Background The rescue act 2011 in Finland stresses that the responsibility of fire safety is on building owners and service providers. The regulation is justifiable, because people in vulnerable positions, for example elderly and disabled, have an increased risk being fire victims.

The aim of this study was to investigate the implementation of rescue service act among service providers in residential, institutional and home care facilities and to monitor changes from 2013 to 2015.

Methods Online surveys on fire hazard assessment and risk management practices were done in 2013 and 2015. Respondents were managers of residential, institutional and home care facilities for the vulnerable people.

Information of the facilities was obtained from the nationwide Register of Institutions in Social Welfare and Health Care. The study sample was systematically selected (every other) and it consisted 1605 organisations.

Results In 2013 93% of institutional and 95% residential units had written guidelines to ensure fire safety. In 2015 the proportion has decreased to 84 in institutional and 88% in residential units. At home care written guidelines had less than 50%. The accident prevention guidelines had increased in institutional units from 66% to 74% and in residential units from 66% to 77%. At home care the guidelines had 50%. Safety guidelines in general e.g. crime prevention has also decreased and was now less than 50%, at home care only 22%. Patient and residential safety guidelines were increased only at home care from 55% to 60%.

Conclusions The organisations have increased their preparedness for fire risk with sprinklers. But at the same time they made less written guidelines to prevent to fire. Fire risk assessment and management practices have improved only in home care. In IR-units the situation seems to be weaker than in 2013. The situation is not acceptable and the reasons should be diagnosed.