In nursing home fire risk assessments, one statement comes up again and again: if matches and lighters are taken away from residents, HIQA will say it is a breach of their human rights.

It is usually said with confidence. It is also often said without enough evidence.

Residents in nursing homes do have rights. They have rights to dignity, autonomy, privacy, choice and control over day-to-day life. Those rights matter, and they should not be brushed aside because a person lives in a regulated care setting. But those rights do not create an unrestricted right to personally keep matches or a lighter in every circumstance.

The better question is not whether a resident has a human right to a lighter. The better question is whether a resident who smokes is being supported to smoke safely, proportionately and with proper regard for the safety of other residents, staff and visitors.

A nursing home may need to facilitate a resident who wishes to smoke. It may also need to provide access to a means of lighting a cigarette. That does not mean the resident must personally hold matches or a lighter, particularly where that creates a foreseeable ignition risk in a building occupied by people who may be frail, confused, oxygen-dependent, bed-dependent, using emollients or unable to evacuate without support.

The purpose of a fire risk assessment is not to remove choice for the sake of control. It is to identify foreseeable hazards and advise management on proportionate controls. Portable ignition sources are foreseeable hazards. They can be lost, dropped, shared, hidden, misplaced or used by someone who should not have access to them. That risk cannot be dismissed by using the language of rights without also considering the duties that sit alongside those rights.

The Irish legal and regulatory starting point

The Health Act 2007 (Care and Welfare of Residents in Designated Centres for Older People) Regulations 2013, as amended, place clear obligations on registered providers. Regulation 9 deals with residents' rights, including privacy, dignity, choice and participation in life within the centre. Regulation 12 deals with personal possessions, but it is qualified. Residents should have access to and retain control over personal property in so far as is reasonably practicable.

That wording matters. It does not support casual or arbitrary removal of residents' belongings. It also does not support the idea that every item must remain in a resident's possession regardless of risk.

Regulation 26 requires a risk management policy covering hazard identification, risk assessment, control measures and learning from serious incidents or adverse events. Regulation 28 requires adequate precautions against the risk of fire, suitable fire equipment, staff training, fire prevention, emergency procedures, evacuation arrangements and procedures to be followed if a resident's clothes catch fire.

Regulation 5 is also relevant where a smoking arrangement forms part of a care plan. Care plans must be formally reviewed at intervals not exceeding four months and revised where necessary, after consultation with the resident and, where appropriate, the resident's family.

The Fire Services Act 1981 places duties on persons having control over relevant premises to take reasonable measures to guard against fire and, as far as reasonably practicable, to ensure the safety of persons on the premises if fire occurs. A nursing home cannot rely on rights language while ignoring the foreseeable fire risk created by uncontrolled ignition sources.

Section 47 of the Public Health (Tobacco) Act 2002, as revised, does not apply to a nursing home. That is not the same as saying a resident can smoke anywhere, at any time, with any ignition source. It simply means the general statutory smoking prohibition does not apply to nursing homes in the same way. The provider still has to manage smoking safely.

Where a capacity, support or restrictive-practice issue arises, the Assisted Decision-Making (Capacity) Act 2015 is also relevant. Its guiding principles support a necessary, proportionate and least-restrictive approach, with respect for dignity, privacy, autonomy, will and preferences. That points towards a balanced position: facilitate the resident where possible, restrict only where necessary, and record the reasoning.

What HIQA guidance actually points towards

HIQA's Fire Safety Handbook, updated on 31 March 2025, is directly relevant. It says that, in so far as possible, fire precautions should not unnecessarily reduce residents' quality of life. It gives smoking as an example: adult residents should be facilitated to smoke tobacco in designated smoking areas if they wish, with appropriate controls in place.

The Handbook does not say residents must personally retain matches or lighters. It says smoking should be included in risk management procedures and the fire safety strategy. It also says that, where smoking is permitted, there should be a safe, suitably located and risk-assessed designated smoking area. For each resident who smokes, appropriate assessments and care plans should be prepared.

The detail is important. Staff should be trained to identify unsafe smoking practices, increased risk from an adverse health event and unsafe use of lighters or matches. Care plans should identify the level of assistance or supervision required and any protective equipment, such as a large smoking blanket or smoking apron.

That is a long way from the simple claim that residents must keep lighters. HIQA guidance points towards assessment, supervision, care planning and controlled arrangements. It supports safe access to smoking where smoking is permitted. It does not support unmanaged possession of ignition sources.

Access is not the same as possession

This distinction should be clear in a fire risk assessment. A resident may need access to smoking. A resident may need access to a way of lighting a cigarette. That does not automatically mean the resident must personally possess matches or a lighter in a bedroom, pocket, handbag or drawer.

Access can be provided through staff assistance, a controlled lighter in the designated smoking area, a wall-mounted lighter, or another site-specific arrangement. Possession means the resident retains the ignition source personally, potentially outside the smoking area and outside supervision.

Those two positions carry very different levels of risk. A portable lighter can move quickly. It can be lent to another resident, left in a chair, dropped into bedding, taken into a bedroom, hidden from staff or used by someone with a known smoking restriction. A resident who is safe to smoke under supervision may not know that another resident is not safe to smoke independently.

The fire risk assessment should therefore advise management to make an individual decision for each resident who smokes. That decision should record whether the resident may retain cigarettes, retain matches or a lighter, access a lighter only in the smoking area, use a wall-mounted lighter, be assisted by staff, smoke independently, smoke only under supervision, or use a smoking apron or other protective equipment.

The assessment should also identify review triggers. A smoking risk can change after a fall, infection, medication change, cognitive deterioration, confusion, reduced dexterity, oxygen therapy, emollient use, alcohol use, scorch marks, dropped smoking materials or unsafe disposal. A previous safe arrangement may no longer be safe.

The assessor advises; the provider decides

A fire risk assessor should not try to write a resident's care plan or make a rights decision on behalf of the provider. That is for the registered provider, person in charge and care team, with the resident involved as far as practicable.

The assessor's role is to identify the fire hazard, explain the risk, advise on proportionate controls and make clear where the current arrangement is weak. For example, the assessor may say that unrestricted personal possession of a lighter is not suitable for a particular resident because of known incidents, supervision needs or the location of oxygen. Management then needs to record the agreed care-plan arrangement and any restrictive-practice consideration.

This protects both sides of the decision. From a rights perspective, the resident is not restricted informally or without review. From a fire-safety perspective, staff are not left applying unwritten rules differently from shift to shift.

Smokers' aprons need proper control

Smokers' aprons are often treated too casually. They can be left hanging in a smoking room, shared by several residents and rarely linked to a cleaning or inspection record. That is a weak control.

A smoking apron is protective equipment in practical terms, even if the workplace PPE regulations are not being applied directly to a resident in the same way they apply to an employee. The same management discipline still makes sense: the item should be selected for the risk, fit the person, be maintained, be stored cleanly and not create hygiene problems through shared use.

Where a resident needs a smoking apron, the centre should consider individual allocation. One communal apron may not fit different residents properly. It may not cover the lap, sleeves or upper body exposure identified in the assessment. It may also create dignity and infection-prevention concerns.

Management should hold the manufacturer's instructions, laundering requirements and any performance information supplied with the product. Some products depend on surface treatment to achieve flame-retardant performance. If laundering affects performance, and laundering is not recorded, the control cannot be relied upon with confidence.

A workable system should show who the apron is allocated to, how it was fitted, how it is laundered, how often it is inspected, where it is stored and when it should be removed from service. If that evidence cannot be produced, the apron should not be treated as a robust control.

Fire blankets should not become the whole plan

HIQA's Fire Safety Handbook includes fire extinguishers, fire blankets, firefighting equipment, call alarms and other controls in relation to smoking areas. That list is useful, but it should not replace a competent risk assessment.

A fire blanket can create false confidence if the procedure assumes staff will wrap a resident whose clothing is on fire. That is a difficult, high-risk intervention. The resident may be moving, panicking, seated awkwardly, in a wheelchair, frail, confused or unable to follow instructions. Staff may be alone. They may not be physically able to apply the blanket safely. The blanket may expose staff to burns or delay a simpler response.

Regulation 28 requires staff training in the procedures to be followed if a resident's clothes catch fire. The practical question is whether the centre can train relevant staff, including night staff, agency staff and new staff, to respond safely and consistently.

A suitable water-based extinguisher, selected by a competent person for the specific location and hazards, may be a more practical control in many smoking-area scenarios. Staff can be trained to use it from a safer distance. The method can be standardised and audited. That does not mean a fire blanket can never be present. It means the centre should not build the entire emergency response around an intervention staff cannot reliably deliver.

The procedure should cover raising the alarm, stopping the resident from moving if safe, using suitable firefighting equipment where trained and safe, cooling and first aid, summoning medical assistance, moving other residents from danger, preserving the scene and reviewing the smoking assessment before smoking recommences.

Wall-mounted lighters need assessment, not assumptions

Wall-mounted lighters divide opinion. They create a fixed ignition source in a smoking area, so they must be assessed. They can also reduce risk by removing portable matches and lighters from circulation.

The issue is not simply whether a wall-mounted lighter exists. The issue is how the smoking area is supervised and managed. If a resident who requires supervision can access a wall-mounted lighter without staff knowing, the problem is not just the lighter. The problem is that the resident can smoke without the supervision recorded in their care plan.

A wall-mounted lighter should be assessed as part of the wider smoking system. Is it in the designated smoking area only? Can residents enter that area without staff knowledge? Can staff isolate or control the lighter? Is it close to furniture, waste, oxygen or other hazards? Does it reduce portable lighters in bedrooms and communal rooms? Do staff understand who may use it independently and who may not?

The correct answer will depend on the building, resident profile, staffing, supervision model and incident history. It should not be installed casually. It should also not be blamed for a wider supervision failure without looking at the whole system.

Restrictions must be recognised

If staff hold a resident's cigarettes, lighter or matches, that arrangement may be a restrictive arrangement and may need to be considered within the centre's restrictive-practice governance. That does not make it wrong. It means it should be recognised, justified, proportionate and reviewed.

The weakest position is informal control. For example, staff usually keep the lighters, but there is no assessment, no care-plan entry, no resident consultation, no review date and no record of how the resident can access smoking when they wish.

A better record states the resident's preference, smoking pattern, capacity or support needs where relevant, specific fire risks, cigarette and lighter access, supervision requirements, protective equipment, review date and evidence that the resident or representative has been involved where appropriate.

There is also a privacy point. Smoking assessments may include health information, cognition, behaviour, supervision needs and capacity-related information. The information should be available to staff who need it for care and safety, but it should not be displayed casually or discussed unnecessarily.

What a defensible nursing home system looks like

A defensible policy is usually simple: residents who smoke should be facilitated to smoke safely where smoking is permitted, but personal possession of matches or lighters should not be assumed. Access to a means of lighting should be provided through a risk-assessed arrangement that reflects the resident's capacity, dexterity, cognition, mobility, smoking history, supervision needs and the safety of others.

Every resident who smokes should have a current smoking risk assessment. The assessment should address ignition sources, supervision, smoking location, protective equipment, call-bell access, clothing, seating, ash disposal, oxygen, emollients and previous incidents.

The care plan should be specific. Avoid vague wording such as staff to monitor. State who holds cigarettes, who holds the lighter, how the cigarette is lit, whether the resident may smoke independently, what supervision means in practice and what should happen if the resident's risk changes.

Smoking areas should be checked and kept free from combustible clutter. Ashtrays should be suitable and emptied safely into metal containers. Call bells should be accessible. Firefighting equipment should be appropriate for the area. Scorch marks, burn marks or unsafe disposal should be treated as incident learning, not normal wear and tear.

Relevant staff should be trained in the smoking arrangements and in the clothing-fire response. Training should include what staff should do, what they should not attempt, when to raise the alarm, how to use selected equipment where trained, and how to report unsafe smoking or unauthorised ignition sources.

The practical evidence is straightforward. Management should be able to show current assessments, care plans, apron records where used, staff training, smoking-area checks, incident reviews and actions completed. That moves the discussion away from opinion. The centre either has the evidence or it does not.

Conclusion

The phrase residents have a human right to matches and lighters should not be accepted at face value. It is too broad and too imprecise.

A more accurate position is this: residents have rights to autonomy, dignity and choice. Residents who smoke should be facilitated to smoke safely where smoking is permitted. Those rights must be balanced against the safety and rights of other residents, staff and visitors. In a nursing home, unrestricted possession of matches or lighters can create a foreseeable fire risk.

The right answer is not an unmanaged ban. It is also not unmanaged possession. The right answer is controlled access, individual assessment, documented care planning and competent fire-safety management.

For nursing home owners and persons in charge, the test is practical. If a resident's lighter is restricted, can management show why the restriction is necessary, proportionate and reviewed? Can management also show that the resident still has safe, dignified and timely access to smoking where smoking is permitted?

If the answer to both questions is yes, the centre is in a much stronger position. If the answer is no, the problem is not HIQA. The problem is governance. The fire risk assessment should be clear: control the ignition source, do not remove the resident's dignity, and do not confuse access to smoking with an unrestricted right to possess matches or lighters.

Related Phoenix STS pages

Fire Safety in Nursing Homes: Guide for Irish Providers - connect smoking controls with wider nursing home fire safety management.

HIQA Regulation 28 Fire Safety - understand what designated centres need to evidence around fire precautions and staff training.

Fire Extinguishers vs Fire Blankets for Clothing Fires - review the practical limits of fire blankets and the need for realistic clothing-fire response planning.

Nursing Home PAS 79-1 Fire Risk Assessment - connect ignition-source controls with nursing home fire risk assessment, compartmentation and evacuation planning.

Healthcare Fire Safety Consultancy - connect resident smoking controls with wider healthcare fire safety strategy, risk assessment and management arrangements.

Important note

This article is provided for general information only. It is not legal advice and does not replace a site-specific fire safety, health and safety, training or professional assessment for a particular premises, organisation or care setting.