General Health and Safety Policy

Brighton and Hove Children and Families has a general, comprehensive health, safety and welfare policy covering all its employees. This meets its statutory responsibilities to staff, service users and other members of the public concerned with services, this includes foster carers.

This policy states:

We should all be aware that we are all responsible for our own safety, the safety of staff under our control and the safety of service users, contractors, volunteers and other members of the public. We appreciate that many of the people for whom we care and with whom we come into daily contact, represent some of the most vulnerable members of society, including those who have no perception of danger. In addition, many of us face people who are upset or aggressive during the normal course of our duties. This means that we all have to be exceptionally alert, in order to safeguard our own health, safety and welfare and the safety and welfare of our clients.

Health And Safety For Foster Carers

Promotion of the health of children and young people placed with foster carers

Each child placed with you should have a Health Care Plan (HCP) detailing all aspects of their medical and health care needs, which should have been drawn up by the child’s health professional and with their parents as appropriate.

Consideration must be given to the race, culture, religion and abilities of the child. Children and young people of different races may be susceptible to different medical conditions and have different health care needs.

The child’s social worker should ensure with you that the child is registered with a GP, that dental examinations occur at least once every six months and that medical, immunological, ophthalmic or other treatment as required occurs. Wherever possible a child should remain with their existing GP to help ensure continuity of health care.

Children and Families has a Health Care and Medication Policy which social workers must follow. The child’s social worker and your supervising social worker should share relevant parts of this policy with you. All medications must be stored in a lockable cabinet.

Normally a birth parent(s)’ consent should be sought for any medical treatment, including immunisations, that may be required, which the child’s social worker should obtain.

Prescribed medication should only be administered under the direction of the child’s health professional. You should discuss with the child’s health professional the implication of giving any non-prescribed (over the counter) medication to a child aged 0 to 5 years. Children under 5 years should not be given non prescribed cough or cold medicines or remedies.. Children under 16 should not normally retain their medication unless is agreed as part of their Health Care Plan. Children over 16 should be encouraged to administer their medication where it is deemed safe to do so. Children under 16 must not be given Aspirin or Aspirin products or Bonjela mouth gel (except on medical advice).

A child who has been fostered should have their health assessed in accordance with the Children Act 1989 and Department of Health/Department for Education guidance on promoting the health of looked after children. The child’s social worker should advise you about the requirements. This should occur in a planned way before a placement is made but, if this is not practicable, as soon as possible afterwards. A health assessment of the child should occur within one month of a placement being made. If a health assessment of the child has been undertaken recently before placement, the child’s social worker in consultation with the appropriate health professional may decide a further assessment within a month is not required and will advise you. Thereafter, the child’s health will be assessed by a health professional once every six months if aged 0 to 4 years and annually aged 5 to 18 years; it is appreciated that with young people over 16 the assessment should be tactfully negotiated and they should be encouraged to view the assessment as part a promotion of positive health and well-being. No child can be forced to undertake a medical if they refuse to co-operate

You should keep records of any accidents, injuries, illnesses the child has and treatment given. The child’s social worker and your supervising social worker must be kept regularly informed of all relevant health developments, with serious accidents and injuries reported immediately.

You have a responsibility for ensuring sex education is provided for children, in consultation with the child’s social worker, your supervising social worker, birth parents and school. The responsible social workers must ensure you are able to provide this and give you appropriate support. Children and Families has policies on promoting the positive sexual health of all young people with whom it is in contact and to prepare them for responsible parenthood. The policies advise on counselling and sex education, legal implications of sexual activity by children under the age of 16, consultations with parents and HIV/AIDS. The child’s social worker and your supervising social worker should advise you about these policies.

You also have a responsibility to promote the positive mental health of a child or young person placed with you and to help build their self-esteem and resilience so they can cope with adverse life experiences. In accordance with government guidance, you will be asked to complete a mental health screening tool – The Strengths & Difficulties Questionnaire every year for any child in you care aged 4 – 16 years. This will be scored by the LAC Health Team and you will be contacted to discuss a high score. Helping the child or young person to engage in hobbies, leisure, sport and after school activities and to discover their interests and talents can aid the promotion of good mental health. If you have any concerns about the child’s or young person’s mental health you should alert the child’s social worker and your supervising social worker so as, if appropriate, referrals can be made the Child and Adolescent Mental Health Service (CAMHS)

General health responsibilities of foster carers

The Children Act 1989 and the Care Standards Act 2000 impose clear duties on foster carers as well as social workers and managers to improve the health of looked after children. Responsibilities of foster carers in ensuring that a looked after child’s health needs are met include:

• an understanding that achieving optimum health starts early and includes the provision of good quality care which starts in infancy and which provides a child with a positive sense of identity and self-esteem;
• encouraging and supporting each child in achieving optimum health, especially as a health educator;
• providing a home environment which actively encourages and supports a healthy lifestyle;
• ensuring the child attends health appointments and clinics as necessary;
• contributing to the child’s health and care plans;
• ensuring and facilitating contact and communication with the child’s parents and family in accordance with agreed plans;
• ensuring the child/young person takes maximum benefit from education and broader experiences offered by leisure activities, hobbies and sport.

The importance of education to a child’s good health

It is important to link the promotion of good health for looked after children to their educational experiences. Access to good education has a direct impact on a child’s wellbeing, including a sense of self-worth and self-confidence. It can enable integration within a social network and encourage a sense of being a valued member of the local community, as well as helping to establish positive peer relationships.

Access to good health will support the child’s experience in school and facilitiate good attendance and participation.

School provides children with both formal and informal opportunities for developing cognitive and social skills.

Many looked after children experience disruption to their schooling through placement moves. They make up a disproportionate number of children either temporarily or permanently excluded from school. This not only affects their academic achievement, but contributes towards them becoming socially excluded and places them at greater risk of engaging in activities which may be detrimental to their health and wellbeing.

Lack of a proper educational assessment of a looked after child may lead to the extent of learning difficulties not being recognised. This may also lead to a failure to recognise a child’s gifts and strengths. Carers, along with social workers, should act as advocates with education services, for example ensuring that a young person who moves retains his or her GCSE options, ensuring access to an appropriate school and providing practical and financial support for a child’s participation in extra curricular activities.

The importance of leisure, hobbies and sport to a child’s good health

Research has demonstrated that success and involvement in a range of activities and sports have provided a turning point in the lives of looked after children and young people.

Opportunities for physical activity and for expressing creativity are recognised as important factors for enhancing emotional wellbeing and combating a low sense of identity and self-esteem.

Sporting activities in particular can provide opportunities both for risk taking and developing teamwork skills. Arts and drama can have therapeutic applications through providing a means for expressing feelings and discussing health issues in a safe environment.

Children and young people may enter the looked after system with leisure interests and hobbies which should be supported by carers and developed during their stay in care. Equally there is a great potential for carers to engage children and young people in their own hobbies and interest or to engage them in opportunities available in the local community which can aid the promotion of their health and development. Listen Up cards, which enable free access to a range of leisure facilities across the city, are provided to all looked after children and young people. Any questions about the cards or their use should be directed to the Fostering Support Team.

A safe and caring environment

As part of the assessment of a prospective carer(s) and the annual review of approved carers a Health and Safety Check is conducted. National Minimum Standards for Fostering Services require foster carers’ homes and any cars used to transport children to conform to high levels of health and safety. Health and safety standards are re-checked at each annual review. This is a requirement of re-approval as a foster carer. Failure to co-operate with this check or to rectify health and safety problems identified could lead the matter being referred to the Fostering Panel as a standard of care issue. In extreme circumstances, this could lead to the termination of approval as a foster carer. However, it is hoped that you and your supervising social worker would work together to resolve any problems about health and safety that could adversely affect a child placed. If the cost of carrying out checks in your household, such as electrical wiring, or rectifying identified problems are likely to cause you financial difficulty, you should discuss this further with your supervising social worker. Depending on your circumstances, Children and Families may be able to make a contribution or meet the full cost of work required.

One of the crucial competencies required of modern foster carers is the ability to provide a safe and caring environment. Providing a physically safe environment will include carers ensuring:

• any water areas such as garden pools and swimming pools are secured so that no child can access the area without adult supervision;
• toxic substances, such as bleach, medicines, gardening materials, should be secured and out of the reach of any child placed;
• all reasonable and practicable steps must be taken to prevent fire. Smoke alarms should be installed and maintained in good working order. Family members must have a clear sense of what to do in the event of a fire and communicate the plan to children in their care.

On top of maintaining a physically safe environment, foster carers need to ensure:

• children are cared for in a home where they are safe from harm or abuse, including bullying
• children are helped to keep themselves safe from harm and abuse
• children know how to seek help if their safety is threatened
• if foster carers have their own children, that their safety needs and ‘safe caring’ skills are equally addressed.

You should expect to receive support from the child’s social worker and your supervising social worker in creating and maintaining a safe and caring environment. This should include attention to self care and respite from fostering.

Smoking and Vaping

Research evidence has documented the adverse effect on children and young people of living in a household where an adult smokes. The risks involved are:

• the effect of passive smoking on a child’s health
• providing a poor role model for a child as there is a greater likelihood that a child will become a smoker
• the implications for a child placed of losing a carer whose life expectancy is reduced due to smoking.

The full effects on a child of living with a smoker are provided in the Guidance document –‘Looked After Children and Substance Misuse’. If you do not have a copy, your supervising social worker will be able to provide you with one. They can also supply you with a BAAF practice guidance note on the effects of smoking on looked after children. NB From 01 October 2015 it will be illegal to smoke in a car where anyone aged under 18 is present.

Children under 5 and those with respiratory problems and /or disability will not be placed with carers who smoke unless there are exceptional reasons for doing so. Carers who wish to give up smoking should consult a health professional and will receive support and encouragement from their supervising social worker. Help to stop smoking is provided by most GP surgeries or by the NHS Stop Smoking service – who accept self referrals. They can be contacted on 01273 267397.

Children and Families recognises that it has existing carers (and will continue to approve some new carers) who smoke. Those carers need to recognise this could limit the range of children with whom they could be matched. Some older children and young people object to being placed in a smoking environment.

If a child/young person placed with you is already a smoker you will have the opportunity to discuss with their social worker and your supervising social worker how to deal with this potentially difficult situation. Expectations of the young person should be clearly recorded in the placement agreement. Young people should be offered assistance, support and health advice to help them give up smoking, with their carer playing a key role. There is a dedicated Stop Smoking Team who are very keen to support carers and have a specialist young people’s nurse. The team is based at Robert Lodge, Manor Place, Brighton, telephone 01273 267397 and accepts self referrals from adults and young people.

Where a child or young person does smoke, the implications of passive smoking on a carer’s own young children should be considered by placing social workers. The right of any carer to say that they do not want someone smoking in their home should be respected.

Vaping is a relatively new activity, and the initial research indicates that the vapour does not appear to have a harmful effect on those in the same space as the person vaping. However, the psychological impact on children of seeing a carer vaping may mean that they are more likely to experiment with it, and possibly tobacco or other substances, therefore our advice at presentis that carers should not vape where they can be seen by looked after children.

Pets

The potential health risks that pets can pose for children and the implications of pet ownership will have been addressed during your assessment to become a carer. For some existing carers legislation concerning dangerous dogs has been passed since their approval. This will not necessarily affect their approval status but may need to be clarified in reviews and other meetings with supervising social workers.

Carers who are pet owners should be asked about the measures they will take to ensure a child’s safety. There is a clear expectation that should a child be considered at risk, the child’s safety must come first, even if this means making alternative arrangements for the pet.

Clearly a pet can be a very positive factor in a placement, but a child’s previous experience of animals and the implications of health issues such as asthma need to be considered as part of the matching process.

Where a social worker considers that a dog may present a potential hazard to looked after children, they should request a dog assessment from Ali Fell at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Training support

The department provides a training and support programme for approved carers including courses on health and safety, health promotion, sexual health, substance misuse, paediatric first aid and safe caring.

Poisonous plants

Foster carers are responsible for ensuring, as far as possible, that children in their care are not exposed to risks from hazardous plants, bulbs, shrubs, and trees. The Real Gardeners website shows a list of poisonous plants. You should try to ensure that any children cared for by you do not have access to any of these plants. You must always seek immediate medical help if you think a child has ingested any part of the above plants.