Fire Safety Consultant

Specification

North East London NHS Foundation Trust

Estates & facilities Department,

Main Building, Goodmayes Hospital

Barley Lane, Ilford

Essex, IG3 8XJ

Telephone: 0300 555 1201 Ext 4346

CONTENTS
Section A - PREAMBLE
APPLICATION 3

GENERAL INFORMATION ABOUT THE TRUST 3

GENERAL DESCRIPITION OF FIRE SAFETY CONSULTANT DUTIES 3

FIRE RISK ASSESSMENTS 3

FIRE TRAINING 4

SPECIFICATION REQUIREMENTS 4

DEFINTIONS 4

Section B - FIRE RISK ASSESSMENTS 5

Section C - FIRE SAFETY TRAINING 6

LEGAL REQUIREMENTS 9
FIRE AWARNESS TRAINING 9
FIRE WARDEN TRAINING 11

FIRE TEAM TRAINING 12

FIRE TRAINING FOR NELFT TRUST BOARD OF DIRECTORS 13

TRAINING LOCATIONS 14

Training Session Requirements 16

Section D - GENERAL FIRE SAFETY Duties

GENERAL DUTIES OF THE FIRE SAFETY CONSULTANTS 17

MONITORING PERFOFORMANCE 17

Section E Fire Safety Consultant Tender Pricing Schedule 18

Appendix A – MH/Corporate List of Properties 19

Appendix B – Community Services List of Properties 25

Appendix C – Fire Management Structure 29

Appendix D - Geographical Spread of Properties 30

Appendix E - Fire Risk Assessment Sample

31

Page 2 of 56
SECTION A - PREAMBLE
APPLICATION

This specification outlines the roles, responsibilities and work relating to the tender for the appointment by
the North East London NHS Foundation Trust of a Fire Safety Consultant.

The Fire Safety Consultant role encompasses the Fire Risk Assessment of Trust properties, providing
seminar type face to face Fire awareness training of all staff and Fire Warden Training of specified staff and
advising the Trust on all matters regarding Fire Safety.

GENERAL INFORAMATION ABOUT ATHE TRUST

North East London NHS Foundation Trust (NELFT) provides mental health and community services for
people living in Outer North East London in the Boroughs of Waltham Forest, Redbridge, Barking &
Dagenham and Havering and community health services for people in South West Essex in the areas of
Thurrock, Basildon and Brentwood. These services are provided from a range of environments ranging
from offices and clinics to inpatient hospitals which are located throughout the Trust.

NELFT provides care and treatment for a population of almost 1.5 million. We employ around 6,000 staff.

Responsibility for the safety of Trust premises (including Fire Safety) rests with the Trust Board of
Directors. On a practical level this responsibility is managed by the Estates Director who reports regularly to
the Trust Board by way of an six monthly report to a Board sub-committee (Quality and Safety Committee)
and an additional report to the Board (by way of an annual report on health and safety)

The Trust Governance arrangements in respect of Fire Safety are included as a flow chart in Appendix A of
this document

GENERAL DESCRIPTION OF FIRE SAFETY CONSULTANT DUTIES

The Fire Safety Consultant shall ensure that all duties within the Tender Specification comply with the
guidance and methodology in the code of practice that is PAS79 methodology. The consultant shall ensure
that in terms of the Regulatory Reform (Fire Safety) Order 2005 all requirements imposed upon the
responsible person are met.

FIRE RISK ASSESSESSMENTS

Fire Risk Assessment’s (FRA`s) will focus on the physical adequacy of the building’s Fire Safety provision
and the Trust’s operational activity and use of the environment as it impacts the Fire Safety provision.
FRA`s will take place every 2 years, with the exception of premises which accommodate Service users
overnight (in-patient areas) which shall be assessed every 12 months.

The consultant shall carry out FRA`s that are suitable and sufficient assessments of risk to which relevant
persons are exposed. For the purposes of the Regulatory Reform (Fire Safety) Order 2005, the `` relevant
persons`` are any person who is or who may be lawfully on the premises, or any person who may be in the
vicinity of the premises, who is at risk from a fire on the premises.

The Fire Safety Consultant will be responsible for maintaining records of completed assessments,
arranging re-assessments to ensure that all premises covered by this tender have a ‘current’ FRA in
accordance with the above timescales.

FIRE TRAINING

Page 3 of 56
The Fire Safety Consultant shall provide annual Fire training in accordance with the Trust fire policy (a copy
of the Trust’s Fire Policy is available on the Trust website. The Policy is currently in the process of being
updated and a copy of the latest draft can be obtained by contacting Dennis Emmings, Head of Estates
(Corp/MH) at dennis.emmings@nelft.nhs.uk) without exception to all Trust staff, regardless of the nature of
their duties, of a type and at frequencies detailed within the body of this document.

Other duties required by the Fire safety Consultant are as follows

 Advising the Trust on all matters on Fire Safety issuers, including informing policies & procedures.

 Produce an Annual Fire report to an agreed format.

 Advise the Trust in respect of new premises acquisition, refurbishment or construction in relation to
Fire Safety

 Attend bi-monthly Fire safety meeting with Trust H&S manager and Head of Estates

Specification Requirements

This Specification requires that the competent person or persons (Fire) must be able to demonstrate a
sound knowledge and specific skills in relation to Fire Safety within the healthcare environment. Specific
knowledge and experience of the application of Fire Safety in the specific environments of Mental Health
and Community Health services provided by the Trust will be desirable.

The Fire Safety Contractor shall also be required to meet the following criteria

 To be a member of suitable professional organisation for example the Institution of Fire Engineers
(IFE); Institution of Fire Prevention Officers (IFPO); National Association of healthcare Fire Officers
(NAHFO)

 Have and excellent and thorough knowledge of Fire Safety, Fire risk assessment, Fire legislations ,
fire Safety training

 Qualified to undertake Fire Risk Assessments

 Detailed knowledge of the NHS fire code

 Experience of preparing various methods of delivering Fire safety training courses

 Knowledge of risk management techniques

 Ability to work within a changing environment.

 Experience gained within the Fire Service would be advantageous

All works shall be in accordance with 2005 Fire legislation detail by the Regulatory Reform (Fire Safety)
Order 2005 and all relevant document including National Health Service HTM & HBN`s documentation and
any amendments or additions to the Fire safety legislation that are published subsequent to the start of the
contract.

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The Fire Safety Consultant shall be required to provide technical expert support to the Fire Safety Manager
to enable them to fulfil their duties effectively and also provide expert advice on the application and
interpretation of fire legislation and fire safety guidance, including Firecode.

DEFINTIONS

In this Specification, the following words and expressions shall have the meanings hereby assigned to
them, unless the context requires otherwise:

Head of Estates: means the person who is in overseeing Estates & Projects Department at North East
London Foundation Trust or his nominated representative.

Fire Safety Consultant: means the Consultant engaged and with the responsibility for ensuring compliance
for all duties included within this specification.

Fire Risk Assessment’s (FRA`s): the act of identifying possible fire risks, calculating their likelihood and
severity. .
Fire safety manager: A Trust nominated person with responsibility for carrying out day-to-day management
of fire safety.

MHS – Mental Health Services Business unit

MHS/Corp - Mental Health Services Business unit & Corporate Services

NELCS – North East London Community Services Business Unit

SWECS – South West Essex Community Services Business Unit

PAS 79: sets out a methodology for undertaking a Fire risk assessment.

Premises: Any place, such as a building and the immediate land bounded and enclosed by it, moveable or
temporary structure or any installation or workplace.

Pre – Contract interview – It is a condition of this specification that one or more consultants may be
required to attend a pre contract interview with the Trust Fire Safety manager and Head of Health and
Safety prior to the award of the contact.

Contract

It’s the intention of NELFT to procure this Contract in accordance with NHS standard conditions of contract
for the supply of services (September 2010)

Contract period

The contract period for the Fire Safety Consultant shall be base upon a two year contract with the Trust
having an option to extension the contract for one further year.

Geographic Spread

The Trust operates over a wide geographical area as indicated above. Appendix D is included within this
document as a guide only to give a representation of the spread of Trust sites.

Page 5 of 56
SECTION B - FIRE RISK ASSESSMENTS
NELFT staffs operate and provide healthcare services from a range of owned, leased/licensed and other
properties where formal occupation arrangements are ‘undocumented’. In respect of FRA’s that are
required and included as part of this specification and tender, these are restricted to all owned properties
and some leases or licensed properties where the Trust has documented liability. The list of properties
covered by this specification are included in Appendix A and B.

By the nature of NHS rationalisation and change, it is possible that the number of premises requiring FRA’s
will change over the life of this contract. The Trust can not therefore guarantee the level of estate will
remain static. The Trust therefore reserves the right to add or remove properties from the list included in
Appendix A and B. Additions and deletions will be treated as variations to the contract and the contract
price will vary accordingly by agreement.

Properties where NELFT staff operate or provide services from that NELFT does not have a documented
premises liability or are undocumented in terms of the Trusts occupation, are excluded from this tender in
relation to the undertaking of FRA’s. In respect of these premises, it is the responsibility of the Trusts Fire
Safety Manager to ensure adequate and current FRA’s have been completed by 3rd party landlords or
organisation/person who have are responsible for the premises and persons occupying those premises.

Fire Risk Assessment’s (FRA`s) will focus on the physical adequacy of the building’s Fire Safety provision
and the Trust’s operational activity and use of the environment as it impacts the Fire Safety provision.
FRA`s will take place every 2 years, with the exception of premises which accommodate Service users
overnight (in-patient areas) which shall be assessed every 12 months.

Fire risk assessments are to be submitted to the Head of Estates in both hard copy (1 x copy in a Red A4
folder for retention at each premises) and electronically (to be held on a central record system).

The Fire Safety Consultant will be responsible for maintaining a record database on Excel type software (or
similar approved) of completed assessments, arranging re-assessments to ensure that all premises
covered by this tender have a ‘current’ FRA in accordance with the above timescales.

Appendix A identifies those areas where NELFT currently has a liability that are to be assessed (in
accordance with the above timescales criteria).

Appendix B identifies those areas where it is planned NELFT will have a liability for assessment from 1st
April 2013 (in accordance with the above timescales criteria).

NOTE: The acquisition by NELFT of the properties included in Appendix B requires Trust Board approval,
this is anticipated to be finalised by December 2012, however, this approval is by no means certain and the
Trust therefore can not guarantee that any or all of the properties noted in Appendix B will require FRA’s to
be undertaken as part of this tender throughout the term of this contract.

The FRA will look at departmental fire safety management, hazardous material handling & storage, general
arrangements and procedures. It is a requirement of this Specification that all premises shall be required to
be assessed in accordance with the above timescales, apart from when premises that have undergone
alteration/refurbishment that impact the fire safety of that premises and or where Law requires a Fire Risk
Assessment to be undertaken before the area is re-occupied. These additional Risk Assessments will be
undertaken over and above the requirement of this contract and will be notified to the consultant by the
Head of Estates. FRA’s that are required to be undertaken as a result of improvements/refurbishments as
noted above and are in addition to those that accord to the above timescales will be treated as variation to
this contract.

The following is a list of areas that Fire Risk Assessment should examine in respect of any given premises
(FRA’s should not be limited to the areas listed below, it is the Fire Safety Consultants responsibility to

Page 6 of 56
ensure that all areas that need to be assessed under Fire legislation and guidance are included within the
FRA) :

 Means of escape- that escape routes are adequate and sufficient for the number and distribution of
occupants, that they are protected where necessary and generally free of obstruction and hazards,

 Fire Compartmentation – That stairs, escape routes in general and risk areas are fire separated in
accordance with means of escape requirements to protect occupants escape and limit the spread of
fire within and to adjoining areas/buildings.

 The Fire Alarm System – provides adequate warning, that Automatic Fire Detection ( AFD) is
provided where necessary, that the system in being maintained, to highlight significant unwanted
alarms issues and assist in taking appropriate action to reduce.

 Emergency Lighting – ensure that adequate emergency light is provided to secure the means of
escape, that it is being adequately maintained and highlight any significant deficiencies.

 Signage – the adequacy and provision of fire safety signage & fire action instructions.

 Fire Brigade & Fire Fighting Equipment – an audit of the fire fighting and fire brigade equipment,
fixed fire suppression systems and maintenance arrangements

 Hazardous Substances – overview of the hazardous substances, compressed gases and

flammable liquids stored or used in the premises- assessments of bulk flammable of liquid storage
under DSEAR

 Emergency Plan – review and draw up a general building emergency plan

 Occupational activity and use of the premises – review and make recommendations on any use of
the building that compromises or impacts fire safety.

 Fire wardens – review and make recommendation to the number of Fire Warden required to provide
adequately cover for all premises used by NELFT.

The Fire Safety Consultant is required to prioritise, by way of a risk assessment, each of the
recommendations identified in the FRA.

The Fire Safety Consultant is to undertake FRA’s to the inpatient areas identified in Appendix A within the
next 12 months and every 12 months thereafter.

The Fire Safety Consultant is to undertake FRA’s to non-inpatient areas identified in Appendix A within
the next 24 months and every 24 months thereafter.

The Fire Safety Consultant is to undertake FRA’s to the inpatient areas identified in Appendix B within the
next 12 months and every 12 months thereafter (see note above re the transfer of these properties to
NELFT).

The Fire Safety Consultant is to undertake FRA’s to non-inpatient areas identified in Appendix B within
the next 24 months and every 24 months thereafter (see note above re the transfer of these properties to
NELFT).

NOTE: The size of the buildings varies as does the non ward areas associated with those buildings.
Appendix A and B includes an approximate m² of each building (or part of a building) as a guide only. The
consultant is to satisfy themselves that they allow for all areas requiring a FRA and that is to include the
whole building associated with the inpatient and non-inpatient areas.

Page 7 of 56
Page 8 of 56
SECTION C - Fire Safety Training

Legal requirements

It is a legal requirement that all employees undergo basic fire safety training at induction and
periodically thereafter, expected annually in most workplaces. The training must be carried out by a
competent person with suitable and sufficient skills and knowledge of fire safety. By doing this, staff will
be prepared in the event of fire, ensuring their own safety and the safety of other people on the
premises.
The Fire Safety Consultant is to provide the following training at various locations throughout the Trust
and details of which are noted the following section of this document:
 Fire awareness training (at Staff Induction courses, annually for inpatient staff and bi-
annually for all other staff)
 Fire Warden training (every 3 years)
 Fire Team Training (Goodmayes annually)
 Trust Board of Directors Training (annually)

Fire Awareness Training

The Trust approach to satisfying the requirement to providing fire awareness training to all staff is in line
with Department of Health guidance. The principle will be as follow:
 All new staff will receive fire awareness safety training as part of their induction. This
training is to be provided by the Fire Safety Consultant as part of this tender
 All inpatient staff will receive fire awareness training annually that will be specific to their
environment. This training will be provided by the Fire Safety Consultant as part of
this tender.
 All non inpatient staff will receive fire awareness training every two years. This training
will be provided by the Fire Safety Consultant as part of this tender.
 All non inpatient staff will receive fire awareness training and assessment by a e-learning
software package, every two years. This training and assessment will be provided by
the Trust and is therefore excluded from this tender.
In line with DoH guidance, the approach for Fire Training of all non-inpatient staff will be face to face
and e-learning training on alternate years as described above.

Page 9 of 56
The training you implement should satisfy the requirements of the Trust statutory duty to staff and
support the Trust’s fire policy, the fire safety manager, and emergency plan.

The Fire Safety Consultant is expected to provide training courses on fire Awareness Training for all
Clinical & non - clinical staff, and ensure that the contents of their presentation is informative and
engage attendees . The contents of the training will need to be varied from year to year and be suitable
and sufficient in order to satisfy the Trusts statutory liabilities and duty of care.
The contents of the fire awareness training must cover the following areas. The list is not exhaustive
and it will be the Fire Safety Consultants responsibility to ensure that all relevant subjects are covered
and specific to the staff/area being trained

 Staff role & responsibilities with regard to Fire Safety

 To outline and develop an appreciation of the danger of Fire and how it can spread
 The threat to people and property
 The basic elements required for combustion, fire and heat transfer
 How to prevent fire and good practice within the workplace
 Fire classification and the use of extinguishers on different types of fires
 Practical demonstration with discharge of extinguishers (this may cause the rest of the training to
become compressed due to the time requirements involved in taking a class full of students
outside to watch an extinguisher being set off, unless we are talking the discharge of CO2 in the
class room) (Confirmed with D Emmings that a full explanation in the classroom will suffice
Interactive demonstration of how to use a fire blanket (We are to provide a fire blanket
demonstration in the classroom)
 Appreciate the main causes of workplace fire and preventative strategies
 The action to take on discovering a fire and how to raise the alarm
 Discussion regarding local arrangements
 Means of escape
 Fire rehearsal drills
 Will estates make extinguishers available to us for discharge? (No, we need to go down the
empty extinguisher demo route)

Duration of fire awareness training sessions will be expected to be approximately 1 Hour. (Agreed with
D Emmings that it will be a fixed time or schedules will not be feasible.)

Fire Warden Training

Page 10 of 56
The Trust strategy, in accordance with Trust policy, is to ensure there are sufficient numbers of trained
fire wardens at each of the premises it occupies. It will be the responsibility of the Fire Safety
Consultant to provide adequate and sufficient training of fire wardens at face to face sessions.
Fire warden training will be provided to staff every three years. Exceptions to this will be to provide
training to new fire wardens or existing fire wardens when there are changes to their working
environment that impacts fire safety.

Trained fire wardens will undertake fire awareness training by face to face sessions or e-learning whilst
they are acting as trained fire wardens. Trained fire wardens will not be required to undertake fire
awareness training (either face to face or e-learning) within 12 months of receiving fire warden training.

The contents of the fire warden training must cover the following areas. The list is not exhaustive and it
will be the Fire Safety Consultants responsibility to ensure that all relevant subjects are covered and
specific to the staff/area being trained:

 The role & responsibilities of a Fire Warden Marshal

 To develop an appreciation of the primary reason for fire prevention
 Understand the principals of combustion, fire and heat transfer
 Appreciate the main causes of workplace fires and preventative strategies
 Fire classification and the methods of extinguishing different types of fire
 Practical demonstration with discharge of extinguishers (As per D Emmings)
 Interactive demonstration of how to use a fire blanket (As per D Emmings)
 To understand the different types of warning & detection systems
 Frequency and importance of Fire logbook checks
 Understand how to evaluate emergency escape routes
 Discussion regarding local arrangements
 Responsibility in respect of reporting to the Fire Brigade during an evacuation incident

Duration: The duration of fire warden training sessions will be expected to be approximately 3 hours

Page 11 of 56
Fire Team Training

Due to the size and dispersion of its larger hospital sites, the Trust operates a Fire Team to
coordinate the response to fire incidents. Currently a fire team operates at one site – Goodmayes
Hospital.

It will be the responsibility of the Fire Safety Consultant to provide adequate and sufficient training of
the Goodmayes Hospital Fire team at face to face sessions.

The contents of the fire team training must cover the following areas. The list is not exhaustive and it
will be the Fire Safety Consultants responsibility to ensure that all relevant subjects are covered and
specific to the staff/area being trained:

 The role & responsibilities of a member Fire Team

 To develop an appreciation of the primary reason for fire prevention
 Understand the principals of combustion, fire and heat transfer
 Appreciate the main causes of workplace fires and preventative strategies
 Fire classification and the methods of extinguishing different types of fire
 Interactive demonstration of how to use a fire blanket
 To understand the different types of warning & detection systems
 Frequency and importance of Fire logbook checks
 Understand how to evaluate emergency escape routes
 Discussion regarding local arrangements
 Human behaviour in fire
 Emphasis the use of teamwork and communication
 Responsibility in respect of meeting and reporting to the Fire Brigade during an alarm or
evacuation incident

Duration: The duration of fire Team training sessions will be expected to be approximately 5 hours.

Page 12 of 56
Fire Training for NELFT Trust Board of Directors

The Trust Board of Directors attends monthly workshop sessions which are used to inform, train and
discuss with Executive and non-Executive Directors of Trust in respect of a range of Trust issues.
Once annually the workshop session includes for an hour long session on encompassing Trust
Board Fire Training. This training session is used to provide annual awareness training to the Board
and provide an overview of the Trust position in respect of statutory fire compliance across the trusts
three business and corporate business units.

The Fire Safety Consultant will be required to provide to provide the training and overview to Trust
Board Directors on an annual basis.

 Their personal and strategic role & responsibilities with regard to Fire Safety
 Legislative framework and any changes that impact the Board
 An brief outline of training given to staff, including
 An appreciation of the danger of Fire and how it can spread
 The threat to people and property
 The basic elements required for combustion, fire and heat transfer
 How to prevent fire and good practice within the workplace
 Fire classification and the use of extinguishers on different types of fires
 Appreciate the main causes of workplace fire and preventative strategies
 The action to take on discovering a fire and how to raise the alarm
 An overview of the Trust performance in respect of Fire Safety Compliance

Duration: The duration of Trust Board Fire Awareness Training and Trust Compliance Overview will
be expected to be approximately 1 hour.

Page 13 of 56
Training Locations

List of Fire Training venues

NELCS venues
Comely Bank Clinic, 46 Ravenswood Road, Walthamstow, London E17 9LY

The Child and Family Centre, Axe Street, Barking RM9 5TT

Barking Learning Centre, 2 Town Square Barking, IG11 7NB

Chingford Health Centre, 109 York Road, Chingford, London E4 8LF

Chadwell Heath Health Centre, Ashton Gardens, Chadwell Heath, Romford RM6 6RT

Long Term Conditions Centre, The Drive , off Gubbins Lane, Harold Wood Romford RM3
0AR

Five Elms Health Centre, Five Elms Road, Dagenham RM9 5TT

Green Man Medical Centre, 1 Hanbury Drive, Leytonstone E11 1HR

Heronwood& Galleon Unit, Makepeace Road, Wanstead, London E11 1UU

Hainault Health Centre, Manford Way, Hainault, Essex IG7 4DF

Julia Engwell Health Centre, Woodward Road, Dagenham RM9 4SR

Leyton Green Clinic – Leyton Green Road, Leyton, London E10 6BL

Marks Gate Health Centre, Lawn Farm Grove, Marks Gate, Romford RM6 5LL

Oxlow Lane Health Centre, Oxlow Lane, Dagenham RM10 7YU

Romford Clinic, 40 Main Road, Romford ,Essex RM1 3BS

Ardleigh Education & Training Suite, A Block, St George’s Hospital RM12 6RS

St James Health Centre, 47 James Street, Walthamstow E17 7PJ

South Woodford Health Centre, 114 High Road, South Woodford E18 2QS

Wood Street Health Centre, 6 Linford Road, Walthamstow, London E17 3LA

Page 14 of 56
SWECS venues
Brentwood Community Hospital - 11 Crescent Dr Brentwood CM15 8DR

Corringham Community Safety Centre - 43 Fobbing Road, Corringham, SS17 9BN

Essex

Stifford Clays Health Centre - Crammavill Street, Grays, Essex, RM16 2AP

MHS & Corporate venues

Barking Community Hospital – Crescent Drive, Brentwood, Essex,CM15 8DR

Thorpe Coombe - Thorpe Coombe Hospital, 714 Forest Road, Walthamstow, E17
3HP

Chapel Centre - Goodmayes Hospital, 157 Barley Lane, Ilford IG3

Hawkwell Court Day Unit – 34 Colvin Gardens, Chingford, London

Lecture Room - Goodmayes Hospital, 157 Barley Lane, Ilford IG3

Morland Rd Day Hospital - Morland Road Dagenham, Essex RM10 9HW

Naseberry Court – 2 Merriam Close, Chingford, London E4 9JQ

Petersfield Hospital – Petersfield Av, Harold Hill, Romford RM3 9PB

Red Oak Lodge – 17 Thorne Close, Langthorne Road, Leytonstone, London E11 4
HU

Sutton's Hse - 119 – 120 Suttons Lane, Hornchurch, Essex RM1 4HP

Training Suite - Goodmayes Hospital, 157 Barley Lane, Ilford IG3

Victoria Centre, - Pettits Lane, Romford, RM1 4HL

Woodbury Unit – James lane, Leytonstone, London E11 1NR

Note: All Trust impatient staff to received basic fire awareness training within the ward environment which
they operate. Trust reserved the right to amend the list of the Trust training venues throughout the duration
of the whole contact period.

Page 15 of 56
Training Session Requirements
A schedule of training sessions to be included by the Fire Safety Consultant are detailed below:

Business/Corp Unit Fire Awareness

Training Fire Warden Fire Team Fire Training
Sessions Training Training for NELFT
Board
Total
MHS & Corporate 60 13 1 1

NELCS 64 12 0 0

SWECS 40 7 0 0

Grand Total 176 34 1 1

Note; Due to the introduction of E-learning for Fire Awareness training the present number of sessions
are likely to be amended by the trust.

 Where does that leave us in regard to quoted cost? (NELFT will provide the E-Learning package
[see page 9] so it is not part of the tender.)

Page 16 of 56
D - GENERAL FIRE SAFETY DUTIES
General Duties of the Fire Safety Consultant

It is a condition of this specification that the Fire Safety Consultant shall be required to allow reasonable
amount of time to carry the following general duties:

 Providing expert advice on the application and interpretation of fire legislation and fire safety
guidance for a Healthcare environment

 Attend quarterly meetings with the Head of Estates and Health and Safety Manager to include
reviewing monitoring performance (see below*)

 Advising on the content of the NELFT fire safety policy

 Advising the Trust on the development of the organisation fire strategy

 Liaising with staff & managers on fire safety issues

 Advice on the number of fire wardens required within each premises

 Liaising with the local Authorising on Fire safety issuer on behalf of the Trust

 Advising the Estates Department on fire safety issues regarding new development or refurbishment
of existing premises.

 Collate key Performance Information’s (KPI) to be confirmed on appointment

 Requests by the Trust Fire Safety manager to investigate and report on fire related incidents

Monitoring performance

The Head of Estates is responsible for the review of all fire safety matters. Standard agenda items include
specific areas of performance including: -

 Number of completed fire Risk Assessments

 Number of fire related issues recorded

 Number of outstanding fire issues

 Fire incidents, unwanted fire signals and staff training

Annual Report - Fire Safety consultant shall be required to forward information to the Head of Estates on a
annual basis for the Fire Safety report at the end of each financial year.

Page 17 of 56
SECTION E – FIRE SAFETY CONSULTANT TENDER
PRICE SCHEDULE
Fire Safety Consultant Tender Pricing Schedule
ITEM £

Section A – Preambles – Allow for any costs associated with the

Preambles section of this document
Included in B & C below
Section B – Fire Risk Assessments – Allow for ALL costs associated Year 1 & Year 2 costs
with undertaking and providing Fire Risk Assessments included within will be identical at
this specification and detailed in Appendix A £?,855/year
Section B – Fire Risk Assessments – Allow for ALL costs associated Year 1 & Year 2 costs
with undertaking and providing Fire Risk Assessments included within will be identical at
this specification and detailed in Appendix B £?,750
Section C - Fire Safety Training - Allow for ALL costs associated with
undertaking and providing Fire Safety Awareness, Fire Warden, Fire
£??,550
Team and Trust Board of Directors Training as described and for the
number of sessions outlines within this document
Section D – General Fire Safety Duties - Allow for ALL costs associated
with undertaking and providing General Fire Safety Duties as Included in B & C above
described within this document
Sub Total £??,155-2% if paid
within 30 days of
monthly invoice =
£??,351.90
Contingency – Allow the sum of £5,000, to be used at the complete
discretion of the Trust in relation to Fire Safety Consultancy activity,
advice or work which is not included within or is beyond the remit of
£5,000
this document.
Total to form of tender £??,351.90

Page 18 of 56
.

Page 19 of 56
Appendix A
List of MHS and Corporate Properties

In patient units
Property Title Site and Provider Building Age or Tenure GIFA M² Comments
Address Services Description (approx)
Activity

Sunflowers Goodmayes Adult In Constructed Freehold 6500

Court (new Hospital, Barley patient (5 2011 steel
build) Lane, Ilford, wards) framed building
IG3 8XJ

Sunflowers Goodmayes Adult In Constructed PFI 6500

Court (PFI - Hospital, Barley patient (6 2000
Ex Chapters Lane, Ilford, wards)
House) IG3 8XJ

Brookside Barley Lane, Young Modern half Freehold 1900

Ilford, IG3 8XJ persons In storey building
patient (2 with pitched
wards) roof and
+school area concrete tiled
roof. Brick
faced walls.

Woodbury James Lane, Elderly Frail 1960's & Leasehold 1824

Unit Leytonstone, Inpatient (2 refurbished
London E11 wards) 1966
1NR
2 storey
building
(previously
known as
Samuel Boyce
House)

Naseberry 2 Merriam Adult 1990 2 storey Freehold 1500

Court Close, inpatient (2 modern
Chingford, wards) building
London E4 9JQ

Hawkwell 34 Colvin Rehab Mixture of Freehold 407

Court Gardens, residential single and 2
Residential Chingford, storey
residential
London E4 6PF
houses

Page 20 of 56
Appendix A
List of MHS and Corporate Properties

Non In patient units

Property Title Site and Provider Services Building Age or Tenure GIFA M² Comments
Address Activity Description (approx)

Good Goodmayes Office 1900 Victorian Freehold 22750

Hospital Hospital, accommodation
Barley Lane,
Ilford, IG3
8XJ

Maggie Lilley Goodmayes Pharmacy, Modern c1990s 2 Freehold 3265

Hospital, 157 Procurement, storey building
Barley Lane, Research & with pitched
Development, metal clad roof
Ilford IG3
Practice Improvement and brick face/
8XJ masonry walls

Grovelands Grove Road, Memory Clinic & Day Modern late 20th Freehold 1000
Chadwell Hospital HTT for century single
Heath, over 65s storey brick faced
Romford, walls and pitched
Essex RM6 roof
4XH

Tantallon Goodmayes Trust Head Office 2 storey Freehold 675

House Hospital, 157 detached
Barley Lane, structure with
attick rooms.
Ilford IG3
Arts & crafts
8XJ architectural
styling. Brick and
tiled under
pitched roof

Goodmayes 157 Barley Office Freehold 22750

Hospital Lane, Ilford accommodation
IG3 8XJ

Mellmead 4 Orchard CRT West, OP Clinic 1990 2 storey Freehold 924

House Close, property. Brick &
Wanstead, timber clad under
pitched lain tiled
London E11
roof
2DH

Broadway 1st Floor, 1 AOT, Hear & Now Office block in Freehold 182
Chambers Cranbrook Service Ilford lease from
Road, Ilford, London Borough
Essex IG1 of Redbridge
4DU

Ilford lane Part 3rd & 11 Drug & Alcohol 1960`s office leasehold
Chambers st Floor, 11 Services Block
Chapel Road,
Llford IG1
2QU

Thornebury Langthorne Day Unit 1980 with c. 1989 Freehold 443

Hospital, additions. Single
Langthorne story
Road,

Page 21 of 56
 Leyonstone,
London E11
4HU

Loxford Hall Loxford Lane, CAMS 1900 converted 2 Leasehold 200

Ilford, Essex storey house
IG1 2PL

Larkswood Thorpe AOT c.1930s and Freehold 1360

Centre Coombe refurbished c.
Hospital, 714 1996 3 storey
Forest Road,
building (& attic
Walthamstow,
London E17 rooms)
3HP

Psychotherap Thorpe Psychotherapy c.1960s with Freehold 140

y Coombe Service c.1996 additions
Hospital, 714 2 storey building
Forest Road,
Walthamstow,
London E17
3HP

Greenthorne 1 Merriam CRT base c.1990 2 storey Freehold 643

Close, modern building
Larkshall
Road,
Chingford,
London E4
9JQ

Hawkwell 34 Colvin Day Unit c.1980s 2 storey Freehold 1051

Court Day Gardens, modern building
Unit Chingford,
London E4
6PF

Red Oak 17 Thorne CRT and Day Unit c. 1890 Freehold 744
Lodge Close, (refurbished c.
Langthorne 1996) 2 storey
Road, imposed building
Leytonstone, with high ceilings
London E11
4HU

South Forest 21 Thorne CRT base/AOT c. 1890 Freehold 850

Centre Close, (refurbished c.
Langthorne 1996) 2 storey
Road, imposed building
Leytonstone, with high ceilings
London E11
4HU

Child & Thorpe CRT and Day Unit c. 1960's 2 storey 578
Family Coombe flat roofed
Consultation Hospital, 714 building
Forest Road,
Centre
Walthamstow,
London E17
3HP

Thorpe Thorpe Office c. 1760 building Leasehold 110

Coombe Coombe on 3 floors & c.
House Hospital, 714 1997
Forest Road, refurbishment
Walthamstow,
London E17
3HP

Thorne 15 Thorne HTT c. 1840 house Leasehold 110

Close, (refurbished c.

Page 22 of 56
House Langthorne 1999) 3 storey
Road, building
Leytonstone,
London E11
4HU

Pine Lodge James Lane, Psychiatric Liaison Converted 2 Leasehold 100

Leytonstone, Service base storey house
London E11
1NR

Oasis House Oasis House, CRT Modern extended Freehold 350 Under went major
28-30 converted house refurbishment and
Gubbins extension in 2011.
Lane, Harold
Wood,
Romford,
RM3 0AQ

Church Road 137-145 AOT, HTT, Havering Two storey ex Leasehold 650
Church Road, Management Offices, light industrial
Harold Wood, MHIAT, PCTs Primary building
Romford, Care Triage Service converted to
RM3 0SH modern (ground
floor) offices

Petersfield Petersfield Older Adults Day Modern single Leasehold 700

Day Centre Avenue, Hospital, storey brick built
Harold Hill, Psychotherapy under flat roof
Romford,
Therapies, OP Clinic
RM3 9PB

Raphael Victoria CAMS Single storey Leasehold 445

House Centre, Pettits modern purpose
Lane, built brick
Romford, building
Essex RM1
4HP

Suttons 119-121 Older Persons CMHT Converted Leasehold 228

House Suttons Lane, residential
Hornchurch, dwelling
Essex RM12
6RS

4 Pettits Lane Pettits Lane, New Directions Converted 142

Romford, residential
RM1 4HL dwelling

Victoria Pettits Lane, Adult CRT, OPD, Art 1930`s clinic Leasehold 356
Centre Romford, Therapy Groups, building
RM1 4HL Psychology,
Occupational
Therapy, Dietician

Harrow Harrow Lodge Shared use by NELFT Converted Leasehold 230

Lodge House Park, provider team and residential
Hornchurch MIND dwelling
Road,
Hornchurch,
Essex RM11
1JU

Clinic Main Road, AOT, EIP Temporary

Romford, building on the
Essex RM5 site of Romford
Health Clinic

Wigham 6th Floor, 16 NELCS Business Unit 1960`s Office Leasehold 650
Wakering
Road, barking

Page 23 of 56
 IG11 8QN HQ Office Block

Becontree 508 CRT/Psychological Substantial Freehold 600

Centre Becontree Therapy Services detached &
Avenue, converted house,
circa early 20th
Dagenham,,
Century.
Essex, RM8 Masonry walls
3HR rendered under
pitched roof.

Woodward Woodward ESTAR, Early Leasehold 252

Road Road, Intervention in
Dagenham, Psychosis
Essex RM9
4SJ

CAMHS Child & CAMHS New LIFT Leasehold 1150

Family Building
Centre, Axe
Street,
Barking, IG11
7LY

Broad Street Morland Morland Road Day New LIFT Leasehold 620
Resource Road, Hospital, Older building
Centre Dagenham, Persons CMHT,
Memory Service & OP
Essex RM10
Clinic
9 HU

Main Road Main Road, AOT, EIP Portacabin Leasehold 70

Clinic Romford, building
Essex RM5

Page 24 of 56
Appendix B
COMMUNITY SERVICES PROPERTY SCHEDULE

In patient units
Property Title Site and Provider Building Age or Tenure GIFA M² Comments
Address Services Description (approx)
Activity

Grays Court John parker Adult in Build year Leasehold 3042

Close, patient ( 1 2005 – 3
Dagenham, ward) + storey
RM10 9SR outpatient
area

Mayflower Blunts Wall Adult in Build year Freehold 1533

Community road, Billericay, patient ( 2 1995 – A two
Hospital Essex, CM12 ward) + storey brick
9SA outpatient building with a
area pitched
concrete tiled
roof

Page 25 of 56
Appendix B
List of MHS and Corporate Properties

Non In patient units

Property Site and Provider Building Age or Tenure GIFA Comments

Title Address Services Description M²
Activity (appr
ox)

Five Elms Five Elms Community Leasehold 741

Medical Road, Clinic - District
Centre Dagenham, Nursing, Special
Care &
RM9 5TT
Community
Dental Service,
Health
Visitors/Specialis
t Community
Public Health
Services, School
Nursing

Orchards 69 Oval Road Community Build year 1990 - A brick and Leasehold 881
Health Centre North, Clinic - Mentalsteel framed structure with a
Dagenham, Health, Districtcombination of brick and hardboard
cladding and it has a pitched steel
IG11 7RS Nursing
sheet roof.

Elm Park Abbs Cross Community Build year 1938 - A single Freehold 386
Clinic Lane, Clinic storey brick building with a
Hornchurch, small first floor section. The
roofs are a combination of
RM12 4YG
pitched and flat construction.

Harold Wood Gubbins Community Freehold 507

Clinic Lane, Harold Clinic
Wood, RM3
0QA

Rainham Upminster Community Build year 1935 - A brick Freehold 318

Health Centre Road South, Clinic framed building with a small
Rainham, First Floor and a large
pitched roof with two smaller
RM13 9AB
flat roofed sections.

Romford Main Road, Community Build year 1930 - Converted Freehold 613
Clinic Romford, Clinic large residential dwelling A
RM1 3BS three storey structure of brick
construction and multiple
roofs of pitched and flat
construction

Long Terms Gubbins Community Build year 1975 - A large Freehold 3135
Condition Lane, Harold Clinic predominately single storey
Centre Wood, RM3 brick building with a two
storey section and a link
0QA
bridge to the rear of the
Building.

Page 26 of 56
Redbridge 30 Coleridge Community Build year 1990 - A two Freehold 802
Learning Road, Clinic storey brick structure with a
Disabilities Walthamstow, pitched concrete tiled roof.
Clinic E17 6Qu

Redbridge Buntingbridge Community Build year 1980 - A single Freehold 294

Diabetes Road, Clinic storey brick building with a
Centre Newbury flat roof.
Park, IG2 7LR

Maderia 8 Maderia Community Freehold 228

Graove Clinic Grove, Clinic
Woodford
Green, IG8
7QH

Wanstead 35 Wanstead Community Build year 1890 - two storey Freehold 378
Place Clinic Place, Clinic brick building with a pitched
Wanstead, roof.
E11 2SW

Chingford 109 York Community Build year 1950's - Two Leasehold 1489
Health Centre Road, Clinic storey brick building
Chingford, E4
8LF

Leyton Green Leyton Green Community Build year 1930's - Single Freehold 408
Clinic Road, Leyton, Clinic storey building
E10 6BL

Langthorne 13 Langthorn Community Build year 1989 - Single Leasehold 1431

Heath Centre Road, Clinic storey building
Leytonstone,
E11 4HX

Aveley Hall Road, Community Build year 1950 - A single Freehold 171
Village Clinic Aveley, Clinic storey building with main
Essex, RM15 pitched concrete tiled roof
4HD and multile associated roofs.

Craylands School Community Build year 1930 - A single Freehold 251

Clinic House, Clinic storey brick building with
Craylands, multiple roofs of flat and
pitched construction.
Basildon,
SS14 3JD

Great Oaks Great Oaks, Community Build year 1970 - This is a Freehold 281
Clinic Basildon, Clinic two storey brick building with
Essex, SS14 two flat roofs and a pitched
section to the front elevation.
3JD

Page 27 of 56
Pitsea Clinic High Road, Community Build year 1930 - A single Freehold 234
Pitsea, Essex, Clinic storey brick structure with a
SS17 0BY pitched clay tiled roof and
prefabricated extension.

Stanford Wharf Road, Community Build year 1965 - A two Leasehold 400
Clinic Stanford-le- Clinic storey brick building with
Hope, Essex, roofs of flat construction
SS17 0BY

Tilbury Health London Road, Community Build year 1975 - A single leasehold 893
Centre Tilbury, Clinic storey brick building with a
Essex, RM19 flat roof.
8EB

Chadwell River View, Community Build year 1930 - A small Leasehold 114
Clinic Grays, Essex, Clinic single storey brick building
RM16 4BD with a pitched roof

Gifford House Thurrock Community Build year 2008 - A single Leasehold 400
Community Clinic storey brick building with a
Hospital, pitched roof.
RM16 2PX

Alastair Thurrock Community Build year 1983 - A single Leasehold 893

Farquharson Community Clinic storey brick building with a
Centre Hospital, pitched roof
RM16 2PX

John Tallack Thurrock Community Build year 1970 - A single leasehold 1224
Community Clinic storey brick building with
Hospital, multiple roofs of flat and
RM16 2PX pitched construction.

Physiotherap Basildon Community Build Year 1975 - This is a Leasehold 185

y OT Hospital, Clinic ward therapy unit based
Nethermayne, within the confines of
Basildon, Basildon Hospital
Essex SS16
5NL

GUM - Orsett Anthony Community Build year 2008 - This is a Leasehold 527
Hospital Wisdom Clinic single storey brick structure
Centre, Orsett on the Orsett Hospital site
Hospital, with a two storey
Rowley Road, extension located to the rear
Orsett, Essex, of the block.
RM16 3EU

Diabetes Orsett Community Build year 2005 - This is a Freehold 136

Centre - Hospital, Clinic single storey brick structure
Orsett Rowley Road, on the Orsett Hospital site.
Hospital Orsett, Essex,
RM16 3EU

Page 28 of 56
MIU Orsett Orsett Community Build year 1975 - This is a Leasehold 157
Hospital Hospital, Clinic ward therapy unit based
Rowley Road, within the confines of Orsett
Orsett, Essex, Hospital.
RM16 3EU

Physiotherap Orsett Community Build year 2003 - This is a Freehold 1594

y - Orsett Hospital, Clinic ward therapy unit based
Hospital Rowley Road, within the confines of Orsett
Orsett, Essex, Hospital.
RM16 3EU

SLT - Orsett Orsett Community Build year 1975 - This is a Freehold 180
Hospital Hospital, Clinic ward therapy unit based
Rowley Road, within the confines of Orsett
Orsett, Essex, Hospital.
RM16 3EU

St Andrews Stock Road, Community Build year 1975 -This is a Leasehold 600
Hospital Billericay, Clinic single storey brick building
Essex, CM12 with both a pitched concrete
0BH tiled roof and a flat
mineral felt covering.

Portacabin - Thurrock Community Build year 1990 - A single Freehold 149

Thurrock Community Clinic storey prefabricated timber
Community Hospital, framed structure with a
Hospital RM16 2PX pitched roof.

Grays Health RM17 5BY Community Community Dental Service, Leasehold 844
Centre Clinic Community Nursing, Speech
and Language Therapy,
Children's Service, CCS

Page 29 of 56
Appendix C

Fire Safety Management Structure

Trust Board

Chief Executive

Executive
Director Lead

Estates DirectorLine

Fire Safety Fire Safety

Manager Consultant

Business Unit
Managing
/Corporate

Premises Fire
wardens

Line

Managers

Staff

Page 30 of 56
Appendix D
Map of Geographical Spread of Properties

Page 31 of 56
Appendix E

Fire Risk Assessment Sample Document

Page 32 of 56
 EXEMPLAR FIRE RISK ASSESSMENT (FRA)
REGULATORY REFORM (FIRE SAFETY) ORDER 2005

This fire risk assessment should be undertaken by referring to

Firecode – HTM 05-03: Part K

This exemplar fire risk assessment form is only to give a guide as to what to cover during the risk
assessment process. It is not a mandatory fire risk assessment template and NHS organisations are free to
use any format they wish. This particular template has been discussed and agreed with the Chief Fire
Officers Association.

Duplicated on page 56

Premises full address (inc. Postcode):

Occupier:

Owner (if different to Occupier):

General description of building/premises:

Date of construction: NELFT/Estates

No. of floors in building:

Page 33 of 56
No. of basements:

Name of the person conducting the FRA:

Note: Is the person conducting the assessment deemed to be competent?

I certify that to the best of my knowledge, the information contained in this fire risk assessment is correct,
based on information provided at the time the assessment was undertaken.

Signature of Assessor: …………………………………………………………………….

Page 34 of 56
Assessment Area:

Premises:

Original design guidance (if known) or guidance at last upgrade: (please tick) NELFT/Estates

Red Fire Engine Book

HTM 81 (grey)

Nucleus

HTM 81 (yellow)

HTM 05-02

Other (state)

Use of Assessment Area:

Hours premises in use:

Details of other employers in the building:

Name/position of the responsible person(s): NELFT/Estates

Name of the person(s) providing the information:

Contact details:

Maximum number of persons:

Staff

Page 35 of 56
 Patients

Others

Minimum number of staff on duty at any time:

Typical occupant dependency: (please tick)

Independent

Dependent

Very High dependency

Page 36 of 56
CONTENTS

ASSESSMENT REVIEW

ASSESSMENT AREA PLAN

FIRE RISK ASSESSMENT

SIGNIFICANT FINDINGS & ACTION PLANS

Page 37 of 56
Fire Risk Assessment Review

Assessments should be kept under constant review, and in any case reviewed whenever
circumstance change which affect the validity of the current assessment. Whilst there is no
maximum period between assessments, it is recommended that the review period should not
exceed 12 months.

Revision Date Name of assessor Signature

Initial assessment

Revision 1

Revision 2

Revision 3

Revision 4

Revision 5

Revision 6

Revision 7

Revision 8

Revision 9

Revision 10

Page 38 of 56
Assessment Area Plan

INSERT AN ASSESSMENT AREA PLAN DETAILING MEANS OF ESCAPE AND OTHER EXISTING
PREVENTATIVE AND PROTECTIVE MEASURES

This will need to be provided by NELFT Estates in PDF A3 format

Page 39 of 56
Fire Safety Risk Assessment

Page 40 of 56
Step 1 Identify the hazards

1.1 Examples of sources of fuel that might be present (Tick those identified)

Paper and card

Wood

Furniture including fixtures and fittings (window blinds etc)

Flammable liquids

Waste materials

Other (specify)

Will tend to be repetitive

1.2 Examples of sources of ignition that might be present (Tick those identified)

Portable and fixed electric heaters

Cooking

Electrical equipment

Overloaded electrical sockets

Static electricity

Arson

Smoking materials

Hot work

Other (specify)

Will tend to be repetitive

Page 41 of 56
Sources of ignition
Y N
1.3 Does the activity
involve
Processes such as
cooking,
Welding or frictional
heat?
1.4 Is there gas or
burning oil equipment?
1.5 Are there light
bulbs etc. near
flammable materials?
1.6 Does electrical
equipment have
current PAT test?
1.7 Are there wander
or extension
leads/multi point
adapters in sockets?
1.8Are portable
heaters in use? Are
they unobstructed and
secured?
1.9 Is arson a potential
problem?
NELFT/Estates
Sources of fuel Sources of oxygen
Y N
1.10 Are highly
flammable materials
stored or used?
1.11 Is combustible
waste allowed to
accumulate?
1.12 Are excessive
quantities of
combustible materials
used/stored?
1.13 Are substantial
areas of walls or
ceilings covered with
flammable linings or
materials?
1.14 Are there any
other combustible
materials that
represent a hazard i.e.
aerosols?
1.15 Is smoking
permitted or smoking
materials present?
Page 42 of 56
Y N
1.16 Is there piped
oxygen in use?
1.17 Are there oxygen
cylinders used/stored?
1.18 Are Nitrous
oxygen cylinders
used/stored?
1.19 Is storage and use
of cylinders in
accordance with
legislation/guidance?
1.20 Are medical gas
shut off switches
identifiable and suitably
located?
1.21 Is there an
operational procedure
for isolation?
1.22 Are oxidising
materials used or
stored?
Description of hazard Identify necessary measures to eliminate (or reduce
ALARP) hazards

Page 43 of 56
Step 2 Identify people at risk

2.1 People in and around the premises (Tick those identified)

Medical staff (including agency or temporary staff)

Non medical staff incl. cleaners/security/maintenance staff etc

Member of the public – both visitors and patients

Others, including contractors

2.2 Also consider (Tick those identified)

Lone workers (including cleaners/security/maintenance staff esp. at night)

Those with language difficulties

Non patients with disability

Other people in the immediate vicinity of the premises

2.3 Special considerations for young persons (Tick those identified)

Have young people been given special consideration, due to their immaturity and inexperience,
the nature and duration of work, the physical properties of materials used and the training they
require?

2.4 Other considerations (Tick those identified)

Are Personal Emergency Evacuation Plans (PEEPs) required/in place?

Are there specific risks that might affect fire-fighter safety? Are they controlled?

I suggest we send the relevant sections of this form to the senior person of the ward/department to
be answered before FRA.s start.

Page 44 of 56
2.5 People at risk Independent / dependent / very high dependency

I suggest we send the relevant sections of this form to the senior person of the ward/department to
be answered before FRA.s start.

Staff No. Dependency category / times at risk

Days NELFT/Estates

Nights NELFT/Estates

Lone workers
NELFT/Estates

Patients - is the assessment Y/ N Dependency category / number / times at risk

area:

A sleeping area
NELFT/Estates

A patient access area (e.g.

OPD, Physiotherapy,
Radiology etc.)
NELFT/Estates

A non patient area

NELFT/Estates

Others in the immediate No. Control measures

vicinity who may be affected

Visitors NELFT/Estates

Contractors NELFT/Estates

Others (details)
NELFT/Estates

General comments & Existing control measures Further control measures

observations required

NELFT/Estates

Page 45 of 56
 Step 3 – Evaluate, Remove or Reduce and protect from Risk

Principles of Prevention Applied (article 10 & schedule 1, part 3)

Areas for Consideration (hierarchy)

 Avoid risks
 Remove risks
 Evaluate risks which cannot be avoided
 Combat risks at source
 Adapt to technical progress
 Replace dangerous substances by non dangerous or less dangerous substances (refer to
DSEAR Regulations)
 Develop a coherent overall prevention policy which covers technology, organisation of work and
the influencing factors relating to the work environment
 Give collective protective measures priority over individual protective measures and;
 Give appropriate instruction to employeesALUATE, REMOVE, REDUCE AND PROTECT FROM
RISK

3.1 Evaluate the risk of a fire occurring

Cause and ignition source Observations inc High, Med or Low risk
3.1.13 General comments & 3.1.14 Existing control 3.1.15 Further control
3.1.1 Smoking
observations measures measures required
3.1.2 Fire started by patient

3.1.3 Arson

3.1.4 Work processes

3.1.5 Fire hazard rooms

3.1.6 Equipment

3.1.7 Non patient areas (e.g.

examples from Table 1 in HTM 05-02)
NELFT/Estates

3.1.8 Lightning NELFT/Estates

3.1.9 Electrical NELFT/Estates

3.1.10 Toasters and portable

equipment NELFT/Estates

3.1.11 Cooking NELFT/Estates

3.1.12 Contractors NELFT/Estates

Page 46 of 56
 3.2 Evaluate the risk to people from fire.

Means of Escape Comment

3.2.1 Is there an alternative direction of escape?

3.2.2 Is the travel distance acceptable?

3.2.3 Are escape routes free from obstruction and

combustible materials?

3.2.4 Are escape routes clearly indicated with correct

signage?

3.2.5 Is escape lighting provided and adequate?

3.2.6 Are fire/smoke dampers and control systems NELFT/Estates

maintained and tested?

3.2.7 Are elements of structure adequate? NELFT/Estates

3.2.8 Is (sub)compartmentation integrity adequately

maintained?

3.2.9 Are suitable refuge areas provided?

3.2.10 If refuge areas are provided, are

communications provided and tested?

3.2.11 Are all internal fire doors clearly marked?

3.2.12 Is fire door integrity/strips/seals and all furniture

adequately maintained?

3.2.13 Are fire doors wedged open?

3.2.14 Is patient observation adequate for risk?

3.2.15 Are staff numbers adequate for the risk?

3.2.16 Are staff trained in correct evacuation

procedures?

3.2.17 Do staff carry out evacuation drills yearly?

3.2.18 Are staff/visitor fire notices adequate?

3.2.19 Are high risk rooms adequately protected?

3.2.20 Are there rooms utilised as fire hazard rooms,

which do not meet current standards? Identify the
rooms and the strategy to upgrade.

Page 47 of 56
3.2.21 Are there security devices on doors that are
suitable & acceptable? Do they comply with Appendix
C in HTM 05-03: Part K?

3.2.22 Detail facilities provided for fire fighters. Is the

maintenance appropriate & are records kept?

3.2.23 If vertical evacuation is necessary (internal or

external), are stairways suitable in size & width?
(Table 1 – HBN 40-02: Part C)

3.2.24 Detail any necessary action to eliminate or reduce ALARP identified risk

3.3 Remove or reduce the fire hazards

Controls in place Comment / Action taken to remove/reduce

hazard

3.3.1 Are stock levels kept to a minimum?

3.3.2 Are flammable liquids stored correctly?

3.3.3 Is an effective waste management system

in place and observed?

3.3.4 Is housekeeping to a high standard?

3.3.5 Is electrical, mechanical and gas

equipment used and maintained correctly?

3.3.6 Are extension, wander leads or socket

adaptors used?

3.3.7 Are portable heaters in temporary use? If

so, can they be replaced with fixed heaters or
secured?

3.3.8 Are the recommendations of HTM 05-03 NELFT/Estates

Pt F on arson being adopted?

Page 48 of 56
3.3.9 Are combustible materials / surface
finishes and notice boards etc to appropriate
standards?

3.3.10 Are contractors ‘work’ and ‘hot work’ NELFT/Estates

permits issued and monitored?

3.3.11 Can any hazardous substance be NELFT/Estates

removed or replaced with a less dangerous
substance

3.3.12 General comments & 3.3.13 Existing control 3.3.14 Further control
observations measures measures required

3.4 Remove and reduce the risks to people from fire

Means of escape Comment / Action required

3.4.1 Is an AFD system installed, tested and NELFT/Estates

maintained to HTM 05-03 Pt B?

3.4.2 If the AFD system does not conform to NELFT/Estates

HTM 05-03: Part B what is the standard?

3.4.3 Are call points clear and available?

3.4.4 Is the fire alarm /AFD linked to an alarm NELFT/Estates

centre?

3.4.5 Are appropriate fire action notices at all

call points?

Page 49 of 56
3.4.6 Are fixed suppression systems NELFT/Estates
adequately maintained and tested?

3.4.7 Are hose reels provided and maintained? NELFT/Estates (legionella!!!)

3.4.8 Are appropriate portable extinguishers

provided?

3.4.9 Are the extinguishers suitably located,

indicated and readily available?

3.4.10 Has all fire fighting equipment been

serviced / recorded in the last 12 months?

3.4.11 Are smoke control systems adequately NELFT/Estates

maintained and tested?

3.4.12 Are staff trained to the required level? NELFT/Training/FSI

(see HTM 05-03: Part A)

3.4.13 Is there clear access for Fire Service

vehicles/personnel?

3.4.14 Are all textiles and furniture to NELFT/Estates/FSI

HTM 05-03 Pt C?

3.4.15 Do all commercial enterprises conform to

HTM 05-03 Pt D?

3.4.16 Detail additional measures to eliminate or reduce ALARP identified risk

3.5 Management issues

Page 50 of 56
 Issue Comment / Action required

3.5.1 Is a suitable emergency plan in place?

Has it been practiced within the past 12
months?

3.5.2 Have all staff received all appropriate NELFT/Training/FSI

training in the last 12 months?

3.5.3 Are these Trust policies available and NELFT/H&S/FSI

do staff know where and how to access the
Trust Fire/arson/security policy?

3.5.4 Were sufficient fire wardens present on

the day of audit?

3.5.5 Are fire wardens completing and

recording their routine checks?

3.5.6 Are maintenance records available for

AFD, /emergency lighting/FFE?

3.5.7 Are test records available for AFD?

3.5.8 Is co-ordination/co-operation with other NELFT/???

Trusts working and recorded?

3.5.9 Has an Equality Act Assessment NELFT/Estates/H&S/FSI

Disability Discrimination Act (DDA)
assessment been completed?

3.5.10 Are the requirements of the DDA NELFT/Estates/H&S/FSI

Equality Act 2010 being met?

3.5.11 Is this area subject of an action plan or NELFT/Estates

enforcement notice from the Fire Service?

3.5.12 Are staff proactive in the avoidance of NELFT/Estates/H&S

unwanted fire signals?

3.5.13 Detail the number of fires and NELFT/Estates/H&S

unwanted signals in this area in the last 24
months. Include action taken to reduce UwFS.

3.5.14 Which HTM 05–03 Pt H category is NELFT/Estates/H&S ref uwfs

achieved?

3.5.15 Are there any special evacuation aids NELFT/Estates/H&S

present? If so, are staff trained in their use?

3.5.16 Is there a plan on the wall indicating fire

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safety measures?

3.5.17 Have employees, contractors etc. been NELFT/Estates/Training/H&S

made aware of all relevant factors relating to
the Trust’s fire safety arrangements?

3.5.18 Detail additional measures to eliminate or reduce ALARP identified risk

Page 52 of 56
STEP 4 Significant Findings & Action Plans

RISK VALUE MATRIX

LIKELIHOOD (L) VALUE SEVERITY OF OUTCOME (S)

Negligible 1 Negligible

Low 2 Slight damage to property

Minor injury to occupants, first aid required

Moderate damage to property

Moderate 3 Partial evacuation required
Injury to occupants, medical attention required

Large scale damage to property

High 4 Complete evacuation required
Occupants require hospitalisation

Extreme 5 Major loss of property

Major loss of life
1 2 3 4 5

2 4 6 8 10
Severity
3 6 9 12 15

4 8 12 16 20

5 10 15 20 25

Note: Beware of low likelihood but high severity

Risk Rating Action

1-3 Record findings and review in twelve months

4-6 Moderate risk – Implement additional controls within 12 months

8 - 12 High risk – Implement interim measures immediately and full controls within 3
months

15 - 25 Extreme risk – Cease use of area until additional controls have been applied.

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 FIRE RISK ASSESSMENT - SIGNIFICANT FINDINGS & ACTION PLAN

Variation / Interim Final Control Initial/Final Person Date

justification or control Measures & risk rating responsible completed
Ref Location Findings Action required. measures Date /Competent
No. Person
Initials
 Responsible manager for Recommended
Remedial action point actions time frame to Date of Comments
complete Completion
remedial works
1 Management controls below: Centre Manager and
Healthcare Initial Contracts
Kitchen – G2: Instruct domestic cleaner not to place Manager
cleaning tools in front of alternate fire escape. Undertake
regular audits particularly when using agency staff. B

Recommend under stairs clutter is removed from building

and allocated as the cleaners store with door kept closed
shut.

2 Centre Manager 27/06/2012 – Risk reduced whilst on

Kitchen - G2: Arrange for removal of double ring electric
site Centre Manager relocated electric
cooker out of the building or a least away from window A cooker away from curtains and made
curtains and notices displayed leaving a toaster and
an entry in the handing over book. MB.
microwave for warming food.

3 Building Remedial works below:
Ground floor corridor: Smoke detection required to give
early warning of fire upgrading system to an L3 category
as required by Fire code.
4 Estates - Senior Operations
1st floor dead end corridor: Replace existing doors on risk
rooms x 3 to fire doors giving 30 minutes fire resistance.
Estates - Senior Operations 27/06/2012 – Estates Capital Project
Manager team should put in a bid to secure funds
C for fire safety remedial works 2012-13.
MB.
27/06/2012 – Estates Capital Project
Manager team should put in a bid to secure funds
A for fire safety remedial works 2012-13.
MB.
A

Massey Shaw Healthcare - Audit trail and recommended time frame for completion of actions:
Key: A B C D E F

Immediately 7 days 28 days 3 months 6 months Other

Page 55 of 56
 EXEMPLAR FIRE RISK ASSESSMENT (FRA)
REGULATORY REFORM (FIRE SAFETY) ORDER 2005

This fire risk assessment should be undertaken by referring to

Firecode – HTM 05-03: Part K

This exemplar fire risk assessment form is only to give a guide as to what to cover during
the risk assessment process. It is not a mandatory fire risk assessment template and
NHS organisations are free to use any format they wish. This particular template has
been discussed and agreed with the Chief Fire Officers Association.

Premises full address (inc. Postcode):

NELFT/Estates

NELFT/Estates
Occupier:

Owner (if different to Occupier): NELFT/Estates

General description of building/premises: NELFT/Estates

Date of construction: NELFT/Estates

No. of floors in building: NELFT/Estates

No. of basements: NELFT/Estates

Name of the person conducting the FRA:

Note: Is the person conducting the assessment deemed to be competent?

I certify that to the best of my knowledge, the information contained in this fire risk
assessment is correct, based on information provided at the time the assessment was
undertaken.

Signature of Assessor: …………………………………………………………………….

NELFT/Estates/Training/H&S