A tabletop exercise is one of the most useful fire safety tools a nursing home can use, but only when it is done honestly. It is not a paperwork exercise, a quiz, or a way of avoiding practical fire drills. It is a structured discussion that tests how staff would think, communicate and make decisions when a fire scenario starts to unfold.

That matters because a real fire in a nursing home is rarely a simple evacuation. Residents may be asleep, confused, unable to walk, dependent on oxygen, anxious, bariatric, in pain, or unable to understand the alarm. Staff may be working with reduced numbers at night. Corridors may be busy with equipment. The nearest compartment may not be available. A resident may refuse to move. A fire door may fail to close. A tabletop exercise lets managers and staff work through those problems before they are under pressure.

The value is not in getting every answer perfect. The value is in finding the weak points while there is time to fix them. If a tabletop exercise reveals that staff are unclear about who calls the fire service, where evacuation equipment is kept, how to prioritise residents, or what to do when the first route is unavailable, that is useful learning. It is much better to discover those gaps during a discussion than during an alarm activation at 3am.

For Irish nursing homes and designated centres, tabletop exercises should sit beside fire drills, staff training, fire risk assessment, resident evacuation planning and routine checks. They are not a substitute for any of these. They are a way of joining them together.

What a tabletop exercise is

A tabletop exercise is a facilitated scenario. Staff sit around a table, or meet in a training room, and are given a realistic fire situation. The facilitator then asks what they would do, what information they need, who they would tell, what equipment they would use, which residents would be moved first, and what problems might arise.

The discussion should be practical and building-specific. A useful scenario names the area, the time of day, the staffing level, the residents affected and the first pieces of information available. It should not be so vague that everyone can give a safe textbook answer. The point is to make people think about their own centre.

For example, a scenario might begin with smoke reported in a bedroom in a protected compartment at night, with two care staff and one nurse on duty in that area. One resident is on oxygen, one uses a ski sheet, one is mobile but confused, and the corridor has a hoist parked near the cross-corridor doors. That scenario immediately raises real questions about first response, door control, evacuation sequence, communication, equipment and staffing.

A tabletop exercise should feel calm, but not comfortable. It should be safe enough for staff to speak honestly, while still challenging enough to reveal uncertainty. If everybody simply agrees that they would follow the fire procedure and the exercise ends there, it has not gone far enough.

The Irish compliance position

Regulation 28 requires registered providers to take adequate fire precautions, maintain fire equipment and means of escape, provide suitable training, and ensure through fire safety management and drills that staff and, as far as reasonably practicable, residents are aware of the procedure to be followed in the case of fire. It also requires arrangements for evacuation and safe placement of residents where necessary. Regulation 28 is therefore concerned with whether arrangements work in practice, not just whether a policy exists.

The Health and Safety Authority's emergency escape and firefighting guidance also points employers towards emergency procedures, training, drills, adequate means of escape, maintenance and consideration of people who may need assistance. In a nursing home, that assistance is central to the fire strategy.

HIQA's Fire Safety Handbook is particularly relevant because it expects providers to use fire drills as a quality improvement tool, to record the scenario and result, and to review whether procedures and strategy need to change. It also encourages providers to identify difficult evacuation situations and ensure procedures are realistic. A tabletop exercise is a practical way of doing that thinking before, between and after live drills.

What tabletop exercises can test

A well-designed exercise can test the parts of the response that are hard to see in an ordinary drill. It can test decision-making, communication, escalation, role allocation, resident prioritisation, use of compartments, assumptions about night staffing, and what staff would do if the first plan does not work.

It can also test the link between documents. The fire procedure may say one thing, the resident's care plan another, the personal emergency evacuation plan another, and the fire risk assessment may contain assumptions that staff have never seen. A tabletop exercise brings those pieces into the same conversation. If they do not line up, that is a finding.

The exercise can also test judgement. Staff may need to decide whether to close a bedroom door, whether to begin moving the nearest resident, whether to wait for more information from the fire alarm panel, whether to use a ski sheet, whether to move mobile residents first, or whether a resident who is refusing to move needs a different approach. These decisions are not always solved by memorising a script.

This is where tabletop work is especially useful for managers. It shows whether staff understand why the procedure is written as it is. Staff who understand compartmentation, door control, smoke spread, resident dependency and evacuation priority are more likely to make sound decisions if the situation changes.

What tabletop exercises cannot prove

A tabletop exercise cannot prove that staff can physically evacuate residents. It cannot prove that an evacuation chair works on the stairs, that a ski sheet will pass through a tight doorway, that night staff can move a bariatric resident, or that a corridor will remain clear. Those points need practical checks, drills, equipment trials and fire risk assessment.

It also cannot be used to claim that an unrealistic evacuation time has been achieved. Talking through a scenario is not the same as moving people, managing equipment, opening doors, communicating with residents and working through the actual route. Timings from tabletop exercises should therefore be treated with care. They may help identify a sequence, but they are not proof of evacuation capacity.

This distinction matters. Tabletop exercises are excellent for testing thinking. Drills and practical exercises are needed to test action. A strong fire safety programme uses both, then compares the learning from each.

Night staffing deserves separate attention

Night-time scenarios should not be treated as a minor variation of the day procedure. At night, residents may be asleep, agency or relief staff may be on duty, managers may be off site, and fewer hands may be available for progressive evacuation. The building is the same, but the response capacity is different.

A tabletop exercise should therefore ask what the night team can actually do first, who takes charge, how help is called, which residents are moved earliest, and how staff avoid leaving other residents unsupervised while responding to the fire area. If the answer relies on day staff or managers arriving before the first residents are protected, the plan is not strong enough.

Choosing the right scenarios

The best scenarios are based on the centre's real risks. They should come from the fire risk assessment, previous drills, incidents, near misses, resident dependency, staffing patterns and known weak points in the building. A generic scenario about a waste bin fire may be useful once, but it will not test the hardest parts of a nursing home evacuation strategy.

Useful scenarios include a bedroom fire at night, smoke in a corridor, a laundry fire, a fire in a kitchen, a resident smoking incident, oxygen involved in a room, alarm activation with no obvious fire, failure of a cross-corridor door to close, an unavailable compartment, a blocked route, a missing evacuation aid, a resident refusing to leave, or a simultaneous medical emergency during the fire response.

The scenario should include realistic constraints. Do not give staff perfect conditions. If the night shift normally has fewer staff, use that staffing level. If a compartment contains several high-dependency residents, include that detail. If certain rooms are awkward, use them. If staff regularly rely on one experienced person, test what happens when that person is not on duty.

This should be done fairly. The purpose is not to trap staff. The purpose is to test the system. If staff struggle, managers should ask whether the procedure, training, staffing, equipment, layout or communication arrangements are giving them enough support.

Who should take part

Tabletop exercises should include the people who would actually respond. That usually means nurses, healthcare assistants, household staff, maintenance where relevant, managers and the person in charge. Night staff should be included, because the hardest evacuation conditions often occur at night.

It is also useful to include different levels of experience. New staff may reveal gaps in induction. Experienced staff may know informal workarounds that are not written down. Managers may discover that the official procedure is not how the building is actually managed. That is exactly the sort of information the exercise should uncover.

The facilitator should understand fire safety in care settings, but should also be able to draw information from the group without turning the exercise into a lecture. A good facilitator asks clear questions, keeps the scenario moving and records actions. They should challenge unsafe assumptions without embarrassing staff.

Running the exercise

Start with the purpose. Staff should know that the exercise is about learning, not blame. Then describe the scenario in stages. Begin with the alarm or first report, ask what staff would do, then add new information as the situation develops. For example, the fire alarm panel shows a bedroom zone, smoke is seen under a door, one resident is missing from a lounge, or the nearest compartment is already occupied.

At each stage, ask practical questions. Who goes to investigate? Who stays with residents? Who calls the fire service? Who checks the alarm panel? Which doors should be closed? Which residents are moved first? What equipment is needed? Where is it stored? Who communicates with the nurse in charge? Who meets the fire service? What happens if the fire service is delayed?

The discussion should keep returning to the actual building. Use floor plans, compartment drawings, resident dependency information and equipment locations. If the group cannot answer a question without checking the building, that may be a useful action point.

Learning from case studies

Serious care-home fires show the same lessons repeatedly. Fire can develop quickly. Smoke spread can become the main threat. Doors and compartmentation matter. Staff may have only limited time to make early decisions. The fire service is essential, but it is not the provider's evacuation plan. The first actions by staff inside the centre can determine how many residents are protected before external help arrives.

Tabletop exercises should use those lessons carefully. The aim is not to frighten staff with extreme examples. The aim is to ask whether the centre's arrangements would hold up under pressure. If the scenario depends on the fire service arriving before residents are moved from immediate danger, the centre needs to review its assumptions.

The exercise should also challenge the idea that all residents can simply be evacuated from the building immediately. In many nursing homes, the realistic strategy is progressive horizontal evacuation, supported by compartmentation and staff action. Staff need to know what that means in practice, not just recognise the phrase.

Recording the findings

The record should be more than an attendance sheet. It should state the scenario, date, participants, key decisions discussed, problems identified, good practice observed, actions required, responsible person and target date. If the exercise identifies a serious gap, it should not wait for the next annual review.

Actions should be specific. 'Provide refresher training' may be too vague. Better actions might include relocating an evacuation chair, updating a resident's evacuation plan, adding night staff to the next drill, checking a door closer, revising the fire procedure for oxygen rooms, removing storage from a route, or arranging practical equipment training.

Managers should then close the loop. If the same issue appears in the next drill or tabletop exercise, the system has not learned. The purpose of the exercise is improvement, not a folder of completed forms.

How often should they be done

There is no single interval that fits every centre. A low-risk, stable service may need fewer tabletop exercises than a large or complex nursing home with high dependency, regular admissions, agency staff, building works or recent fire safety findings. The programme should reflect risk.

As a practical approach, many centres benefit from tabletop exercises between formal drills, after significant changes, after an alarm incident, after a poor drill, when new equipment is introduced, when dependency increases, or when managers want to test a specific scenario before running a practical drill. They are also useful for night teams because they can test thinking without creating unnecessary disturbance to residents.

Common mistakes

The first mistake is making the scenario too easy. If the answer is obvious, little is learned. The second is allowing one confident person to answer everything while quieter staff stay silent. In a real fire, the confident person may not be there. The third is treating the exercise as training only, without recording findings or changing the system.

Another mistake is separating the exercise from resident-specific planning. If the scenario involves a named bedroom or compartment, staff should know the evacuation needs of the residents in that area. If they do not, the action may be to improve handover, update records or make resident evacuation information more accessible.

The final mistake is using tabletop exercises to avoid difficult practical checks. If the exercise raises doubt about whether staff can move a resident, use equipment or clear a route, that doubt needs practical follow-up. A discussion is useful because it points to the work that must happen next.

How Phoenix STS can help

Phoenix STS can design and facilitate nursing home tabletop exercises that are specific to the building, residents, staffing and fire strategy. We use realistic scenarios to test decision-making, communication, progressive evacuation, equipment access, resident prioritisation and management oversight.

This work can be linked to fire risk assessment, fire safety training, fire drill review, evacuation planning and resident-specific evacuation arrangements. The outcome is a practical action list, not a generic certificate. The purpose is to help the centre understand what would happen in a difficult fire scenario and what needs to be improved before one occurs.

A good tabletop exercise makes the fire plan more honest. It shows where staff are confident, where they are uncertain, where the building helps, and where the procedure depends on assumptions that may not hold. That is exactly the information a nursing home needs before a real emergency tests the system.

Disclaimer

This article is general guidance only. It is not a substitute for a suitable fire risk assessment, competent fire safety advice, legal advice, resident-specific care planning or direct assessment of a designated centre. Each nursing home should assess its own residents, staffing, building layout, equipment, procedures and fire precautions.