Health and Safety
Scope of this chapter
This chapter explains what needs to be in place when assessing a foster/residential home in relation to health and safety issues.
For all safety issues, 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 in respect of keeping a child/young person safe.
A child or young person should not be prevented from learning and developing naturally but they need to grow up in a safe environment protected from unnecessary harm. This requires a combined approach through education and training for foster carers and residential staff who are involved in caring for children, safe product design and modifications to the environment.
Amendment
In January 2024, additional information was added about online safety.
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.
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, light and window blind cords that they get tangled in. These should be fitted appropriately to prevent strangulation.
See Child Accident Prevention Trust Website, Making sense of accidents.
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.
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, razors, knives etc.
The Agency or the local authority should provide/reimburse costs for safety equipment to enable a foster carer 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:
- 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;
- 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;
- Foster Carers could also request the fire service visit their homes to ensure smoke detectors and carbon monoxide detectors are fitted in the correct position. Also, to discuss evacuation plan (escape routes) as mentioned above.
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 with this reviewed annually for foster carers as part of their review. It must be marked down on the Health and Safety checklist that it has been seen and that appliances have been tested. As part of unannounced visiting undertaken by supervising social workers to foster carers homes carbon monoxide alarms are checked.
Good supervision is important when a child or young person is outside. Age, disability, behaviour or known risks must 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.
Children must normally use a child car seat until they’re 12 years old or 135 centimetres tall, whichever comes first.
Children over 12 or more than 135cm tall must wear a seat belt.
The seat your child can use (and the way they must be restrained in it) depends on their weight.
Group Seats
| 0 | 0kg to 10kg - Lie-flat or ‘lateral’ baby carrier, rear-facing baby carrier, or rear-facing baby seat using a harness. |
| 0+ | 0kg to 13kg - Rear-facing baby carrier or rear-facing baby seat using a harness. |
| 1 | 9kg to 18kg - Rear- or forward-facing baby seat using a harness or safety shield. |
| 2 | 15kg to 25kg - Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield. |
| 3 | 22kg to 36kg - Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield. |
The Child Car Seats website has information on how to choose a seat and travel safely with children in cars. Further information can also be accessed at Child car seats: the law: Using a child car seat or booster seat - GOV.UK
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. These documents need to be reviewed as part of annual reviews for foster carers and licenses of carers should also be checked via the DVLA.
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 fitted appropriately. Legal Requirements for Internal Window Blinds (makeitsafe).
- A health and safety assessment will be completed as part of the assessment process and annually by the supervising social worker once approved as part of the annual review. This may also be undertaken if there are any changes in the child’s/young person’s behaviour or circumstances.
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.
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.
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. Denying online access to children can be abusive in itself (e.g. loss of opportunity to develop resilience, risk of alienation, risk of turning to secret devices).
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 abusive in itself (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.
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.
Health and safety checklists/assessments 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.
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.
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.
Please also refer to Bedroom Sharing in Fostering Households Procedure.
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.
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. See Domestic CCTV systems (ICO).
As a general rule in order to respect rights and privacy, CCTV should not be used in in foster home. This is to ensure the privacy of all members of the foster family, which is essentially a family home.
In very exceptional cases, due to the unique situation or risks related to a child or young person, CCTV may be agreed in communal areas of the home, in line with the child or children’s/ young person(s) needs, and should be reviewed on a regular basis within Looked After Reviews, Fostering Reviews and upon any changes of circumstances.
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. Any agreement to use CCTV in a home must be risk assessed and agreed by service managers for the fostering service and children’s social work team with final agreement being provided by a group manager. The reasons for agreeing the use of internal CCTV must be clearly recorded on the foster carer and children’s files and the timescales for this to be reviewed.
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. Where internal CCTV is placed in the home, it is also imperative that children’s wishes and feelings are obtained in a way that respects their rights and privacy.
The Health and Safety checklist and Safer Care Agreement 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.
Foster carers must seek agreement from the fostering service if they are going to install, or change, a home-based CCTV system, so that the service is aware of the nature and purpose of any recordings, how long they will be kept for, and who is responsible for them. Foster carers should also expect fostering services to ask them about any cameras and microphones in the foster home at regular intervals.
Further information and guidance can be found via the Fostering Network: Using CCTV at a foster home.
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.
Last Updated: January 12, 2024
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