignity, choice and close partnership working.

The HFSC and Safe and Well visit delivered a bespoke, personalised fire risk assessment, which was tailored towards individual need and, by working with partners for inward and onward referrals, ensured resources were focussed on, and tailored to, high risk and vulnerable individuals.

Fire and Rescue Services in the UK have a statutory duty to prevent fires and considerable effort and resources had been focussed on reducing risk using a variety of prevention activities.  LFRS’ largest prevention offer was the HFSC which assessed risk in the home and enabled specific fire safety advice and equipment to be provided to meet the needs of the individual.

Historically the HFSC was target driven where success tended to equate to a high number of checks being carried out.  As time progressed it was recognised that targeting at such a wide geographic level was becoming increasingly inefficient and a shift occurred towards targeting the individual’s presenting greatest risk by suing lifestyle and societal factors.

In 2015 the Chief Fire Officers Association, now the National Fire Chiefs Council, together with the Local Government Association, Public Health England and Age UK produced a joint consensus statement setting out their intention to collaborate and strengthen efforts to tackle a range of shared health risks.  The aim of this was to improve safety and quality of life thereby reducing pressures on the NHS.

To address this LFRS shaped the transition from a HFSC to a new co-designed, more holistic visit, centred on the person/family.  This was the Safe and Well visit which now formed part of the complete HFSC Service.

The Safe and Well visit included additional questions relating to seven areas which were selected not only because they linked to the types of health risks partners were seeking to address, but also because they were inexorably linked to fire risk. These were:

1.    Falls prevention;

2.    Social isolation;

3.    Living with dementia;

4.    Diabetes;

5.    Healthy homes/ winter pressures;

6.    Home security/ arson vulnerability;

7.    Mental health.

If appropriate and with the person’s consent, a referral could be made to the appropriate service/organisation to access further support (and reduce risk). The Service recognised the benefit of individuals making their own decisions and being involved with their fire risk assessment so that they were fully engaged with the process.

The opportunity for Fire and Rescue Services and strategic health and social care partners to work more effectively together was based on one important factor, the individuals’ wishes and needs.  Evidence that could be derived from fire fatalities across the UK indicated that there remained common risk factors. Research showed that health and care issues, when coupled with fires in the home, resulted in worse outcomes including a much higher likelihood of fatalities. These factors included: multi-morbidity and frailty, cognitive impairment, smoking, drugs, alcohol, physical inactivity, obesity, loneliness and cold homes. Some of these factors such as smoking increased the likelihood of having a fire and others such as frailty increased the likelihood of sustaining more serious injuries or fatalities.

Alongside the refined approach a new risk scoring criteria was implemented with any referrals scoring 22 or above automatically offered a Safe and Well Visit and those scoring lower were provided with bespoke fire safety advice.  This had enabled LFRS to triage all referrals and identify the most vulnerable and high-risk people across Lancashire.  LFRS worked closely with over 241 partner organisations and provided a fast track mechanism for referrals for any of their service users.

The report detailed how HFSC figures and the number of accidental dwelling fires (ADF) and casualties had varied over the past decade and showed how the fire risk map had changed in that time.  In 2010 the Service delivered over 55,000 HFSCs and by 2020 that number had reduced to just below 20,000 while in the same period the number of accidental dwelling fires continued to fall by over 30% and in the same period annual casualty figures reduced by a similar percentage.  It was not statistically sound to fully link HFSC delivery to ADF rates and casualty outcomes as to do so ignored the multitude of other risk reduction methods used.  However, risk tended to link with deprivation and other associated determinants such as fuel poverty so the data presented should be taken in the context of the wider decade which covered the austerity period.  What the data tended to show was that it was possible to reduce the absolute number of HFSCs while at the same time continuing to reduce risk, provided the risk reduction activity was targeted effectively. 

As the Safe and Well offer had significant depth and the referral pathways varied significantly based on local provisions LFRS had introduced a quality assurance process which checked a minimum of one Safe and Well visit per area per month to ensure that agreed standards were being consistently delivered, the appropriate questions were being asked and the relevant advice and equipment provided. 

LFRS also delivered evidence-based campaigns to raise awareness regarding certain risk and behaviours.  These were focussed and targeted on geographical and demographics that were experiencing the highest risk of fire.  Examples of typical campaign activity were presented in the appendix.

The report also detailed ongoing work being developed through the National Fire Chief Council Prevention Committee to further refine the risk factors which lead to fire in the home and the effectiveness of the associated control measures and referral pathways necessary to mitigate them.  This project was currently being initiated at a national level and strategically was intended to support Fire and Rescue Services to deliver against objectives in the future Prevention Fire Standard (currently in draft for consultation) with likely objectives included in the report alongside characteristics that should be evident when providing a person-centred HFSC (these included: affording people dignity, respect and compassion, offering co-ordinated and personal support, being enabling and to recognise these characteristics and that individuals may have varying and increasing fire risk based upon numerous and changing factors).

In response to questions raised by County Councillor Riggott the Deputy Chief Fire Officer confirmed that the work currently under development through the National Fire Chiefs Council Prevention Committee was expected sometime later this year.  He reassured Members that this work was not new to LFRS who had been working for the last 6 or 7 years to target resources in the right place and provide a person-centred Home Fire Safety Check. 

The Deputy Chief Fire Officer also confirmed that LFRS delivered in the region of 20,000 HFSCs per annum.  He advised that when the HMICFRS did inspect they looked at the volume of checks carried out against the population headcount.  LFRS worked closely with its partners and there was a clear referral mechanism to target the right people.  Monitoring identified the proportion of checks undertaken for the vulnerable was in the region of 65 - 70%.

The Deputy Chief Fire Officer also confirmed that the quality assurance process checked one safe and well visit per district/unitary area per month. 

In response to a question raised by County Councillor Riggott regarding the percentage of referrals that scored 22 or above and were offered a Safe and Well visit, Area Manager for Prevention and Protection, Mark Hutton advised he would provide an exact figure after the meeting but from memory it was in excess of 70% of people that were offered a physical HFSC.  The remaining 30% (who scored under 22 and were low-risk) received an appropriate form of HFSC via telephone or email.

Councillor Williams asked whether the high demand for portable heaters over the winter months had in turn caused additional accidental dwelling fires.  In response the Deputy Chief Fire Officer advised that the report for the next Performance Committee was currently in draft and although accidental dwelling fires had increased this was not significantly and he was not aware of any trends of the impact of higher use of gas canisters.

County Councillor Hennessy was pleased to receive the report and to be assured that the safe and well visits were person-centred particularly given the business risk implications as outlined in the report.

In response to a comment from the Chairman regarding the changing fire risk over time, the Chief Fire Officer advised that the Service was preparing the next Integrated Risk Management Plan (IRMP) which gave an opportunity to reflect.  The overall risk management score was taken regularly to the Performance Committee but the IRMP was a good opportunity to show the direction of travel achieved.

RESOLVED: - That the report be noted.