Health and Safety

1. Introduction

Foster/residential homes should be safe, secure, provide a comfortable environment for children and protect children from harm or the risk of harm.

A Health and Safety checklist should be completed prior to placement and should be regularly updated. The Health and Safety checklist should additionally be updated when any structural work, or changes to the existing property are made. If foster carers move then a new Health and Safety checklist should be completed.

The Health and Safety standards of any second homes including holiday homes and caravans should also be considered if a child or young person is using these facilities.

Health and Safety Matters

More accidents happen when people are in a hurry, under stress, or in unfamiliar surroundings.

Falls are the most common cause of accidental injury to children and young people.

Many accidents can be prevented by moving or removing dangerous objects out of a child's reach.

Many childhood accidental injuries occur at home and in the garden. Ponds pose a particular risk for babies, toddlers and young children. Even a small amount of water can pose a risk to a small child.

95% of burns happen at home. Burns and scalds particularly affect babies and very young children, with scalds from hot drinks being the most common cause.

Children grow and learn new skills rapidly. It is important that the foster carers/residential staff who care for them know what risks each stage brings. It is impossible to childproof a home but knowledge of the potential for accidents and of effective safety measures can reduce the risk of serious injury.

Choking or poisoning risks for younger children needs to be considered. It is important for carers not to leave anything lying around which could be a choking or poisoning including hazards such as button batteries and small magnets. Children can also suffer strangulation from ribbons and cords that they get tangled in.

See Child Accident Prevention Trust website, Main causes of accident and injury.

The Risks to Children

It is important to know the child and ask about any risks before the child is placed. These risks should be detailed in the placement plan. A child or a young person placed may not have had much guidance around health and safety matters so it is imperative the carers keep a close eye on the child or young person initially to keep them safe from harm. Chronological age is not always an indicator of a child's abilities – other factors need to be considered around health and safety such as developmental delay, hyperactivity etc.

Any issues around self-harming should also be addressed in the placement plan with clear guidance around what items should be locked away such as medication, knives etc.

The Risks to Foster Children

There are number of reasons why children in foster carer are particularly at risk of accidents. Foster carer's own children will be aware of the potential hazards in their house, as they will have grown up with them. Most foster children joining the household will wish to investigate their new surroundings and the absence of good safety measures will increase the risk of injury.

It is important to know the child and ask about any risks before the child is placed. These risks should be detailed in the placement plan. A child or a young person placed may not have had much guidance around health and safety matters so it is imperative the foster carers keep a close eye on the child or young person initially to keep them safe from harm. Chronological age is not always an indicator of a child's abilities – other factors need to be considered around health and safety such as developmental delay, hyperactivity etc.

Any issues around self-harming should also be addressed in the placement plan with clear guidance around what items should be locked away such as medication, knives etc.

The Agency or the local authority should provide safety equipment to enable a foster carers to support a child or young person such as stair gates, cooker guards, fire guards, fire blanket.

2. Safety in the Home

There are a number of precautions which should be in place. The following is a basic guide:

Fire Precautions

• Install a smoke alarm on each floor of the home;
• Have a fire evacuation plan in place and this should be discussed with any child or young person in placement;
• Exit routes should always be kept clear of obstacles and keys should be accessible;
• Fire and rescue services can complete fire safety checks and are a valuable source of information;
• Attic rooms with one exit can be difficult and may need a smoke alarm;
• Does everyone know what to do in the event of a fire and no exit is possible - go into a room, shut the door, put a blanket at the door and call for help;
• Practice fire escape plan regularly.

Carbon Monoxide

Carbon monoxide (CO) cannot be seen, smelt or tasted so you do not know when it is present. Carbon monoxide is a poisonous gas that is produced by fossil fuel such as gas, coal, oil or wood burners.

A build up of carbon monoxide can be extremely dangerous and cause a variety of symptoms, or even death. Carbon monoxide monitors must be sited in the correct places such as near the cooker or gas fire. All heating and cooking appliances must be serviced regularly and a Gas Safety certificate must be in place. It must be marked down on the Health and Safety checklist that it has been seen.

Gardens and outside play

Good supervision is important when a child or young person is outside. Age and disability have to be considered in this judgement.

• All accessible areas should be safe and secure for all children and young people. Garden exits should be secure. Garden sheds should be locked and greenhouses and cold frames should be made of toughened glass to avoid injuries;
• All hazards should be reduced and appropriate storage for garden equipment and insecticides should be locked away;
• Water butts, ponds, hot tubs, swimming pools or streams should be netted, covered or fenced off;
• Extreme caution must be exercised when using barbecues; these should never be left unattended;
• Washing lines should be out of reach of children who this could be a hazard for;
• Any poisonous plants or trees should be identified and access to them restricted. The child or young person should be taught about the risks and avoid coming into contact with them. Otherwise the plants should be removed from the garden;
• Good supervision must take place in garden areas, including play equipment such as trampolines, sand pits etc. All equipment should be safe, well maintained and age appropriate.

3. Car Safety

Passengers must be carried safely and vehicles should not be overloaded. All passengers in the car must use seat belts or appropriate child restraints.

Cars must be well maintained, regularly serviced, adequately insured and covered by a current MOT certificate if the age of the car requires it. Adequate insurance should be in place for transporting children.

Car keys should be stored safety to avoid a child or young person taking a car or losing the keys.

4. General

• Matches, lighters and sharp knives should be stored safely;
• Bleaches, disinfectants, aerosol sprays and other dangerous substances must be kept out of the reach of small children, or locked away. Cupboard locks should be used - age appropriate;
• Medicines, tablets, cigarettes and alcohol should also be securely stored in a locked cupboard or cabinet;
• Stair gates must be fixed securely where appropriate;
• Windows should be fitted with lock restrictors and keys should be kept at hand in case of emergencies;
• Pull cords on window blinds can be a hazard to children and therefore should be reduced in length.
• Protection covers should be used for plug sockets.

5. Hygiene

Standards around hygiene, cleanliness and infection control should be maintained.

The foster carer/Home should advise the local authority if there is an issue around infection control within the household such as Covid-19 or scabies, and should seek advice about whether this needs to be reported to the Health Protection Agency to seek further advice around treatment and isolation.

If a carer or child or young person has Hepatitis B then measures need to be put in place to prevent the spread of it such as not sharing towels, care needs to be taken when cleaning wounds, use of gloves, etc.

6. Diet, Nutrition and Allergies

Children should be provided with healthy eating and offered a varied and balanced diet, avoiding any food which the child may be allergic to. Good hygiene standards are particularly important with food hygiene.

The Care and Placement Plan and Health Care Plan should contain the following:

• All known allergies and associated risks including spotting the signs and symptoms of an allergic reaction and anaphylaxis for the child/young person;
• Preventative measures should be detailed in the Plan - for example following good hygiene routines in terms of utensils and crockery, hand washing, avoiding cross contamination in the kitchen area, checking labels for allergens and any agreed allergen avoidance in the placement;
• Actions to take when a young person has an allergic reaction. The plan should describe exactly what to do and who needs to be contacted in the event of an emergency. For example, when to use an Epi Pen and calling for an ambulance;
• Staff/foster carers should be aware of the Plan and should have been trained to administer an Epi Pen by a suitable qualified health professional;
• The child/young person should be educated around their allergies and what to do in an emergency - a young person may be able to self-administer their own EpiPen or take antihistamines. If this is the case this should be recorded;
• Medication should be easily accessible so staff/foster carers and/or the child/young person can access their medication in an emergency situation;
• A record should be kept of each episode and any medication given should be recorded. For further information see the NHS website or see Allergy UK Website.

7. Online Safety

There is a correlation between online risk and real-life vulnerability that means care-experienced children have an increased risk of encountering online harm. Young people with prior off-line vulnerabilities are at greater risk of harm online than children and young people with none. For example, young people with eating disorders, looked after children and young people and those with communication challenges may use technology to communicate and socialise in ways they cannot achieve without it.

Carers need to be sensitive to these risks and appreciate that the online experience will be different for each child. Completely denying online access to children can be unhelpful (e.g. loss of opportunity to develop resilience, risk of alienation, risk of turning to secret devices).

Using the Digital Passport, carers should endeavour to have an open discussion with children and young people about their online activity and keeping safe. These discussions should also involve the child’s social worker and cover:

• What Internet connected devices is the child bringing with them?
• Does the child have a mobile phone?
• Does the child have any existing social media accounts?
• If the child is gaming, are they talking to players on other platforms?
• Does the child have their own email address through which their social worker can contact them?
• Is the child part of an existing Microsoft family account, perhaps for Xbox or a Google family link account?
• Are there any risks or vulnerabilities identified with the child’s online behaviour or experience?

For further advice and guidance, see Internet Matters or see Refuge and Risk - Life Online for Vulnerable Young People.

8. Building and Contents

Foster/residential homes must be kept in good repair, adequately insured and safe and hazard-free for children and young people. The home should be warm, adequately furnished and decorated.

All fixtures and fittings should meet regulated standards. All glass that can be reached by children should be toughened to relevant British Safety Standards, or fitted with protective safety film.

Electrical equipment such as portable heaters should be well maintained and in good working order.

Gas fires, boilers and all other gas appliances should be regularly serviced by an appropriately qualified person.

Foster carers must ensure they have adequate household insurance and notify their insurers they are fostering. Insurance companies will generally provide the same cover as for any other member of the household, but this will usually exclude cover for deliberate acts of damage by children. If such damage occurs and is not covered by the foster carers' insurers then advice should be sought from the child's social worker to see if any of the costs can be reimbursed.

Other properties

Health and safety checklists should be in place for foster carers who have second homes including holiday homes and caravans if a child or young person is also staying there.

Foster carers who live on a farm

For foster carers that live on farms there are additional risks to consider. Agriculture has one of the highest fatal injury rates of any industry in the UK.

There is an additional section of the Health and Safety checklist which needs to be completed for foster carers that live on a farm or small holding, This checklist is based upon the Prevention of Accidents to Children in Agriculture Regulations (PACAR) 1998, and the HSE Leaflet, 'Keep Children Safe on Your Farm'.

As with any Health and Safety Checklist, it is not an exhaustive list and there may be other hazards that foster carers need to address.

9. Accommodation, Bedroom Space and Sharing

The foster carers' house should have enough bedroom space for each child placed and should be able to comfortably to accommodate those who live there. The accommodation should reflect the child's assessed need for privacy, space and specific needs of a child who has disability. Consideration must be given to whether they need a downstairs room for access, adaptable bathroom etc.

Every child over the age of three should have their own bedroom. If this is not possible this arrangement needs to be agreed by the placing Local Authority and a risk assessment needs to be in place considering the child's history, their wishes and feelings and any other factors that seem pertinent.

10. Reducing the Risk of Sudden Infant Death Syndrome Death

The Lullaby Trust (formally The Foundation for the Study of Infant Deaths (FSID)) and the Department of Health and Social Care offer advice to reduce the risk of sudden infant death syndrome.

Up to date advice is available from the Lullaby website, or from the health visitor or midwife.

See also Safe Sleeping in the Multi-Agency Safeguarding Children Procedures, Pre Birth procedure.

11. CCTV in the Household

The regulations and guidance relating to CCTV are covered by the General Data Protection Regulation (UK GDPR) and the Data Protection Act 2018 (DPA18). This legislation is regulated by the Information Commissioner's Office (ICO) and carers must ensure that any CCTV system is operated within regulatory guidelines.

The use of CCTV in a foster home must be considered necessary, proportionate and known to all those living in, or coming to the home. Everyone should be aware it is in place.

CCTV should not be sited in a bedroom, bathroom or toilet and anyone living in the home, or responsible for a child placed with the carer, should be shown where the cameras are sited. At no time should CCTV be an alternative to carers providing supervision or oversight of children and young people.

The Health and Safety checklist should note that CCTV is in place and information should be recorded around who has been consulted and the reason why CCTV is in place.

The Information Commissioner's Office (ICO) also publishes guidance, e.g. Guidance on the Use of Domestic CCTV and Guidance for People Being Filmed by Domestic CCTV.

Further guidance on CCTV uses in the foster home can be found in section 16 Adoption and Fostering of the Resource Library.

12. Foster Carer and Firearms

Prospective foster carers must disclose if they hold or have access to firearms. The family placement social worker must see where all guns and ammunition are stored. Firearms must be stored securely and children or young people should have no access to or be involved in activities involving firearms in any way.

As part of the foster carer's review of approval, the security of arms and ammunition and the ownership of a current firearms certificate will be verified.

There is an additional section on the health and safety checklist which must be completed if a foster carer possesses a firearm or other weapon.

13. Training and Support around Health and Safety

Foster carers and residential staff should have adequate training and support around health and safety issues to carry out their role. Bespoke training should be provided if needed for a child such as moving and handling.