Health and Safety

Foster 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 approval, before any child is placed  and should be regularly updated (at least every year). 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 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 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 care 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.

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 the home;
• 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 annually, 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.

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 safely to avoid a child or young person taking a car or losing the keys.

• 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.

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

The foster carer 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.

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 home;
• 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;
• 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 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.

Hertfordshire Accommodation policy: Carers Accommodation

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: Hertfordshire Safeguarding Children Partnership Procedures, Pre-Birth Protocol, Procedure and Guidance for Pre-Birth Assessment.

See: Policy on the use of CCTV in Foster Homes.

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.

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.