Adoption Health and Safety Guidance

1. Facts

• More accidents happen when people are in a hurry, under stress, or in unfamiliar surroundings;
• Your risk of an accident at home increases in the first few weeks following a major change in your life. This includes when a child is placed;
• Half of all childhood accidental injuries occur - in the home or garden;
• Falls account for almost a quarter of all home accidental injuries to children. They are the most common single cause of home accidental injury;
• Collisions with a person or object are the second most common type of accidental home injury and the only one where the injury rates are approximately the same for children of all ages. Typically these injuries happen when children run into objects, run into each other or are struck by a falling object;
• Burns and scalds are the third most common type of home injury. Burns and scalds particularly affect babies and very young children, with scalds from hot drinks being the most common cause;
• The fourth most common reason for children being taken to hospital is suspected poisonings. These happen when parents or carers think that children have consumed medicines, household cleaners, DIY or gardening chemicals. Nine in ten suspected poisonings involve children under 5 years old;
• Most accidents happen in the lounge/living/dining room - probably reflecting where children spend most of their time. The next most common places in the home for accidents to happen are: the kitchen, bedroom and stairs;
• Young children are not able to assess risk for themselves. They also have poor co-ordination and balance and need to touch and explore to learn about the world around them;
• As children get older they learn new skills and begin to understand what they are able to do safely but they also need to test out their new abilities and to feel that they are taking some risks. These factors all mean that children are particularly vulnerable to accidents in the home;
• Children grow and learn new skills rapidly. It is important that the adults who care for them know what risks each developmental stage brings. It is impossible to completely 'childproof' a home but knowledge of the potential for accidents and of effective safety measures can reduce the risk of serious injury.

2. The Risks to Children

Some children placed for adoption will be developmentally immature and more likely to be at risk from hazards than their peers. Others will not have received appropriate guidance in this area from their birth parents and will be unaware of potential dangers.

The adoption officer completing the assessment will complete a health and safety assessment as part of this process. Any significant issues identified will need to be rectified prior to a child being placed.

3. Safety in the Home

There are a number of precautions which should be taken to ensure the safety of all members of the household. The following is a basic guide:

3.1 Fire Precautions

• Install a smoke alarm on each floor of the home. These are relatively cheap and easy to install;
• Where homes have attic bedrooms, or only one exit, it is particularly important that a fire safety check is arranged;
• Exit routes should always be kept clear of prams, toys and other obstacles;
• When exit doors are locked (e.g. at night), the key must be easily accessible;
• Ensure that all members of the household know how to dial 999 and how to escape in the event of a fire;
• Ensure that everybody knows what to do if trapped by a fire: go into a room, shut the door, put a blanket at the bottom of the door and call for help through the window;
• Run through your fire escape plan regularly;
• Do not attempt to fight the fire yourself unless it can be dealt with quickly and at no personal risk;
• Ensure that fixed guards protect fires;
• Store spare gas cylinders for heaters outside. Do not use paraffin heaters or free standing fires;
• A cooker guard should be fitted if caring for small children and flexes to electrical appliances should be kept short and out of the reach of children.

3.2 Carbon Monoxide

Carbon Monoxide (CO) is a poisonous gas that is produced when any fossil fuel such as gas, coal, oil or wood is burnt without enough oxygen. You can't see it, smell it or taste it so you don't know when it is present.

A build up of Carbon Monoxide can be extremely dangerous and can cause a variety of symptoms, and even death. All heating and cooking appliances should be serviced regularly by a qualified engineer, and a Carbon Monoxide detector should be fitted.

3.3 Garden and Outside Play

• Where gardens slope or have steps, thought must be given to any risks this might present for a child. Steps should have a handrail;
• Garden space and fences should be maintained in a safe condition and garden exits secured;
• Water butts, ponds or streams should be netted, covered or fenced off;
• Garden equipment and insecticides should be locked away when not in use;
• Outside play equipment must be age appropriate and maintained in a clean and safe condition;
• Greenhouses and cold frames should have protected toughened glass and be fenced off;
• Garages and garden sheds often contain sharp tools or dangerous chemicals and should be sound and secure;
• Drains and flue outlets etc, should be secure and fitted with an appropriate guard/cover;
• Washing lines should be out of reach and if caring for young children, carers should be aware of the hazards presented by rotary washing lines;
• Poisonous trees and plants should be safeguarded and children taught not to handle them;
• Extreme caution must be exercised when using barbecues, these should never be left unattended;
• Adequate supervision should always be provided.

3.4 Car Safety

Cars must be well maintained, regularly serviced, adequately insured, and covered by a current MOT certificate if the age of the car requires it.

It is essential when carrying children in the car that Government guidance and laws in relation to seat belts and car seat standards are adhered to at all times. Details of the latest safety standards and legal requirements can be found on the GOV.UK Website.

If seat belts or child restraints are fitted in the rear of the car, it is the driver's legal responsibility to ensure that children under the age of 14 years use them. It is also the responsibility of the driver to ensure that passengers are carried safely and that the vehicle is not overloaded. It is against the law to smoke in a car with children under 18 on board.

Car keys should not be accessible to children and young people and should always be stored safely and securely.

3.5 General

• Matches / lighters and sharp knives should be stored safely;
• Decorative swords are dangerous and should be safely disposed of. Where they are displayed, they must be secure in their scabbard and inaccessible for children to reach;
• Bleaches, disinfectants, aerosol sprays and other dangerous substances must be kept out of the reach of children and young people, or locked away. Cupboard clip-locks are a cheap and safe precaution for pre school children;
• Medicines, tablets and alcohol should also be securely stored in a locked cupboard;
• Stair gates must be fixed securely where appropriate;
• Windows should be bolted where possible or made safe by the fitting of limited opening devices. The keys should be kept securely at hand in case of an emergency;
• Protective covers should be used to prevent young children interfering with low electric sockets;
• Pull cords on window blinds can be a hazard to children (while modern blinds have inbuilt safety features, this may not be the case with older blinds). The Royal Society for the Prevention of Accidents (RoSPA) have produced advice on blind cord safety;
• Bags must not be hung on bunk bed corners - children can become entangled;
• Hot drinks can scald even half an hour after being made. They must be kept well out of reach and never held whilst holding a child;
• Very young children can drown in as little as 3cm of water. They must be supervised at all times when bathing, using a paddling pool etc.

Most childhood accidents can be dealt with fairly easily although medical advice should be sought if there is any doubt. It is advisable to have a well stocked First Aid box available.

Consideration should be given to whether children are allergic to certain ointments and lotions in common use. All medication should be kept securely out of the reach of children.

3.6 Hygiene

Good hygiene standards prevent the spread of illness and infection. Good hand-washing is one of the easiest and best ways of preventing cross-infection. This practice should be followed by responsible adults, encouraging children to do the same.

A range of minor and major infections can be transmitted via blood and body fluids. Hygiene standards should be maintained for all children and young people, e.g. cuts and sores on the hands should be kept covered with waterproof, adhesive dressings. Hands need to be washed thoroughly before and after carrying out first aid procedures or after contact with bodily fluids. Disposable gloves should be used when carrying out first aid procedures.

Because the faeces of a baby can carry live traces of the polio virus following vaccination, it is advisable to check with your GP that you are immunised against polio and to maintain thorough hygiene standards after each nappy change.

3.7 Diet and Nutrition

It is important to promote a healthy lifestyle and to eat a varied and balanced diet. Food and mealtimes can be a source of tension and eating disorders can create a great deal of worry. It is important to recognise that children may come from different backgrounds in terms of diet, and to recognise the need to be flexible and introduce new foods appropriately. Attitudes towards food, mealtimes and eating habits are extremely important and influential.

3.8 Building and Contents

Homes should be in good repair, adequately insured, safe and hazard free for children. All glass that can be reached by a child should be toughened to relevant British Safety Standards, or fitted with protective safety film. Electrical equipment should be well maintained and in good order. Gas fires / boilers / cookers should be regularly serviced by an appropriately qualified person. Portable electrical equipment should be safe and adequately maintained. Doors, windows and floor coverings should be safe and secure.

3.9 Safer Sleeping for Babies

The Lullaby Trust provides the following advice to promote safer sleeping for babies:

• Place your baby on their back to sleep, in a cot in the same room as you for the first 6 months;
• Don't smoke during pregnancy or breastfeeding and don't let anyone smoke in the same room as your baby;
• Don't share a bed with your baby if you've been drinking alcohol, if you have taken drugs or you're a smoker;
• Never sleep with your baby on a sofa or armchair;
• Don't let your baby get too hot or cold;
• Keep your baby's head uncovered. Their blanket should be tucked in no higher than their shoulders;
• Place your baby in the "feet to foot" position (with their feet at the end of the cot or Moses basket).

Up to date advice is available from The Lullaby Trust, NHS Choices or your Health Visitor.

3.10 Alcohol and Drugs

Children may have experienced trauma and abuse associated with alcohol use so it is vital that adopters have full background knowledge of the child, and are sensitive to the child's perception of adult drinking patterns and behaviour.

Drug use is illegal, dangerous, and detrimental to children.

3.11 Smoking

Smoking does not automatically rule you out from adopting. However, if you wish to adopt a child under five or a child with particular medical conditions, you are likely to need to be smoke-free for 6 months before making an application (this includes e-cigarettes and vaping).

Passive Smoking

Children need support to be healthy and stay healthy. Adopters need to provide an environment that encourages improvements in the health and wellbeing of children and young people in their care. Children often have little choice about smoke in their environment. Breathing other people's smoke - passive smoking - has consequences for children because their lungs are smaller and their immune systems less mature. They also breathe quicker, taking in more harmful substances per pound of body weight than adults. It has been found that the risk of sudden infant death syndrome (cot death) is doubled when the parent or carer smokes up to nine cigarettes daily, and trebled when ten or more cigarettes are smoked. Lower respiratory tract infections (pneumonia and bronchitis), asthma and glue ear occur more frequently in young children in smoking households. Passive smoking is also associated with persistent coughing, wheezing, bronchitis, asthma, sore throats, middle ear problems, snoring, impaired lung growth and slower developmental progress.

3.12 Pets

Pets can be important members of the household and can bring benefits for children of all ages who grow up with them. There are however a number of health risks associated with household pets. They can also injure and cause emotional distress to children unfamiliar with animals or who have had negative experiences of them.

Children and animals are unpredictable. Household pets are expected to be well looked after and children should be taught to behave responsibly towards animals.

It is expected that basic animal welfare such as regular worming of domestic pets will be undertaken. Pets' housing, sleeping and toileting arrangements, routine and training must be carefully considered, and good hygiene standards observed. Adopters need to be able to demonstrate that they have measures in place for the welfare of all concerned.

Information about your pets is important when it comes to making decisions about placements, for example of a child with allergies or asthma. Applicants with dogs will be asked to obtain a reference from the vet and/or rescue centre re the temperament of their dog(s). This will be required during stage one of the process.

The presence of certain dogs in a household will need to be carefully considered and may be incompatible with adoption.

3.13 Internet Use

Adopted children can be particularly vulnerable when accessing social networking websites and parents will need to be vigilant in ensuring that any internet usage is adequately supervised. Computers should have "parental controls" activated and these should be reviewed regularly. Children will also need your involvement, experience and guidance so that you can make sure their experience of the internet is educational and enjoyable whilst also safeguarding them from any potential risk of harm.

3.14 Firearms

Prospective adopters must disclose if they hold or have access to firearms. Where applicants confirm that they hold firearms, a current firearm certificate must be seen and a copy placed on file. The assessing worker must be satisfied that guns and ammunition are stored in such a way that they cannot be accessed by children or young people.