Practice tool
Safety and basic care — Tuituia subdomain
This Tuituia domain explores how the parents or caregivers provide for the physical needs of tamariki and how they protect them from harm and risk.Upcoming changes for this content
Subdomain: Protecting from harm and risk
Parents/caregivers are responsible for protecting mokopuna from violence and those who pose a risk to mokopuna safety. The link between family violence and child maltreatment is now firmly established and there is a growing body of evidence that shows the impact of hearing, seeing and being around violence within the family has on the wellbeing of mokopuna. In addition, the impact on the adult victim can also be far reaching, both physically and mentally, affecting their ability to safely parent.
Assessment prompts
- In what ways does the parent/caregiver protect this child from harm and risk?
- How has this been demonstrated in the past with this child and other children in their care?
- In what ways does the parent/caregiver protect mokopuna from harmful and dangerous situations — such as self-harm, contact with unsafe adults?
- Do they condone or otherwise support harmful behaviour — such as offending, substance abuse, concerning/harmful sexual activity?
Descriptors: protecting from harm and risk
10 — Fully protective and capable of identifying risk. Actively encourages safe behaviour amongst children, young people and adults. Actively supports the child or young person in their care and takes responsibility for supporting healthy, safe, pro-social behaviour.
5 — Is protective and supportive some of the time.
1 — Is or has been abusive and/or neglectful towards the child or young person or other children/young people. Does not protect them from others and/or situations that pose a risk. Has had a child/children removed from their care. Does not support the child or young person in their care and takes no responsibility for supporting healthy and safe behaviour. Condones and/or supports offending behaviour.
Subdomain: Meeting physical needs
Providing for children’s safety and basic health care needs is a key function of parenting and an important aspect in ensuring the overall wellbeing of tamariki.
For very young children, the responsibility for protection lies with their parents/caregivers. Young children first learn about safety and basic health care from their parents and other adults. By observing adult actions and receiving verbal instruction, children learn that basic health care and safety practices are important. Children’s knowledge about safety and personal health care needs increase with development. The parent/caregiver role is to help children develop and exercise their abilities that allow them to begin taking responsibility for their own safety and health through the choices and decisions they make.
Children without this support are unlikely to consistently take good care of their physical health and engage in practices that increase their physical safety and reduce the risk of physical harm. In New Zealand unintentional injury remains the leading cause of death in children aged 1–14 years with age and developmental stage affect the types of injury incurred (NZ Paediatric Society, 2011)
Assessment prompts
- Explore the extent to which physical needs of the child are being age-appropriately met by parents/caregivers in the following areas:
- nutritious diet/supporting healthy eating patterns
- supporting healthy rest and activity patterns — safe sleeping space/adequate bedding
- appropriate clothing — clean and suitable for time of year
- personal hygiene/supporting healthy self-care practices
- precautions taken to prevent accidental injury
- smoke free environment
- medical (including hearing/vision) and dental care — how are these areas provided for in a universal way and when needs arise?
- management of particular health conditions.
- Where there is an unborn mokopuna, consider how well Mum is taking care of her own health and nutrition. Is she behaving in a manner that may affect the unborn mokopuna — smoking, taking drugs and alcohol?
Descriptors: meeting physical needs
10 — Physical environment is safe, healthy and child-centred. Child or young person’s basic care needs are fully and appropriately met. Is pregnant and their own health, nutrition and behaviour is directed towards ensuring a healthy baby.
5 — Physical environment is improving and/or the adult recognises harm associated with physical living conditions but needs assistance from other agencies to bring about change. Understands what behaviour change that is needed and is working towards this but requires support and assistance to keep on track.
1 — Physical environment is unsafe and/or unhealthy. Unable to see how this poses a risk to wellbeing needs of children or young people. Basic needs (healthy food, clothing, hygiene, health, dental care, safe sleeping) are not being provided or are age inappropriate. Is pregnant and own health, nutrition and/or behaviour e.g. smoking, drug and alcohol use, unsafe sexual activity is detrimental to development of unborn child.
Subdomain: Partner relationships
Parental conflict is associated with behavioural problems and other negative impacts on mokopuna regardless of whether the parents live together or apart. Spousal conflict can in fact negate benefits for mokopuna of protective factors such as father involvement or co-residence.
Assessment prompts
- How do the partner relationships demonstrate stability, support and the capacity to deal with the challenges of parenting?
- Is there family violence in the relationship?
Use family violence screening questions:- is there someone making you feel unsafe or afraid?
- have you been hit, kicked, and punched, forced to have sex or otherwise felt controlled or mistreated by any member of your house hold or extended family?
- Has anyone threatened to hurt, hurt, or acted violently towards a pet? What happened?
- There may be occasions where the parent/caregiver is obviously injured or distressed and a simple question about what is troubling them or how the injury occurred may result in a disclosure:
- I notice you have a bruise.
- I am worried someone might be hurting you/have caused this.
- Where family violence is occurring describe how this is being manifested?
- physical, psychological/emotional, sexual, financial or economic, spiritual
- what support has been accessed?
- is there a safety plan and/or a Protection Order in place?
Descriptors: partner relationships
10 — Relationships are violence free, supportive, stable and capable of dealing with crises and the challenges of parenting.
5 — Frequency and severity of conflict and/or violence is reducing. There is recognition that problems exist and help has been sought. Change is beginning to occur but is inconsistent and ongoing support is required.
1 — There is frequent and severe conflict, and mutual support is rarely exhibited. Violence occurs on a regular basis and this has impacted the adult’s ability to interact warmly and predictably, problem solve, deal with stress, care for self and meet the wellbeing needs of the child or young person in their care. There may be frequent changes of partner.
Subdomain: Household members
It is important to establish who makes up the household — those who live in the house and those who visit frequently.
Assessment prompts
- Who is living in the home, what is their relationship to each other and the mokopuna?
- What role do they have in the life of the mokopuna?
- How do they enhance wellbeing for the mokopuna, how they pose risk or harm?
- How stable and consistent is the household?
Descriptors: household members
10 — Stable and consistent household membership providing a supportive and safe child and young person focused environment.
5 — Some change in household members. They occasionally support safe parenting but this is inconsistent.
1 — Household members change frequently; they lack a child or young person focus and/or have known history of abuse and neglect of children and/or are currently offending.