Nursing Homes & Tabletop Exercises | Phoenix STS
Picture This

It’s 2 AM on a Saturday. A fire breaks out in a resident’s room. Your skeleton night staff needs to act fast. But here’s the question that keeps safety managers awake at night: Does everyone actually know what to do?

You probably have an emergency response plan. You likely run fire drills. But there’s a crucial gap many nursing homes miss: testing whether your plans actually work in the real world. That’s where tabletop exercises come in.

📋 At a Glance

  • What: A group discussion where staff walk through a fire scenario step by step
  • Duration: 1 to 2 hours in a meeting room
  • Disruption: None to residents or operations
  • Outcome: Identify gaps in your emergency plan before they become life-threatening
  • Frequency: At least annually, more often with high staff turnover

What Is a Tabletop Exercise?

A tabletop exercise is a group discussion in which your team walks through a realistic fire scenario, step by step and decision by decision, without anyone leaving the room. No alarms, no evacuations, no disruption to residents. Just your key staff sitting around a table, talking through exactly what they’d do if a fire started right now.

Unlike a physical drill, you’re not testing how fast people can move. You’re testing something equally important: whether everyone knows their role, can make good decisions under pressure, and can communicate effectively when it matters most.

How It Works

A facilitator presents a hypothetical fire scenario (maybe a kitchen fire on a Sunday evening with minimal staff). As the scenario unfolds, your team discusses their response:

  • How do you alert other units?
  • Who calls 112?
  • Which residents get evacuated first?
  • What if the planned exit is blocked?
  • Who calls the PIC?
  • What happens if the PIC does not answer?

It’s a guided conversation that reveals gaps in your emergency plan before those gaps become life-threatening problems.

Why Bother? Three Powerful Benefits

1

Test Your Plans in Real-World Scenarios

Your emergency response plan looks great on paper. But does it account for a fire during Sunday lunch when half your staff are on break? What about that new extension you built last year?

2

Sharpen Decision-Making Under Pressure

When smoke fills a corridor, you don’t have time to check the manual. Your staff needs to make fast, coordinated decisions based on training and muscle memory.

3

Find the Gaps Before They Matter

Discovering problems in a conference room means you can fix them immediately. These exercises help you assess preparedness in a risk-free environment.

Scenario Complications to Test

“The fire alarm in Zone 2 isn’t sounding.”
“A resident in Room 12 is refusing to leave.”
“The fire brigade is asking about your sprinkler system; who has that information?”

These scenarios quickly reveal whether your procedures hold up under pressure. And it’s far better to discover communication breakdowns or unclear responsibilities during a simulation than during an actual emergency.

What Staff Learn Through Tabletop Exercises

  • Prioritise actions when multiple things are happening at once
  • Adapt when Plan A isn’t working
  • Communicate decisions clearly and quickly
  • Work together under time pressure

🔍 Real Discoveries from Tabletop Exercises

🔐 A nursing home team realised the emergency response plan was locked in a cupboard and only the managers had the key.
💻 One team found their list of residents who needed evacuation assistance was stored only on the office computer, which would be inaccessible if that wing were evacuated.
🔧 Another group discovered that no one could tell the fire brigade where the sprinkler shut-off valve was located.

These aren’t minor issues; they’re potential life-safety problems. But discovering them in a conference room means you can fix them immediately.

How Tabletop Exercises Fit Your Overall Fire Safety Strategy

Don’t think of tabletop exercises as a replacement for anything you’re already doing. They’re an addition that makes everything else work better.

The Three Layers of Fire Safety

1
Physical Protection
Fire doors, alarms, sprinklers, emergency lighting (required by Technical Guidance Document B)
2
Written Plans
Your Emergency Response Plan, evacuation procedures, and staff duties
3
People Preparedness
Training, drills, and exercises to ensure staff can execute those plans

Tabletop exercises bridge the gap between layers 2 and 3. They ensure your written plans actually translate into effective action by real people in crisis situations.

Working Alongside Physical Drills

Physical evacuation drills are essential; you need that hands-on practice. But they have limitations:

🏃 Physical Drills

  • Disruptive to residents and operations
  • Time-intensive to organise
  • Limited to specific scenarios
  • Test physical skills (using extinguishers, moving residents)

🧠 Tabletop Exercises

  • Explore more scenarios more frequently
  • Include management and external partners
  • Focus on decision-making and coordination
  • Test thinking skills (prioritising, communicating, adapting)

Use both together: drills for physical skills and tabletops for thinking skills.

Meeting Your Legal Obligations

Running tabletop exercises isn’t just good practice. It helps you comply with multiple legal and regulatory requirements:

Your Step-by-Step Guide to Running a Successful Tabletop Exercise

1
Before the Exercise

Set Clear Objectives

What do you want to test? Be specific:

  • “Test night shift response to a bedroom fire”
  • “Practice communication between nursing and maintenance during evacuation”
  • “General fire preparedness” (too vague)

Create a Realistic Scenario

Develop a detailed, plausible scenario for your facility:

  • Where does the fire start? (kitchen, resident room, electrical room?)
  • When? (shift change, middle of night, during mealtime?)
  • What complications arise? (blocked exit, alarm malfunction, missing resident?)
Example: “It’s 3 PM on a Tuesday. A small fire starts in the kitchen due to unattended cooking. Smoke begins entering the dining room where 15 residents are having their tea.”

Invite the Right People

Include anyone with a role in fire response:

  • Person in Charge (PIC)
  • Clinical Nurse Managers (CNMs)
  • Healthcare Assistants (HCAs)
  • Maintenance/Facilities
  • Health & Safety Coordinator

Also assign:

  • A facilitator to present the scenario and guide discussion
  • A recorder to take notes on decisions and issues

Gather Your Materials

Have on hand:

  • Your Emergency Response Plan
  • Facility floor plans
  • Emergency contact lists
  • Fire alarm panel information
2
During the Exercise

Set the Ground Rules

Start by explaining:

  • Speak up if you’re unsure about anything
  • This is a no-blame learning exercise
  • Everyone should participate
  • The scenario is fiction, but treat it as real

Walk Through the Scenario

The facilitator presents the situation in stages:

“It’s 3 PM. You smell smoke coming from the kitchen. What’s your first action?”
[Team discusses]
“Okay, five minutes have passed. The fire alarm is now sounding. Smoke is visible in the dining room. What happens next?”

Keep the discussion moving. Ask probing questions:

  • “Who’s calling 112?”
  • “What are you telling the residents?”
  • “The fire brigade just arrived. What information do they need?”

Inject Realistic Complications

Add challenges to test adaptability:

“The usual exit route is blocked by smoke.”
“A resident is refusing to leave.”
“You can’t use the phone because the alarm is too loud.”

These curveballs reveal whether your team can think on their feet.

3
After the Exercise

Debrief Immediately

This is the most crucial part. Ask:

  • What went well?
  • What was confusing?
  • Did everyone understand their roles?
  • Where did communication break down?
  • What surprised you?

Keep it constructive, not critical. You’re looking for learning, not blame.

Document Everything

Write up a simple report with:

  • The scenario you used
  • Who participated
  • What you learned (strengths and weaknesses)
  • Specific action items to address gaps

Example Action Items

Issue: Staff unsure where the gas shut-off valve was
Action: Show all staff and instruct them how to operate the gas shut-off valve by end of month
Responsible: Maintenance Manager

Follow Through

Assign owners and deadlines to each action item. Track progress. Some fixes are quick (update the contact list today); others require planning (budget for an additional fire panel on the first floor next quarter).

Most importantly: communicate changes to all staff, even those who didn’t attend the exercise.

Make It Regular

Don’t let this be a one-time event.

Recommended Schedule

  • At least annually (more often if you have high turnover or facility changes)
  • Between your physical drills
  • With different scenarios each time
  • Covering different shifts and locations

Variety keeps everyone sharp and ensures comprehensive preparedness.

The Bottom Line

  • Fire emergencies in nursing homes are every manager’s worst nightmare. But with proper preparation, your team can respond effectively and protect your most vulnerable residents.
  • Tabletop exercises are a low-cost, high-impact way to build that preparation. They require minimal resources, just a meeting room and a couple of hours of staff time, but they yield invaluable insights that could save lives.
  • More importantly, they create a culture of safety. When staff regularly practice emergency scenarios, they feel more confident. When managers regularly test their plans, they find and fix problems proactively.
  • Start simple. Choose one realistic scenario. Gather your key people. Talk through what you’d do. You’ll be amazed at what you discover.

Ready to Get Started?

If you need help designing scenarios or facilitating your first tabletop exercise, consider working with the fire safety consultants at Phoenix STS who specialise in healthcare settings.

But don’t wait for perfection. Your first exercise can be simple and still be valuable. The important thing is to start building this crucial habit into your safety management routine.

Contact Phoenix STS

Disclaimer

This article is provided for general informational and educational purposes only. While every effort has been made to ensure accuracy, this content does not constitute legal, regulatory, or professional advice. Fire safety requirements may vary depending on your specific circumstances, building type, and applicable regulations. Always consult with qualified fire safety professionals and refer to current legislation, including the Fire Services Acts, Safety, Health and Welfare at Work Act 2005, HIQA standards, and Technical Guidance Document B, for guidance specific to your facility. Phoenix STS accepts no liability for any actions taken or not taken based on this article.

About the Author

Patrick McDonnell (BEng Fire Engineering, F.IIRSM, M.IFSM, CMIOSH, MIHEEM, M.NFPA) is CEO of Phoenix STS and a Certified Member of the Institution of Occupational Safety and Health (IOSH). With extensive expertise in fire engineering and healthcare fire safety compliance, Paddy specialises in helping Irish nursing homes and designated centres meet HIQA Regulation 28 requirements.

As a Fellow of the International Institute of Risk and Safety Management and Member of the National Fire Protection Association, Paddy delivers CPD-accredited training programmes and conducts fire risk assessments to PAS 79:2020 standard across Ireland. His work focuses on practical, evidence-based solutions for healthcare facilities, particularly in nursing home fire safety management and emergency evacuation planning.

Paddy is registered with the National Fire Risk Assessors Register (NFRAR) and contributes to advancing fire safety standards through professional development initiatives and industry collaboration.

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