Making the wider connections with housing, home safety and the built environment

November 2012

Decent housing is an essential part of children’s health, safety and wellbeing. Here we outline some of the ways in which people working in child accident prevention can build connections with housing, home safety and the built environment.

Research highlights the need to provide a common evidence base and an integrated approach to housing-related support for vulnerable groups. In 2004, nearly 25% of children aged 0-15 lived in ‘non-decent’ homes, while nearly 10% lived in ‘homes in serious disrepair’. Homeless, temporary accommodation and overcrowding can all impact on the health and development of children. A higher rate of accidents is one of the factors linked to poor housing.

In 2008, the Family and Parenting Institute's Homes Fit for Families evidence review explored how children and families are affected by their physical environment, both in their home and their immediate neighbourhood. Issues include space, with particular child safety risks from lack of space in the kitchen, high-rise building and overcrowding. There are also links between unsafe housing, care and wellbeing.

The Children's Society's Promoting positive well-being for children report identifies a safe and suitable home environment and local area as one of six priorities.

General resources and guidance

NICE Public Health Guidance 30, Preventing unintentional injuries among under-15s in the home contains recommendations for home safety.

RoSPA has published case studies from Safe at Home - the National Home Safety Equipment Scheme, which benefitted more than 66,000 families.

In April 2012 the Chartered Institute of Housing and Foundations produced guidance on developing housing and health partnerships. The guidance focuses on the health and housing needs of older people, including accidents and falls prevention, but contains useful information about developing closer working relationships across health and housing - which can provide opportunities for engagement to support the wider housing, health and safety needs of children and families.

Too hot to handle DVD resource packBath water scalds

Hot bath water is responsible for the highest number of fatal and severe scalding injuries among young children. Fitting a simple thermostatic mixing valve (TMV) is an effective way to reduce the risk of bath water scalds.

For more information, see:

Environmental health

The Chartered Institute of Environmental Health has published a toolkit for environmental health practitioners. Good Housing Leads to Good Health explores the links between public health and housing, including the use of Health Impact Assessments and the influence of health determinants as a wider contribution to quality of life and society, rather than just health costs.

Building regulations

Building regulations ensure the health, safety and welfare of people in and around buildings. The regulations apply to most new buildings and many alterations of existing buildings in England and Wales, whether domestic, commercial or industrial, and the guidance is contained in a series of ‘Approved Documents’.

Safety in the home, for example, is covered by recent revisions on fire safety (Approved Document B - 2006) and Electrical safety (Approved Document P - 2006). As a result of changes to Approved Document G, from October 2009 all new build homes will have protective measures such TMVs fitted to baths to reduce bath water scalding – a particular home safety risk for children.

Housing Health and Safety Rating System

From April 2006, the Housing Health and Safety Rating System (HHSRS) replaced the fitness standard to provide a systematic risk assessment of hazards that might be present in homes. For some children and young people, such as those with disabilities, housing may be unsuitable because of the restrictive environment in which they spend much of their time. This can lead to injuries such as falls and accidents in the kitchen.

In addition to tackling major home hazards through the HHSRS, such as fire safety, all homes can be made safer for children through the installation of simple but essential home safety measures such as smoke alarms, safety gates, fire guards, cupboard locks and window locks.

Fire and gas safety

Free home fire risk checks are carried out by the Fire and Rescue Service in many areas. Community fire safety staff and advocates will advise on fire prevention in the home and particular domestic fire risks such as the safety in the kitchen.

Guidance on preventing accidental deaths from carbon monoxide (CO) poisoning has been issued by the Department of Health. Children are among those at increased risk from CO poisoning in the home. Further information on gas safety and carbon monoxide awareness can be obtained from Gas Safe Register.

Social housing standards

Tenants groups actively campaign about decent housing standards. From April 2010 social housing providers have had to meet a regulatory framework - and a new version of the framework came into force in April 2012. It includes a number of standards with outcomes which landlords should meet, including ‘home’ (Decent Homes and the health and safety of occupants), and ‘neighbourhood and community’ (working in partnership to keep the neighbourhood and communal areas associated with homes clean and safe).

Health and spatial planning

Child safety and wellbeing are likely to be among the concerns of those involved in planning and neighbourhood management. The important links between planning and health are recognised in the Department of Health's guide to town planning for NHS staff.

The Prevention is still better than cure case study from the Planning Advisory Service reports on successful initiatives councils are taking in creating health-promoting environments and contributing to the provision of health facilities.

In 2010 the TCPA published Spatial Planning for Health: A guide to embedding JSNA in spatial planning. The Spatial Planning and Health Group (SPAHG) website includes evidence on spatial planning and health gathered for a NICE public health guidance project.

Product safety regulations

Product safety regulations and the work of local trading standards officers help to ensure that there is less risk to children as a result of faulty or dangerous consumer goods in the home. Specific child products safety regulations cover items such as hood cords, bunk beds, pushchairs and the flammability of children’s clothing.

The safety of other child use and care products is covered by the General Product Safety Regulations 2005. Other areas of particular focus for product safety in relation to children include toy safety and the sale of novelty lighters. For home safety more generally it is estimated that Furniture Fire Safety Regulations have saved hundreds of lives through reduced numbers of dwelling fire deaths.

See also Levels of intervention for information on the role of regulation in safety interventions.

Newer home safety risks

As well as the well-established measures which help to ensure safer homes, the emergence of newer risks in recent years have given cause for concern and vigilance. These include injuries and death from falling TV sets, strangulation hazards from window blinds with looped cords or chains, and children being trapped in electrically powered gates to homes or housing developments.

Electrically powered gates

For certain incidents, such as electrically powered gates, where there may be design, construction or installation issues, the Health and Safety Executive (HSE) may publish a Safety Notice to alert manufacturers and other organisations, and to minimise the risk of further incidents. See, for example, the safety notice on electrically powered gates.

Window blind cords

Recognising the hazards posed by window blind cords to children, mainly under four years of age, and vulnerable adults, the Department of Health has issued an estates and facilities alert advising that risk assessments should be carried out on looped blind cords, primarily in healthcare environments where children and vulnerable adults are commonly present.

The Make it safe campaign from the British Blind and Shutter Association (BBSA) has advice on reducing the risk from looped blind cords and chains used in the home. See also CAPT's Talking about strangulation resource for practitioners.

Where to find current information

Information on current developments in home safety can be found on the following websites and, where available, e-bulletins:

Updated June 2013