Sunday, 9 November 2014

Risk assessments after an accident…

Accidents and near miss accidents sadly happen, even in the best managed provisions. We cannot keep every child safe from harm all the time because children trip and fall, run and crash, jump and bump, climb and tumble, pull and push and run in front of swings… and do all sorts of other dangerous things without thinking or realising. We simply cannot be there to watch out for them every single time! We are even told by experts to engage children in risky play and to let them explore the world around them which increases the risk of them having an accident. Plus, studies tell us (and we know from our own personal experiences) that children have to learn about danger if they are ever going to learn to risk assess for themselves.

Accidents and near misses present important learning opportunities for providers and must be carefully reflected on and managed because they can tell us a lot about our provisions and ways of working and they can help us to prevent future accidents. When a child has an accident or near miss, write it up on an accident and injury form along with any first aid administered and, when signed by parents, put it in their file… report the accident or injury if required… and keep a brief record of what happened in your personal diary so you can look back on it and think about how you might improve your provision in the future. A list of previous accidents and near misses will also help you to see if there are any trends – things that are happening over and over again which need to be resolved.

For example, looking back at your accident and injury or incident forms you might note –
• 3 children have bumped into the same garden feature –> move the feature to another area of the garden.
• A child is regularly running towards the road on outings –> give her a choice between reins or a wrist strap from now on.
• A child is constantly falling over your threshold and tripping on steps –> suggest parents take him to the optician for an eye health check-up. Meanwhile, think about how you can highlight the threshold / steps so they are more visible to the children.
• Children are slipping and falling on your grass -> cover the grass, re-seed, cordon the area off or take other steps to keep them safe.
• 3 children have slipped on your new wooden floor -> supply / ask parents to provide non-slip socks or slippers.
• A child is biting others -> start to shadow the child to note any triggers. Ask parents in for a meeting to discuss your concerns and plan a strategy to work together and support the child.
• A child is getting out of their car seat on journeys -> stop the car, re-fasten the child, explain the danger firmly – and ask parents in for a meeting to discuss a plan for the future. You might also consider buying a safety cover for the seat fastener.
• An older child has caught a younger child’s finger in a car door -> think about whether the older child is taking on too much responsibility. Revisit your procedures for getting in and out of the car and ensure you are in charge of closing doors and taking responsibility for keeping the little ones safe.

Of course, making changes to your provision goes hand-in-hand with teaching children about their own safety by, for example –
• Involving them in the risk assessment process;
• Teaching them about personal safety through books and role play;
• Reading books, telling stories and planning sessions to cover stranger danger;
• Reminding children about safe play rules at the park before they run off to play;
• Asking children to walk in the house so they do not slip;
• Explaining why it is important that they wear high visibility clothes and wrist bands on outings;
• Using wrist straps, backpacks with reins etc even on very short outings;
• Reminding children that they need to tell you if they hurt themselves or break your equipment or notice something is wrong or spot a hazard.

Working with parents
It is very important to work closely with parents to reinforce safety messages. When you teach the children about safety – personal safety, stranger danger, how to play safely at the park etc – share information and planning with parents and tell them the words you are using so they can reinforce your teaching at home. Similarly, if you have written a social story for, for example, a child who is running away from adults and it is working well, let them borrow it or take a photocopy so they can read to their child at home.

Parents need to be informed if their child is not responding to safety messages. Ask them in for a meeting to discuss your concerns and try to find out what is happening at home. For example –
• If a child is getting out of their car seat with parents and they are not strapped back in it is going to take much longer for them to learn the importance of staying safe in the car
• If grandparents indulge a child by laughing when he hits them, he is not going to learn that hitting is inappropriate in a childcare setting
• If an older child is frightened to tell parents he has broken a toy because he is always harshly punished, he will hide things in your house as well which might lead to a baby choking or hurting himself on small parts.

Communicating concerns with parents works both ways… if a child is doing something dangerous with parents or other family members at home they need to tell you quickly so you can take steps to support their child. For example…
• If a child came shooting down the slide head first at the weekend you need to know for when you next take them;
• If a child is worrying the pet dog at home you can take steps to keep him away from your animals unless fully supervised;
• If parents have noticed their child is fascinated by electrical sockets, you can put barriers in place around yours – and plan some activities to teach the child about electrical safety;
• If a baby has started climbing or rolling over the weekend you can be extra vigilant;
• If a child is opening the door at home to try and get out you might need to re-think where you keep your keys;
• If parents are worried because their child is talking to / approaching strangers on outings, you can suggest some books to read and activities for role play in the provision and at home;
• If an older child is fascinated by fire, you can advise parents who to speak to for help and ensure risk assessments are in place for flammable materials and the child is closely supervised while on your premises.
Remember - if a child has had an accident at home you need to record it so you can keep an eye on them in the provision – and so you can learn from what they have done and review your own risk assessment - it is good practice to have some printed ‘existing injury’ forms with your attendance register so you can quickly fill them in when children arrive. You will find some free forms (written by me) on the website.

Going back to the original reason for writing this blog – we need accept that accidents happen but, instead of getting defensive and saying, ‘it wasn’t my fault’ we need to reflect on accidents and near misses and consider how we can improve our provision and ways of working to support the children. We need to do this for a number of reasons -
• For ourselves – to ensure that we are reflective practitioners who take safety seriously and are ready to respond positively to learning experiences.
• To support parents – they are sometimes ok after an accident and sometimes they need to blame someone. If they see you thinking about what happened and reflecting on how you can improve things in the future, they are more likely to respond positively to your explanations.
• For Ofsted – if a complaint is made or we have to notify them about a serious accident and injury and they come out to investigate, they will want to see that we have used the incident as a learning experience.

The following self-reflection questions after an accident or near miss might be useful…
• What happened? Did you see what happened? If you didn’t see it, why not?
• Were there any witnesses? Can they suggest how the accident might have been avoided?
• Was an accident, injury and first aid form promptly written up to be signed by parents?
• How did parents react? Did they shed any light on why it might have happened eg ‘oh yes she’s doing that at home’ or ‘yes we have noticed him biting’?
• Does the accident / injury need to be reported? If yes, who needs to know – Ofsted, RIDDOR, Local Safeguarding Children Board, Local Authority advisor? Has it been reported promptly and within the required timescales?
• What does the current risk assessment for the area of provision in which the accident happened say? Does it cover what happened? Does it need to be re-written / updated? Is it robust enough?
• Were you within ratios at the time of the accident?
• Were children being effectively supervised? Were you distracted elsewhere?
• Was there a problem with your premises or equipment? For example, was the flooring uneven or the rug a trip hazard? Were the locks on your cupboard doors in need of replacement – but you hadn’t got round to it yet?
• Did you make a mistake? For example, did you leave the ironing board out or forget to put away a knife after making lunch? Did you forget to strap the child into the pram? Did you answer the phone while a child ate the paints? Did your enthusiasm to take the children to the park in wet weather lead to the child slipping on play equipment? None of us are perfect – and it is important to acknowledge that sometimes we need to change our own ways of working to ensure we protect children – especially as we work from a home environment. We need to remember that we are, after all, running a business and not a home during working hours.
• Were you following your own safety rules? For example - baby needed a nappy change and your procedures say ‘1 in all in’… but you left 2 children out playing because they were involved in their game... and one of them bit the other or had an accident that was avoidable if only you had followed your procedures and brought them inside with you.
• Was a child taking on more responsibility than they should for their age? For example, was an older child lifting a baby who they subsequently dropped or putting food in a toddler’s mouth causing them to choke?

And then the big question… how can the child/ren be kept safe in the future? What, if any, changes need to be made to your provision or ways of working? For example –
• Do ratios or staff deployment need to be reviewed? Perhaps you were in ratios but in the future staff could be better utilised to ensure more effective supervision. Or you were in ratios but on reflection 4 children under the age of 5 or 2 babies under 1 plus 2 pre-school children for continuity of care is too much to manage by yourself and you need to take on an assistant or give notice to a child.
• Can you plan some group or one-to-one activities to teach the children to take more responsibility for their own safety? How can you share this learning with parents so they use the strategies you are teaching children when they are at home?
• Do the older children need to run their pent up energy off at the park after school rather than climbing the walls in the house?
• Do you suspect that a child has an as yet undiagnosed medical condition that means he responds to danger in a different way from other children? How can you work with parents to get him the help he needs?
• Do you need to buy extra safety equipment / update your house or garden to keep children safer?
• Is the child over 8 and impacting negatively on outcomes for the little ones? Do you need to give notice as required by the EYFS?
• Were you expecting too much from the child for their age / stage of development? You might find it useful to go back to Early Years Outcomes and Development Matters and look at physical development / health and self-care and note typical behaviours for different ages of children.
• Think about how parents / the child’s family can be involved to support the child in the future and record this on your ‘working with parent’s documentation.

It is very easy after an accident or near miss to go into denial mode. You want to protect your business and reputation and you don’t want to accept that something you did (or didn’t do) has contributed to a child being hurt. However, parents need to see that you are taking responsibility for what happened to their child and changing your procedures as a result of the accident.

If Ofsted come out to investigate a serious accident to a child, they will want to see that you have reflected on what happened and recorded how you will prevent similar accidents from happening in the future. This can be very hard sometimes because you might feel that you did everything possible and it was simply an accident – and as we said at the beginning accidents do sadly happen. However, it is an unusual situation when some lessons cannot be learned after a child has been hurt, even if it’s to bubble wrap the child from now on…

For more information about risk assessments please see e-book 5 ‘Risk assessments’ from my Knutsford Childminding website.

I have also written some free risk assessment advice on my EYFS for Childminders website.

I hope you find this blog useful and informative. Please let me have your feedback - or contact me to ask me to write other blogs which you feel will help you to improve your provision. You can contact me via the Independent Childminders Facebook group or the Childminding Forum.

Thank you. Sarah.

Sarah Neville / Knutsford Childminding