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Fire safety in care homes and assisted living settings rests on a premise that does not hold in most other buildings: the people inside may not be able to leave quickly, or at all, without help. A combination of factors—from frailty and limited mobility to cognitive impairment and continuous occupancy—sets care environments apart from most other buildings. The standard assumption of fire safety design, that occupants will hear an alarm and move themselves to safety, cannot be relied upon.
This changes what fire protection must achieve. Where rapid escape is not possible, the priority shifts to controlling a fire at its earliest stage and limiting the spread of heat and smoke. The objective is to create time for staff to move residents to safety in an orderly sequence. Detection provides a warning, compartmentation contains the fire, and suppression limits its development. Together, they determine the outcome.
Reflecting this, the Regulatory Reform (Fire Safety) Order 2005, oversight by the Care Quality Commission, and recent changes to building guidance now place active suppression closer to the centre of care-sector fire strategy than before. Since 2 March 2025, new care homes in England have been required to incorporate automatic fire suppression as standard.
This paper examines the risk profile of care environments, the obligations that govern them, the limits of evacuation as a primary defence, and the role suppression systems play. It’s intended to help those responsible for care premises (operators, developers, and estate managers) assess their provision against resident vulnerability and current regulatory requirements.
For further personalised guidance on the topics covered in this whitepaper, contact Sam Finch, Head of Regulatory Affairs & Technical Standards at SmartMist, by emailing info@mistingsolutions.co.uk.
A care home functions simultaneously as a workplace, a clinical setting, and a residential environment—occupied continuously by people whose capacity to respond to a fire is reduced. This distinguishes it from most other premises governed by the same fire safety legislation and raises the level of protection the building itself must provide.
Many residents cannot walk unaided, use wheelchairs, or are bedbound. An evacuation that a physically able adult completes in seconds may require several staff members and several minutes per person. The time before a fire becomes untenable is fixed. The time required to respond to it is considerably longer.
Cognitive and sensory impairment (dementia, confusion, reduced hearing, and reduced sight) can interrupt the sequence fire safety assumes: notice the alarm, understand it, decide to move, and find the exit. A resident may not recognise an alarm as a warning, or may resist assistance, adding delay at the point where it is most critical.
Care settings are occupied overnight, when residents are asleep, and staffing levels are at their lowest. A fire occurring during these hours is likely to be detected later and responded to by fewer staff, each potentially responsible for the safety of several dependent residents.
These factors rarely occur in isolation. In combination, they place a greater demand on the building and its systems to provide the protection that, in other settings, occupants are able to provide for themselves.
Fire safety in care settings is governed by several frameworks that work together, with one shared aim: that the people least able to escape receive the highest standard of protection.
The Fire Safety Order is the primary fire safety legislation for non-domestic premises in England and Wales. It requires the responsible person, usually the provider, to carry out a suitable and sufficient fire risk assessment, act on its findings, and take account of those especially at risk.
Since October 2023, under section 156 of the Building Safety Act 2022, that assessment must be recorded in full. Fire and rescue authorities enforce the Order.
The CQC registers and inspects providers under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Regulation 12 requires that premises are safe to use, and Regulation 15 that they are suitable and properly maintained. Fire safety falls within both and within the CQC's assessment of whether a service is safe. Personal emergency evacuation plans for individual residents are expected.
For new buildings, Approved Document B sets the design expectation. Since 2 March 2025, all new care homes in England are required to incorporate sprinkler systems, regardless of height. The same guidance specifies compartments limited to ten beds and self-closing bedroom doors. Residential sprinkler systems are designed to BS 9251:2021. Requirements differ across England, Scotland, and Wales.
In most buildings, the response to a fire alarm is clear: all occupants evacuate simultaneously. In a care home, this is rarely achievable. Moving dependent residents requires time and sufficient staff. A full building evacuation can place more people in corridors and stairwells than staff can safely manage, particularly during night hours.
The recognised strategy in most care settings is progressive horizontal evacuation: moving residents away from the fire into an adjoining fire-resisting compartment on the same floor, in stages, before any vertical movement is considered. The objective is to extend the time available rather than require immediate full evacuation.
This approach depends on several conditions being met:
Each of these depends on time, and time depends on how quickly a fire is brought under control. This is where active suppression plays its role. Acting in the early stages of a fire, it limits heat and smoke and helps preserve the compartmentation that horizontal evacuation relies on. It extends the period in which staff can move residents safely, too. Suppression does not replace evacuation planning, but it makes the plan viable.
When fire protection fails in a care setting, the consequences extend beyond the immediate incident. The implications reach residents, regulators, and the organisation as a whole.
The most serious consequences involve resident safety. Where residents cannot be moved before fire and smoke spread, the outcome can be serious injury or death. The same vulnerabilities that complicate evacuation reduce residents' tolerance of smoke exposure, which remains the principal cause of harm in fires.
Fire safety shortcomings bear directly on the CQC's assessment of whether a service is safe. They can lower a rating, trigger conditions on registration, or restrict new admissions. In serious cases, they may result in cancellation of registration and closure.
Fire and rescue authorities enforce the Fire Safety Order. Breaches may result in enforcement and prohibition notices and, under Article 32, unlimited fines. In the most serious cases, custodial sentences have been imposed. The largest fire safety penalty in the care sector has exceeded one million pounds.
A serious fire, or enforcement action following one, can force the relocation of vulnerable residents and result in loss of occupancy and income. Higher insurance costs and reputational damage are likely consequences, too. For a provider, the reputational impact can persist long after physical repairs are complete.
Among active suppression options, high-pressure water mist has qualities that suit occupied, sensitive buildings particularly well. Understanding why begins with how it works.
A water mist system forces water through nozzles at high pressure to produce a fine spray of very small droplets. Dividing the same water into far more droplets multiplies its surface area, allowing it to absorb heat considerably more efficiently than a conventional jet.
The mist rapidly cools the fire and surrounding air, and as the droplets turn to steam, they displace oxygen locally—suppressing combustion while using a fraction of the water a sprinkler discharges. Residential systems are designed to BS EN 14972-1:2020+A1:2025.
That efficiency brings practical advantages for care settings:
SmartMist's water mist systems demonstrate this in practice. The DOME mist head protrudes less than the diameter of a one-pound coin from the ceiling, protecting with minimal visual impact.
The way suppression is delivered depends heavily on whether a building is being designed or already occupied. The considerations differ.
For new care homes in England, suppression is a baseline requirement. Since 2 March 2025, Approved Document B requires all new care homes to be built with sprinkler protection, regardless of height.
Designing it from the outset is the most efficient approach: system components can be coordinated with compartmentation, detection, and the building's wider fire strategy. Early integration avoids compromise later.
Sprinkler systems follow BS 9251:2021. Water mist (designed to BS EN 14972-1:2020+A1:2025) can be proposed as an alternative where its equivalent performance is demonstrated and accepted by the building control body, as the guidance is framed around sprinklers.
Most existing homes are not required to retrofit suppression, though it is strongly encouraged, particularly during refurbishment. The challenge in an occupied building is disruption: work must proceed around residents whose routine and well-being depend on stability.
Water mist is well-suited here. Its low flow allows connection to the mains without a large storage tank and the structural work a tank entails, while slim, flexible pipework can often be routed with less intrusion than a conventional system. SmartMist supports retrofit in occupied homes with this in mind, alongside fire risk and compartmentation assessment.
Resilience in a care setting comes from layers that work together: passive protection that contains a fire, detection that provides early warning, suppression that controls it, and trained staff who can act within the time those systems create. Assessing fire protection requires examining how well those layers reflect the vulnerability of the occupants.
A practical review might begin with the following questions:
Few providers will answer every question with full confidence, and the gaps are where attention is best directed. For those reviewing their suppression provision, specialist input helps match the right system to the building and its occupants.
SmartMist provides this specialist support, delivering end-to-end suppression solutions. To discuss your specific setting, connect with our team.