Handling Serious Incidents and Injuries in OSC's

Handling Serious Incidents and Injuries in and Out of School or Wraparound Childcare Setting

Throughout the summer term 2024 and into the school holidays, we’ve handled a relatively large number of requests for support with responding to more serious injuries that happen during children’s time in club. We’ve detailed the steps to take below, but we also want to highlight the importance of risk benefit assessment and appropriate supervision to support adults to be in a good place to step in when children need them most.

Balancing the need to minimize risks while promoting children’s right to play freely is crucial for out-of-school providers. Here are some strategies that can help achieve this balance:

1. Conduct Regular Risk Assessments

  • Regularly assess the play environment to identify and mitigate potential hazards without overly restricting children’s activities. The aim is to allow children to engage in play that is sometimes challenging, but in a way that is as safe as possible.
  • Involve children in this process by educating them on recognizing risks, which empowers them to make less hazardous choices during play.

2. Provide a Stimulating Environment

  • Ensure that play areas are safe by regularly checking equipment, surfaces, and surroundings. However, avoid removing all elements of challenge, as these are essential for children’s development.
  • Use age-appropriate and well-maintained play equipment that encourages physical activity and exploration.

3. Support staff to supervise, observe and intervene appropriately

  • Staff should be trained to supervise effectively, ensuring that they can intervene when necessary while still allowing children the freedom to explore and play independently.
  • Model good practice and mentor staff on how to observe play without interrupting unnecessarily, stepping in only when a genuine risk of harm, or need for support is present.
  • Support staff to understand that even though they might be stepping back, that doesn’t mean that they shouldn’t be observing, listening, thinking and considering what’s going on for the children and whether they might be needed.  

4. Implement Clear Play Policies

  • Develop and communicate clear policies that balance safety with the need for child led play. These policies should outline acceptable levels of risk and the role of staff in supervising of and intervening in children’s play.
  • Ensure the policy is clearly explained to staff, parents, and partners so that everyone understands their role, and also what the play policy looks and sounds like in practice - sometimes seeing children at play might not look like adults expect.

5. Promote Risk-Benefit Thinking

  • Adopt a risk-benefit approach, where the benefits of play are weighed against potential risks. This approach encourages allowing children to engage in activities that might carry some risk but offer significant developmental benefits.
  • Encourage and support children to take manageable risks, such as climbing or using new equipment, under supervision and support, to build their confidence and abilities.

6. Engage with Parents and Guardians

  • Communicate with parents about the importance of free play and how it is balanced with safety in the setting. Help them to understand how to support children in playing freely outside the setting too!

7. Encourage Safe Risk-Taking

  • Provide opportunities for children to engage in activities that encourage safe risk-taking which helps them learn to assess risks and make informed decisions.
  • Support children in testing their limits in a controlled environment, which helps them develop resilience and problem-solving skills.

8. Regular Review and Adaptation of Procedures

  • Continuously review safety procedures and adapt them based on observations, feedback, and incidents. The goal is to create a dynamic environment where safety and play can coexist.

9. Foster a Culture of Safe Play

  • Encourage a culture where children are aware of how to play safely and responsibly. This can include supporting them to use equipment safely and to look out for one another, whilst still being playful, creative and curious.
  • Use positive reinforcement to encourage safe behaviours during play.

We know that children should experience more opportunities to play outside of the setting and that this is important for their overall development. We also understands that these opportunities are limited where children are engaged in more sedentary and solitary play at home, or spend time in other coached and adult led activities. We must ensure that children have as much opportunity to play safely and courageously in our settings to balance this as much as possible.

Responding to Serious Injuries in Out-of-School Clubs: A Guide for Childcare Providers in England

Accidents can happen in any setting, and when they involve children, it’s crucial that out-of-school clubs respond swiftly and effectively, particularly when dealing with serious injuries such as broken bones or head injuries that require hospital treatment. Here’s a comprehensive guide on how out-of-school clubs in England should manage such incidents, including when and how to report to Ofsted and under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations (RIDDOR).

 

Immediate Response to the Injury

1. Ensure the Child’s Safety:

  • Immediately assess the situation to ensure the child is safe and remove them from any further danger.
  • Comfort the child and remain calm to help them stay as calm as possible.

2. First Aid Administration:

  • Administer first aid as necessary. If a child has a broken bone, avoid moving the child and try to keep the injured area as still as possible.
  • For head injuries, monitor the child closely for signs of concussion or any deterioration in their condition.

3. Calling Emergency Services:

  • If the injury is serious (e.g., broken bone, head injury, severe cut requiring stitches), dial 999 or 112 for an ambulance.
  • Provide clear and concise information to the emergency operator, including the nature of the injury, the child’s condition, and the location of the setting.

4. Informing Parents or Guardians:

  • Contact the child’s parents or guardians immediately. Provide them with details of the incident, the child’s condition, and any steps already taken (e.g., calling an ambulance).

5. Accompanying the Child to Hospital:

  • A member of staff should accompany the child to the hospital if parents are not immediately available, ensuring the child is not alone during the journey.

 

Recording the Incident

1. Accident Book:

  • Record the details of the incident in the setting’s accident book as soon as possible after the event. Include the time, date, nature of the injury, how it occurred, what actions were taken, and who was involved.
  • Ensure this record is factual and free from opinions or assumptions.

Reporting the Incident

1. Notifying Ofsted:

  • Ofsted must be notified if the injury is serious. According to Ofsted guidelines, providers must report any serious accident, illness, or injury to a child while in their care. This includes incidents that require medical treatment or hospital admission.
  • Providers should report the incident to Ofsted as soon as possible but no later than 14 days after the incident.

2. RIDDOR Reporting:

  • The Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations (RIDDOR) require that serious injuries, such as fractures (excluding fingers, thumbs, and toes), loss of consciousness, and injuries leading to hospital admission for more than 24 hours, be reported to the Health and Safety Executive (HSE).
  • Reporting under RIDDOR must be done within 10 days of the incident. The report can be made online through the HSE website.

3. Internal Review:

  • After the incident, conduct an internal review to understand how the accident happened and whether any changes to procedures or the environment could prevent a similar occurrence in the future.
  • Document the review and any subsequent actions taken.

 

Supporting Staff and Children

1. Debriefing Staff:

  • Provide a debrief for staff involved in the incident. This helps in addressing any emotional impact and ensures all staff are clear on the procedures followed.

2. Supporting the Child and Family:

  • Follow up with the child and their family to provide support and updates on any changes made as a result of the incident. This shows the setting’s commitment to child safety and continuous improvement.

3. Communicating with Other Parents:

  • Without breaching confidentiality, communicate with other parents about the incident to reassure them of the steps taken to ensure the safety of all children in the setting.

Final Thoughts

Dealing with serious injuries in an out-of-school club setting requires prompt action, clear communication, and adherence to regulatory requirements. By following these steps, you can ensure that the child receives the necessary care, that parents and authorities are properly informed, and that your setting remains compliant with regulations. Always prioritise the safety and well-being of the children in your care and continuously strive to create a safe environment for them.

 

For more detailed guidance, you can refer to the official Ofsted guidelines and the Health and Safety Executive’s RIDDOR reporting requirements.