FIRE SAFETY POLICY. To be read in conjunction with the H&S Policy and individual building fire evacuation arrangements

FIRE SAFETY POLICY To be read in conjunction with the H&S Policy and individual building fire evacuation arrangements Document Type H&S Policy Unique Identifier HS-003 Document Purpose Health and Safety of Employees and Non-employees Document Author Risk & Security Manager Target Audience All staff Responsible Group H&S Committee Date Ratified 24 September 2014 Expiry Date 23 September 2017 The validity of this policy is only assured when viewed via the Worcestershire Health and Care NHS Trust website (hacw.nhs.uk.). If this document is printed into hard copy or saved to another location, its validity must be checked against the unique identifier number on the internet version. The internet version is the definitive version. If you would like this document in other languages or formats (i.e. large print), please contact the Communications Team on 01905 760020 or email communications@hacw.nhs.uk. Fire Safety Policy Page 1 of 16

Version History Version Circulation Date Job Title of Person/Name of Brief Summary of Change Group Circulated to 1 09/11 H&S Committee members & Merge of PCT and MHPT policy Union H&S Reps 2 10/11 JNCC N/A 3 11/11 Quality & Safety Committee Ratified for use 4 09/14 H&S Committee members and Minor changes as part of Union H&S Reps scheduled review 5 09/14 Quality & Safety Committee Ratified for use Accessibility Interpreting and Translation services are provided for Worcestershire Health and Care NHS Trust, including: Face to face interpreting; Instant telephone interpreting; Document translation; and British Sign Language interpreting Please refer to intranet page: http://nww.hacw.nhs.uk/a-z/services/translation-services/ for full details of the service, how to book and associated costs. Training and Development Worcestershire Health and Care NHS Trust recognises the importance of ensuring that its workforce has every opportunity to access relevant training. The Trust is committed to the provision of training and development opportunities that are in support of service needs and meet responsibilities for the provision of mandatory and statutory training. All staff employed by the Trust are required to attend the mandatory and statutory training that is relevant to their role and to ensure they meet their own continuous professional development. Fire Safety Policy Page 2 of 16

Contents Page 1 Introduction 4 2 Definitions 4 3 Purpose / Statement 4 4 Responsibilities 5 5 Risk Assessment 7 6 Operational Procedures 7 6.1 Training 7 6.2 Fire Log Books 8 6.3 Evacuation Procedures 8 6.4 Personal Emergency Evacuation Plans (PEEP) 9 6.5 Evacuation Drills 10 6.6 Incidents of Fire or Unwanted Fire Signals 10 6.7 Control of Smoking & Arson 11 6.8 Contractors 11 7 Consultation and Communication with Stakeholders 11 8 Development and Approval of Procedural Documents 11 9 Dissemination 12 10 Planning and Implementation 12 11 Monitoring and Review 12 12 Standards / Key Performance Indicators 12 13 References 12 Appendices 1 Emergency Evacuation Assessment 13 2 Personal Emergency Evacuation Plan 15 An Equality Analysis Assessment has been undertaken on this policy Fire Safety Policy Page 3 of 16

1 INTRODUCTION The Trust has statutory obligations under the Health and Safety at Work Act and the Regulatory Reform (Fire Safety) Order to ensure it has robust fire safety arrangements in place within its premises. This document outlines the responsibilities and the operational procedures in place to demonstrate compliance with this legislation and any associated Department of Health guidance. This policy applies to all premises owned or managed by the Trust. It applies to all contracted employees, including agency, locum staff and volunteers, contractors and visitors who may be present on these premises. It does not apply to staff who work in premises owned/managed by a third party e.g. GP surgery. In these circumstances, staff should comply with the building owner/landlord s fire safety policy and be aware of their local evacuation arrangements. 2 DEFINITIONS Responsible person: the person who has control of the premises. This may either be the owner of the building or the occupier, provided they have control of the premises in connection with their trade/business Competent person: someone with sufficient training, experience and/or knowledge enabling them to assist in undertaking preventive and protective measures Risk assessment: a written document complying with the Fire Safety Order to ensure the employing organisation has identified its fire hazards, evaluated the risks of fire occurring and as a consequence implemented suitable control measures Fire Codes: Department of Health guidance in the form of Healthcare Technical Memorandums on fire safety areas i.e. managing fire safety, functional and operational provisions Personal Emergency Evacuation Plans: a specific plan for any employee or nonhospitalised visitor who requires special assistance in vacating the premises during an emergency 3 PURPOSE / STATEMENT The safety of staff, service users and visitors in the event of a fire is an issue of fundamental importance and will receive the same managerial attention as any other business activity. The Trust aims to ensure that the working and patient care environment is as safe from fire as can reasonably be achieved and that if a fire does occur, members of staff are well trained in the recognised Fire Routine Procedures for safe evacuation. The Trust is committed to ensuring peoples safety at work. It aims to do this by: a) Providing a safe working environment which, as far as is reasonably practicable, removes or reduces the fire hazards present on site b) Implementing a proactive approach to risk assessment to identify where risks need to be controlled c) Developing preventive and protective measures to mitigate the impact of fire on life safety, the delivery of service, property and assets Fire Safety Policy Page 4 of 16

d) Providing guidance to management and staff on operational requirements relating to fire safety i.e. instructions, training, evacuation drills, plans etc 4 RESPONSIBILITIES 4.1 Chief Executive The Chief Executive is responsible for overall fire safety within the Trust and for the implementation of this policy. The Chief Executive is responsible for ensuring that the Trust complies with the Department of Health s FIRECODE suite of guidance on fire safety and for the corporate decisions taken in respect of general fire precautions and fire safety training. This includes the appointment of a competent person to provide fire safety advice and support to the Trust as well as ensuring adequate resources for fire protection. 4.2 Company Secretary/Director of Quality (Executive Nurse) The Company Secretary (to 30 November 2014)/Director of Quality (Executive Nurse) (from 1 December 2014) chairs the Health and Safety Committee which has oversight of the fire safety arrangements and which receives and considers quarterly reports of fire safety incidents. The Company Secretary in conjunction with the Risk and Security Manager, the Head of Estates (or his nominated representative) and Head of Training and Development (or her nominated representative) monitors the performance of the contracted fire safety advisers. 4.3 Head of Estates The Head of Estates is responsible for the installation, maintenance and testing of all Trust fire safety equipment, systems and physical controls e.g. fire doors, signage, evacuation chairs, fire extinguishers. All maintenance and examination records are retained by the Estates department; together with a copy of the fire risk assessments and up to date building plans. If there are any building works or structural changes to a Trust building, the Head of Estates will ensure the Fire Safety Adviser has been consulted and that the works are compliant with any building regulations, legislation or British Standards. A permit to work system is in operation for any hot works undertaken on site. This permit system is managed via the Estates department. 4.4 Fire Safety Adviser An independent contractor is appointed to be the Trust s Fire Safety Adviser. They are responsible for advising the Trust on all aspects of fire arrangements. This includes technical expertise and advice on the application and interpretation of fire legislation, Fire Codes etc, undertaking fire risk assessments, consultation on new project works and alterations, policy guidance, fire door surveys, a programme of fire safety and fire warden training, reporting to the Health and Safety Committee, liaison with enforcing authorities, the Fire Safety Manager and Estates staff. 4.5 Fire Safety Manager The Risk and Security Manager has been designated as the Fire Safety Manager. They are required to liaise with the Fire Safety Adviser, Directors and Service Delivery Unit Leads to ensure the following measures are implemented: Fire Safety Policy Page 5 of 16

Adequate fire safety systems and precautions within buildings A fire risk assessment programme A fire safety training programme A maintenance programme funded via capital Co-operation between other employers where two or more share a premises The reporting of fire and false alarms on the NHS Estates and Facilities Management (EFM) information database The reporting of fire safety information to the Health and Safety Committee 4.6 Directors Directors are responsible for ensuring the day to day health, safety and welfare of their service delivery units. They should be familiar with the fire safety arrangements for their buildings and for ensuring the implementation of any control measures designed to prevent a fire from occurring or reduce the impact in terms of damage/harm if one does occur. This will include sufficient provision of information, instruction and training for staff. 4.7 Senior Managers and Manager Responsibilities Managers have a responsibility for the safety of their staff. They should ensure their staff are aware of this policy and of any risk assessment findings for their premises. They are responsible for monitoring staff training and should be proactive about eliminating any poor fire safety on site and maintaining the fire log books. Any concerns must be reported promptly to their Director, Estates Department, Risk & Security Manager or the Health and Safety Manager. Managers must be familiar with the evacuation arrangements for their building. They should arrange a practice drill at least once a year. For the larger premises i.e. hospitals, consideration should be given to table top exercises to minimise disruption to patients. 4.8 Other Roles The descriptions of these roles are taken from Health Technical Memorandum 05-01: Managing healthcare fire safety (Second Edition). 4.8.1 Fire Wardens Designated staff within each building will be nominated and appropriately trained as fire wardens. The number of wardens will vary depending on the size and layout of the site. However, there should always be a deputy to allow for absence. Fire Wardens act as the eyes and ears of fire safety within their area, but they do not have an enforcing role. They are required to: act as the focal point on fire safety issues for the local staff; organise and assist in the fire safety regime within local areas; raise issues regarding local fire safety with their line management; support line managers in their fire safety issues. Fire Safety Policy Page 6 of 16

4.8.2 Fire Incident Manager The most senior person in charge of an area and present at the time that an incident occurs should assume the role of the Fire Incident Manager. 4.8.3 Fire Response Team Leader The most senior manager immediately available will be nominated as the Fire Response Team Leader to ensure initial control of an emergency. The Fire Response Team Leader is required to: respond to confirmed fire events; take responsibility for direction of the Fire Response Team; liaise with the Fire Incident Manager; liaise with the attending fire and rescue service; instigate the internal major incident plan (if required). 4.8.4 Fire Response Teams The Fire Safety Manager should establish Fire Response Teams on all trust sites. Local site circumstances will best determine the quantity of people and skill profile required. The Fire Response Team procedures should reflect and where necessary integrate with the trust s major incident policy and procedures. 4.9 All Employees All staff should be aware of this policy and be familiar with the fire safety arrangements for their building. They must take reasonable care of themselves and others, and be pro-active about fire safety. This includes not interfering with fire precautions i.e. wedging fire doors open or obstructing escape routes with storage. Staff should comply with any risk assessment findings, and notify their line manager of any concerns where precautions are not being followed. They are required to participate in evacuation drills and undertake mandatory annual fire safety training either via an e- learning package or as part of a standard training session. 5 RISK ASSESSMENT In line with the Regulatory Reform (Fire Safety Order) the Trust is required to assess the fire risks associated with each site that it owns or manages. These assessments are undertaken annually for all inpatient/residential facilities by the Trust s Fire Safety Adviser. All other properties are assessed every 18 months. These assessment periods have been agreed with the Hereford and Worcester Fire and Rescue Service. They will be foreshortened should the risk profile of a property change. A schedule of risk assessments is agreed at the start of each financial year with the Fire Safety Adviser. The assessment visits include an inspection of the site in order to highlight any fire hazards and recommend what further action is needed to improve the existing controls. Recommendations will be directed at either Estates staff to correct via maintenance or capital funding; or they will fall to the building s responsible manager (and their locality teams) to correct at a local level. Fire Safety Policy Page 7 of 16

A copy of each risk assessment is sent to Estates. They will forward these to the Risk & Security Manager in his/her capacity as the Trust s Fire Safety Manager and appropriate Directors as necessary. Directors are required to ensure locality teams act on any assessment recommendations. Risk assessments also need to be undertaken for any new build projects, for any major structural change to a building or if a building changes its use i.e. a change of service operating from that building. The responsible manager will need to notify the Estates Manager and the Fire Safety Adviser so that an assessment can be arranged. The responsible manager will be required to fund any additional assessments that were not included on the yearly schedule. 6 OPERATIONAL PROCEDURES 6.1 Training It is a statutory requirement for all staff to attend annual fire safety training. Training sessions can be accessed in a variety of ways: Induction e-learning for all new starters As part of the mandatory class room training for staff involved in direct patient care in in-patient facilities. Details of these are available via the Training and Development Unit A fire safety e-learning package available via ESR, which can be accessed from an PC with a network connection Fire safety training will ensure staff are able to identify fire hazards, understand how a fire starts, raising the alarm, what action to take in the event of a fire, use of fire fighting equipment, means of escape etc. Fire warden training is only required for staff who have been nominated as building fire wardens. This is provided by the Trust s Fire Safety Adviser. Stand alone sessions are run throughout the year at one of the Trust s main training venues. Details of dates and locations are available via Training & Development. Fire warden training will cover all the basics of the fire safety session. In addition it will include the role of the warden during an evacuation. Procedures for confirming the location of the fire via the alarm panel, closing doors and windows, checking rooms are empty, coordinating the actions of staff, patients and visitors, undertaking a roll call at the assembly point, liaising with the Fire and Rescue Service, reporting incidents and maintaining the fire log book. Some Trust buildings with more than one floor may have evacuation chairs provided. These chairs are designed to manoeuvre people down the stairs in an emergency situation. Fire wardens and other nominated staff within these buildings will be given evacuation chair training on site so they are competent to operate the chairs safely. This training is provided by the Trust s manual handling team. Staff who have not received the training should not attempt to handle the chairs. 6.2 Fire Log Books Each Trust building must have a fire log book. This should be maintained next to the fire alarm panel. The book contains evidence of all the on site maintenance and testing visits Fire Safety Policy Page 8 of 16

e.g. extinguisher and emergency lighting checks, portable appliance testing, alarm tests, alarm maintenance, staff evacuation drill training etc. Any maintenance engineer, contractor or member of the Estates team who arrives on site to test the fire safety equipment or systems is required to record their visit on the relevant page of the log book. The log book needs to be accessible for maintenance staff, but also for the Fire Safety Adviser and any Fire Officer from the Fire and Rescue Service. 6.3 Evacuation Procedures Each Trust building is legally required to have a documented evacuation procedure. This should be on display in the front entrance near to the alarm panel. The basic instructions for evacuation should also be detailed on Fire Action Notices displayed within the escape routes. Line managers should explain these arrangements to any new staff as part of their local induction. A basic procedure will detail: How to raise the alarm if a fire is discovered What action to take on hearing the alarm i.e. escape via the closest exit to a place of safety away from the building Do not stop to collect personal belongings Close windows and doors wherever possible to contain the spread of fire Call (9)999 Fire & Rescue Service, giving full postal address Do not tackle the fire if it is not safe to do so Do not put yourself at risk, but wherever possible assist colleagues and others to evacuate to a place of safety Meet at a visible assembly point where the fire wardens and/or Fire Service can see you Do not re-enter the building until the Fire Service give the all clear 6.4 Personal Emergency Evacuation Plans Any staff with a disability should be assessed to determine if they need a personal emergency evacuation plan (PEEP) (Appendix 1). A PEEP should be documented for any member of staff who has a disability that could affect their ability to evacuate their workplace (Appendix 2). The plan will outline what additional measures or assistance are likely to be needed by the individual in order for them to evacuate safely with their colleagues. The plan should have regard to: Temporary refuges - which are a place of safety within the building where people can wait for assistance. A refuge area must be clearly signed and should be of sufficient size to accommodate both people using it as a refuge and any people Fire Safety Policy Page 9 of 16

passing through on their way out of the building. From here, the individual can be evacuated out of the building in a safe and controlled manner. Safe routes unobstructed walkways allowing free movement around floor space, corridors, stairs etc. If possible, horizontal evacuation routes should be sought out so that the evacuating person can move freely into an adjacent area without having to negotiate steps and stairs. It should also be possible for any evacuating person to use any door locks, fob access and key pads. Lifts most lifts cannot be used in an emergency. The Trust s Fire Safety Adviser will be able to tell you if, and under what circumstances, a lift may be used in the event of a fire. Mobility equipment e.g. wheelchairs for ground floor level; evacuation chairs for upper floor evacuation should be available where appropriate. Evacuation chairs should be located in protected stairways. The disabled person should self transfer into the chair Designated staff should be trained to operate the evacuation chairs. Hearing impaired individuals need to be familiar with the evacuation procedure so that they see and understand the behaviour of others. In cases where they work alone, a visual or vibrating method of alert should be considered. Sight impaired individuals a buddy system so they are accompanied out of the building. Training staff require instruction and practical demonstrations. Communicate the PEEP to the individual but more particularly to colleagues and fire wardens. Participate in trials and fire drills. 6.5 Evacuation Drills The effectiveness of any evacuation procedure must be tested via drills. These should be undertaken at least once a year. Depending on the size and complexity of the building, the drills can include the whole building, part of the building or individual wards. This will ensure staff can become competent about evacuating their area. Fire drills should be performed with the minimum disruption to service, and include a scenario of a blocked exit so that staff learn to consider alternative routes and/or role play of using staff as patients. The Fire Code does not recommend that hospitals include inpatients from the wards as part of any evacuation drills. However the responsible manager and the hospital matron should consult with the Trust s Fire Safety Adviser and/or the Risk & Security Manager and the Health & Safety Manager before making this decision. Fire drills should be arranged for different times of the day so that all staff are involved i.e. day and night. Fire wardens need to arrange with Estates for someone to come out and set off the alarm from a break glass point. They also need to ensure the switchboard / Fire and Rescue Service has been notified that the building staff are undertaking a practice drill. Wherever possible, wardens or designated staff should observe the drill. The outcomes can then be recorded on a fire drill report. This will enable senior managers and fire wardens to identify any failings within the exercise and communicate to staff where weaknesses may still exist. It is important to record every drill in the building s fire log book as evidence that staff training is being undertaken. Fire Safety Policy Page 10 of 16

6.6 Incidents of Fire or Unwanted Fire Signals All fire incidents, whether genuine or false alarms must be reported immediately via the Trust s incident reporting system. The fire warden or the manager in control of the premises should ensure this happens. The Risk & Security Manager and the Health & Safety Manager will ensure information on all fire incidents is forwarded to the Estates department, where it will be recorded on the NHS EFM Information Database and sent to the Department of Health. The Fire Safety Adviser will be requested to investigate any serious fire incident. These findings will be presented to the Quality and Safety Committee and in turn the Trust Board. Where any fire involves death or major injury, this incident must be reported to the Health and Safety Executive in accordance with the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations. The Department of Health should also be notified immediately by telephone 0113 2546881 or email fire@dh.gsi.uk. Unwanted fire signals cause disruption to service provision and worry to staff, patients and visitors. These false alarms also need to be reported as incidents and investigated by Estates staff to reduce the likelihood of repeat problems. 6.7 Control of Smoking & Arson Smoking is prohibited in all Trust buildings. Where it is safe to do so, staff should challenge anyone found smoking on their premises. External smoking permitted areas are clearly marked by appropriate signs. Cigarette bins are provided in these areas and may also be located at the entrance to buildings. Wherever possible no smoking will be enforced on NHS grounds, not just within the buildings. Measures to prevent arson will be considered for each building as a result of its fire risk assessment. When identifying suitable controls, the responsible manager for each building should take account of: external lighting, site access, unfrequented areas, bin stores, plant rooms, gas storage, workshops, disused or derelict buildings. 6.8 Contractors Contractors on Trust premises must be controlled at all times in accordance with the Trust s Safe Management of Contractors Policy. In particular with regard to fire safety: A Permit to Work must be in force for any Hot Work. All relevant aspects of the work in progress must have been risk assessed both with regard to preventing fire and to mitigating the effects of any fire that does occur. If the work affects the continuing functions of the fire alarm and automatic detection systems, the prior approval of the Estates Officer must be obtained. Any holes or breaches made in fire resisting walls or above ceiling fire barriers must be repaired, as part of the work in progress. 7 CONSULTATION & COMMUNICATION WITH STAKEHOLDERS The Trust s Health and Safety Committee provides a forum at which managers and staff can consult on any fire issues, in good time, before the introduction or change of legislation, new equipment or new technology. It allows staff representatives to communicate with Fire Safety Policy Page 11 of 16

managers, in order to raise concerns about fire safety that cannot be resolved at a local level. Staff side members of the H&S Committee are accredited Trade Union Safety Representatives. The H&S Committee is directly accountable to the Quality and Safety Committee. 8 DEVELOPMENT & APPROVAL OF POLICY DOCUMENTS This policy is drafted and developed by the Risk & Security Manager and the Health & Safety Manager in accordance with legislation and Fire Code guidance. Key stakeholders and specialist staff are involved in the consultation process e.g. Estates staff and H&S Accredited Reps. The H&S Committee is responsible for reviewing the policy. Final ratification rests with the Quality & Safety Committee. An equality impact assessment has been undertaken on the legal content and best practice guidance of the policy to ensure it is valid and applicable to all. 9 DISSEMINATION Policy documents are available via the Trust website. The principles embedded within the policy will be included in Induction training, class room training and e-learning for all staff. 10 PLANNING & IMPLEMENTATION The Chief Executive will agree annual objectives related to health and safety management with all Executive Directors who will ensure appropriate cascading of relevant objectives throughout their area of responsibility. Executive Directors will ensure that health and safety planning forms an integral part of their business planning process, in order to ensure that needs are identified, prioritised, and that appropriate resources are allocated. 11 MONITORING & REVIEW Fire incidents are reported quarterly to the H&S Committee. The investigation of these incidents will be used to identify the adequacy of existing controls and the effectiveness of the policy. Monitoring of the policy will also be undertaken via the analysis of completed risk assessments, RIDDOR incidents and the review of risk register information. Policies will be subject to review in line with changes to legislation, technology or good practice. The review of policies will also be based on the prioritisation of risk within the Trust and as a consequence of any serious fire incidents. 12 STANDARDS / KEY PERFORMANCE INDICATORS Care Quality Commission requires Trusts to achieve a required level of compliance for health and safety control. This is Outcome 10: Safety and Suitability of Premises, and Outcome 11: Safety, Availability and Suitability of Equipment. Fire Safety Policy Page 12 of 16

13 REFERENCES Health and Safety at Work Act 1974 Regulatory Reform (Fire Safety) Order Department of Health HTM Fire Code documents Care Quality Commission Fire Safety Policy Page 13 of 16

EMERGENCY EVACUATION ASSESSMENT Appendix 1 To be completed by a competent person, appointed by the Head of Department, with the assistance of the disabled person. Name of Disabled Person Work Area: Responsible Manager: Assessment Undertaken by: Date of Assessment: Hearing Impairment 1. Can you hear the fire alarm in normal circumstances? Yes No 2. If you have difficulty in hearing the fire alarm, would a visual indicator Yes No assist? 3. Is there, to your knowledge, any special or purposely designed Yes No hearing system or device available, which might assist in you hearing the fire alarm more clearly? Details: 4. Would your response to the fire alarm being activated be helped by Yes No an assistant(s), who could provide support in the fire evacuation procedure? 5. Would a vibrating paging unit, that operated when the fire alarm was Yes No actuated, be of assistance? Visual Impairment 6. Do you have a visual impairment, which would have an impact on Yes No your leaving the building unassisted in an emergency? 7. Do you use an aid to help you move around the building for example: Yes No a cane, guide dog or other equipment? Details: 8. How long does it take you to leave the building in normal Yes No circumstances from your place of work, unaided? Time in minutes.. 9. Could you find your way to exit the building by an alternative route Yes No should your normal route be unavailable? 10. Do you think that the speed at which you are able to leave the Yes No building, may have the potential to hold-up other people leaving the building in corridors and stairways, or that they may cause you injury as they pass you more quickly? 11. Would tactile signage or floor surface information be of assistance to Yes No you? Details: 12. Are there any other problems you would wish to highlight or solutions Yes No / measures that might assist you? Details: Mobility Impairment 13. Can you leave the building unassisted? Yes No 14. If not do you require help from an assistant to leave the building? Yes No 15. Do you need or use a wheelchair? Yes No 16 a) Is the wheelchair required for all circumstances Yes No b) Can it be dispensed with for short periods? Yes No Fire Safety Policy & Strategy Page 14 of 16

17. Is the wheelchair a standard size or an electrically powered type with Yes No wider dimensions? Normal Electrical Width.. 18. Are you able to self-transfer to an evacuation chair / stair descent device if required? Yes No 19. Could the medical nature of your disability be aggravated by the use Yes No of such a device? 20. Has a member of staff and a deputy been assigned to assist you in an Yes No emergency? Name(s) Details: 21. Any other problems / observations / or solutions? Yes No Details: General Information 22. Do you understand the concept of a Fire Refuge area? Yes No 23. Might the measures needed for you to escape from the building in an Yes No emergency adversely affect the safe escape of other occupants? If yes, why / how? 24. Do you think that any special staff training is required to give you the Yes No assistance that you would need in an emergency? 25. Are you aware of the emergency egress procedures which operate in Yes No the building(s) in which you work or visit? 26. Do you require written emergency egress procedures? Yes No 27. Are the signs which mark the emergency exits and the routes to the Yes No exits clear enough? 28. Could you raise the alarm if you discovered a fire? Yes No Notes: NB PERSONAL EMERGENCY EVACUATION PLAN FORM SHOULD NOW BE COMPLETED. PLEASE SEE NEXT PAGE Fire Safety Policy Page 15 of 16

Appendix 2 PERSONAL EMERGENCY EVACUATION PLAN Name Job Title Department Location Designated Staff to assist Alerted to alarm by Exit Procedure (step by step) Methods of Assistance (physical, verbal) Equipment (evac chair, mobility aids, radios) Safe Route (shortest distance, access, doors) Plan agreed with individual Yes No Signature of Individual Plan agreed with line manager Yes No Signature of Manager Plan agreed with designated staff Yes No Signature of assisting staff Copy of plan sent to fire warden Yes No Plan discussed within team Yes No Fire Safety Policy Page 16 of 16