For health visitors a child’s welfare is of ultimate importance; it is why we are here to do the job we do. Part of our role is to support parents to do the best for their children, promote health and safeguard. It is common for people to immediately think of us and our role in safeguarding in terms of preventing neglect, both physical and emotional. In fact, the definition of safeguarding is as follows:
- Protecting children and young people from maltreatment
- Preventing impairment of children and young people’s health or development
- Ensuring that children and young people are growing up in circumstances consistent with the provision of safe and effective care
- Undertaking that role so as to enable those children and young people to have optimum life chances to enter adulthood successfully.*
When I visited RoSPA, I was surprised by the statistics, in particular the sheer number of accidents that happen to children in the home. It got me thinking, that as public health home visitors, we are in a prime position to offer advice on home safety and so by getting our message across, we may each be able to prevent just some of the many accidents that happen every year. For example, if we alert a family to the risks of hot drinks, medications and blind cords, we may be able to fulfil most of the above and reduce the costs both financially and emotionally to society and individual families. We already routinely give sleep safe advice to reduce the risk of sudden infant death syndrome (SIDS), also known as cot death, as part of our standard care packages, so I thought why not do the same with blind cords?
Families are busy and having a new baby to look after can be both tiring and stressful, toddlers even more so! Most parents want the best for their children, but simply may not have considered the risks their home may pose or how their children’s natural inquisitiveness and development stages could lead to an accident.
Health visiting is not about telling parents what to do, but more about supporting them to make changes, equipping them with the skills they need and empowering them with the information to do the best thing for their children. That’s not to say that we would not bring up issues of safety if asked; we would help people to understand the risks and provide them with the information on how to minimise them. For example, at an antenatal visit we might say, “Have you had any thoughts about safety in the home?” or “What do you know about making the home safer for children?” to get them to talk about what they already know. They may say, “Well we’ve thought about buying safety gates and a child car seat”. We can then compliment them on what they already know, by talking about the correct use of safety gates and child car seats, saying something along the lines of, “I can see you’ve already thought about this, although you may not have been aware that blind cords can also pose a safety risk, however I have some information on how you can manage that too”.
At postnatal visits we might also talk about development and relate that to possible safety risks. A conversation may go something along the lines of, “I see your baby is rolling now, which is great, although it does mean he will keep you busy. Make sure he doesn’t roll into or off things, in fact, changing him on the floor is a lot safer” or “It looks like he’ll be walking soon, I can give you some tips on how to get ready for that by making your home safer”.
We have guidelines as to what to cover at standard visits, although visits are never the same and the process is not a tick box approach. Each family is different and a family may have different needs at each visit or at different stages of the child’s development. Often, there may be an unexpected crisis that needs to be dealt with. However, I think health visitors are always considering whether there are any concerns; it is part of our standard assessment framework to look at a child’s developmental needs, parenting capacity and family and environmental factors. Child safety in the home is encompassed by this framework and health visitors are generally skilled at searching for health needs and recognising where prevention or promotional advice is required.
Most families are receptive to advice and grateful for suggestions but, of course, if a situation is considered as dangerous and families are not receptive to advice and do not put the needs of the child first (and very often there are other concerns in a case like this) we can express our concerns to social care who would look at the whole picture before deciding on any action. This would generally be discussed with the family before enabling them to understand what the concerns are. A referral may actually mean more support can be offered if a family is struggling to keep their child safe from harm.
We may not be able to cover everything in one visit, but we can develop relationships and tackle things in several visits, through leaflets and at clinics. Sometimes the team organises group sessions that cover safety issues and we promote these sessions on visits. However, we can only advise within the scope of what we know and that’s where evidence-based, standardised information and advice from an organisation such as RoSPA could come in.
I have been lucky to undertake a study day on child safety in the home with RoSPA and it has equipped me with the knowledge and skills to recognise risks and to know how to minimise them. In fact, the leaflets that I was able to take away with me have been very useful for striking up a conversation about safety with clients. If I can pass on this valuable information to a family, it may just make a difference to the health and wellbeing of a child by helping to prevent an accident. After all, that’s what we are there to do.
Do you want to find out more and to support RoSPA’s public health campaign? Visit www.rospa.com/about/currentcampaigns/publichealth/
*Taken from The Children’s Act, HM Government, 2004.
By Sally Tilley, student health visitor