Quality statement 2: Identifying households for a structured home safety assessment

Quality statement

Households in which children and young people (under 15) are at greater risk of unintentional injury in the home are identified through collaboration between local agencies for a structured home safety assessment.

Rationale

The risk of unintentional injury in children and young people (under 15) is higher in some population groups (for example in lower socioeconomic groups, with parents who are long‑term unemployed) than in others. Collaboration between local agencies (including primary, community and emergency healthcare, social services, schools and public health teams) can lead to more effective identification of children and young people who are at risk of unintentional injury in the home. Local awareness of neighbourhoods and population groups with characteristics associated with increased risk can provide important context for the sharing of information about injuries or risks identified for specific children and young people, for example those attending emergency departments.

Quality measures

Structure

a) Evidence of a local strategy to ensure that households in which children and young people (under 15) may be at greater risk of unintentional injury in the home are identified through collaboration between local agencies for a structured home safety assessment.

Data source: Local data collection.

b) Evidence that local authority departments, local NHS organisations and other local agencies collaborate to implement a local strategy to ensure that households in which children and young people (under 15) may be at greater risk of unintentional injury in the home are identified for a structured home safety assessment.

Data source: Local data collection.

c) Evidence that local authority departments, local NHS organisations and other local agencies collaborate to identify households in which children and young people (under 15) may be at greater risk of unintentional injury in the home.

Data source: Local data collection.

d) Evidence that local authority departments, local NHS organisations and other local agencies collaborate to identify neighbourhoods and population groups in which children and young people (under 15) may be at greater risk of unintentional injury in the home.

Data source: Local data collection.

Outcome

Number of households identified in which children and young people (under 15) may be at greater risk of unintentional injury in the home.

Data source: Local data collection.

What the quality statement means for service providers, health, public health and social care practitioners, and commissioners

Local health and wellbeing boards ensure that their local strategies include identifying neighbourhoods, population subgroups and households in which children and young people (under 15) may be at greater risk of unintentional injury in the home for structured home safety assessments.

Service providers (such as local authority public health teams, children's social services and NHS organisations) collaborate to ensure that households in which children and young people (under 15) may be at greater risk of unintentional injury in the home are identified for structured home safety assessments.

Health, public health and social care practitioners (such as GPs, health visitors, community nurses and midwives, social workers and health promotion workers) contribute to identifying households in which children and young people (under 15) may be at greater risk of unintentional injury in the home for structured home safety assessments.

Commissioners (such as local authorities and clinical commissioning groups) include within the service specifications for commissioned services the need to identify households in which children and young people (under 15) may be at greater risk of unintentional injury in the home for structured home safety assessments.

What the quality statement means for the public

Households with children and young people (under 15) who are at greater risk of having an accident in the home are identified so they can have an assessment of the safety risks in their home. This is particularly important in households with children under 5 because they tend to have more accidents at home.

Source guidance

Definitions of terms used in this quality statement

Home

This term covers the dwelling where children and young people (under 15) live, the garden or yard, communal areas of flats, as well as other family homes where they visit or stay.

[Expert opinion]

Structured home safety assessment

Structured home safety assessments are carried out by trained assessors and usually involve assessing the risk of the most common causes of unintentional injuries to children and young people (including burns, falls, poisoning, drowning, suffocation and choking) in each room.

The assessment should be tailored to meet the household's specific needs and circumstances, and its purpose should be thoroughly and clearly explained to members of the household. Factors to take into account include (not in a priority order):

  • the developmental age of children and young people

  • whether a child or family member has a disability

  • cultural and religious beliefs

  • whether there is limited understanding of English language

  • levels of literacy in the household

  • the level of control people have over their home environment

  • the household's perception of, and degree of trust in, authority

  • living in a property where there is a lack of appropriately installed safety equipment

  • living in a property where hazards have been identified through the Housing Health and Safety Rating System

  • the size of the family

  • families living on low income

  • overcrowded conditions

  • the complexity of the family's needs.

[Adapted from Unintentional injuries in the home: interventions for under 15s (NICE guideline PH30), recommendation 3, and expert opinion]

Households in which children and young people (under 15) may be at greater risk of unintentional injury in the home

Factors to take into account include (not in an order of priority):

  • the developmental age of children and young people

  • whether a child or family member has a disability

  • cultural and religious beliefs

  • whether there is limited understanding of English language

  • levels of literacy in the household

  • the level of control people have over their home environment

  • the household's perception of, and degree of trust in, authority

  • living in a property where there is a lack of appropriately installed safety equipment

  • living in a property where hazards have been identified through the Housing Health and Safety Rating System

  • the size of the family

  • families living on low income

  • overcrowded conditions

  • the complexity of the family's needs.

[Adapted from Unintentional injuries in the home: interventions for under 15s (NICE guideline PH30), recommendation 1]

Identified for a structured home safety assessment

Households in which children and young people (under 15) may be at greater risk of unintentional injury can be identified by using local injury and socioeconomic data. Local data may come from surveys, health services (such as A&E and hospital admission records), joint strategic needs assessments and existing datasets (such as emergency service datasets, local socioeconomic profiles and housing records). Some data may be accessed via local profiles maintained by the Child and Maternal Health Observatory, which is now part of Public Health England.

[Adapted from Unintentional injuries in the home: interventions for under 15s (NICE guideline PH30), recommendation 1, and expert opinion]