A disaster waiting to happen: the Grenfell tower Inquiry

The long-awaited Phase 2 report from the Grenfell Tower Inquiry has concluded that the devastating fire that killed 72 people on 14 June 2017 was the culmination of decades of failure by central government and other bodies responsible for the safe use of combustible materials in high-rise residential buildings.

Organisations contributed to the disaster ‘in most cases through incompetence but in some cases through dishonesty and greed’, said Inquiry chairman the Rt Hon Sir Martin Moore-Bick.

The seven-volume report identifies the many failings of a wide range of institutions, entities and individuals that together resulted in the Grenfell Tower fire. It makes recommendations that aim to ensure such as Grenfell never happens again.

The report’s authors were scathing of the government from 1991 to 2017, saying it had many opportunities to identify the risks posed by use of combustible cladding panels and insulation. It said the Department for Communities and Local Government (now the Ministry of Housing, Communities and Local Government) was aware of the risks but did nothing, despite what it knew.

For example, the department failed to act on the results of a large-scale test in 2001 involving aluminium composite panels with unmodified polyethylene cores, which burned violently.

The report said the department knew that Approved Document (AD) B, governing fire safety, was unclear and not properly understood. And, by February 2016, it had become aware people were worried that combustible insulation and aluminium composite material (ACM) panels with unmodified polyethylene cores were being used on high-rise buildings.

Of the British Research Establishment (BRE), the report said that, from 1991, much of its work on testing the fire safety of external walls was marred by ‘unprofessional conduct, inadequate practices, a lack of effective oversight, poor reporting and a lack of scientific rigour’. It said weaknesses in how the BRE carried out tests in accordance with BS 8414, exposed it to unscrupulous product manufacturers.

The report was scathing of both the makers of the rainscreen cladding panels and insulation, which it said engaged in deliberate and sustained strategies to manipulate and mislead the market, and certification bodies. It said the British Board of Agrément (BBA) and Local Authority Building Control, failed to ensure product certificates were accurate and based on test evidence.

The inquiry found that, from 2007 to 2017, Arconic Architectural Products had deliberately concealed the true danger of using Reynobond 55 PE in cassette form, particularly on high-rise buildings. It said it caused the BBA to make statements on the certificate that Arconic knew were false and misleading.

The Royal Borough of Kensington and Chelsea (RBKC) and the Tenant Management Organisation (TMO) were responsible for managing fire safety at Grenfell and the report found there were chronic and systematic failings in the TMO’s management of fire safety and an absence of rigorous scrutiny by RBKC of TMO’s health and safety obligations.

Despite fire safety strategy being recommended by an independent fire safety consultant in 2009, no strategy was approved by the time of the fire. The report found the TMO’s fire assessor was not qualified for the role, and failed to take action in response to risks identified.

The choice of combustible materials for the cladding, said the report, resulted from errors caused by the incompetence of organisations and individuals involved in the refurbishment. It said architect Studio E, contractor Rydon and cladding subcontractor Harley Facades took a ‘casual approach to contractual relations’.

Everyone involved in the choice of the materials for the external wall thought responsibility for their safety lay with someone else, said the report, and that the risks of using combustible materials in the external walls of high rises were well known.

The report said Studio E was responsible for the design of the external wall and choice of materials and that: ‘[Its] failure to recognise that ACM was dangerous and to warn the TMO against its use represented a failure to act in accordance with the standard of a reasonably competent architect.’

The report said the architect ‘bears a very significant degree of responsibility for the disaster’.

Rydon and Harley were also said to bear considerable responsibility as they both gave inadequate thought to fire safety and neither had sufficient knowledge of AB.

The report went on to criticise fire engineer Exova, saying it bore a ‘considerable responsibility for the fact that Grenfell Tower was in a dangerous condition on completion of the refurbishment.’ It said the firm had failed to prepare a final version of the fire safety strategy.

Recommendations

Chief among the recommendations is the call for a single, independent body that would report to a government minister responsible for building safety. The proposed body would have a remit that goes beyond the existing Building Safety Regulator.

Its responsibilities would include the regulation of construction products, testing of materials for fire safety, the regulation of building control, accreditation of fire risk assessors and licensing of contractors working on HRBs.

It said the new regulator would enable information to be shared more quickly and more effectively and policy to be developed ‘in a holistic and coherent way’.

The report recommends that statutory guidance generally, and AB in particular, be reviewed and a revised version published as soon as possible. It also said new guidance should have a clear warning saying that compliance with the guidance document AD B, does not necessarily mean compliance with Building Regulations.

The report recommends an urgent review of the definition of HRBs as being either at least 18m tall or having seven storeys and containing at least two residential units. It says this definition is ‘arbitrary’ and unsatisfactory.

The report recommends that the profession of fire engineer be recognised and protected by law, and an independent body established to regulate the profession. It also recommends the AD make it clear that a qualified fire engineer calculate the likely rate of fire spread and the time required for evacuation.

The report said a fire safety strategy should be produced by a registered fire engineer and submitted with building control applications at Gateway 2 for HRBs and for it to be re-submitted at the stage of completion at Gateway 3.

CIBSE reaffirmed its commitment to building safety following the report’s publication. CIBSE’s technical director, Dr Anastasia Mylona, said: ‘As the report highlights systemic failures, CIBSE remains committed to driving the necessary reforms in building and fire safety engineering practices.’