Safer Sleep - Making Changes

Let's imagine the scenario - you've been a childminder for many years now and you have always put sleeping children outside in prams or buggies. You don't have a lot of inside space, parents are happy with your current arrangements and everyone sleeps well. Children are safe, they have high levels of wellbeing after a good nap and you are able to support other children's care and learning effectively while watching them sleep.

You have seen social media posts about new sleep requirements - but you are unhappy about making any changes - it will disrupt the children and you don't have space or money for cots (no funding is available). You even considered your friend's idea of walking around for an hour every day just so the babies could still sleep comfortably in their buggies after a disastrous attempt to move them onto mats, but you don't think this will work for you or the older children long term.

What should you do?

The quick answer is that you need to make the changes to the new safer sleep requirements now. DfE and Ofsted have said that providers shouldn't wait until September when the changes become law - babies and children need to be safer now.

Your thinking is that they have always been safe - but you have to accept that, whatever used to happen, DfE have introduced the new sleep requirements and change must happen.

Ofsted has clearly said 'no buggies for sleep in the setting' as well - and if babies or children fall asleep on outings in prams, buggies or car seats, they need to be transferred to their cot (for babies under 1) or sleep mat when you return.

When your Ofsted inspector contacts you to visit, it's about being confident in your safer sleep practices.

Read the requirements

For example, you must be confident understanding:

• Why routine sleeping in a buggy or pram is no longer an option.
• The difference between transporting a child in a buggy and using a buggy as a safe sleep space.
• Why a flat, firm, waterproof mattress is considered the safest option as a sleep surface.
• The increased emphasis on regular observation - from now onwards, babies and young children must be in sight and hearing when sleeping.
• How babies under 6 months of age must be in the same room as you when sleeping.
• That even if you have a monitor, you must still go into the room to look at and touch babies when they are sleeping to check their wellbeing and temperature.

As well as simply knowing the new rules, it will help to understand the reasons behind the changes. Babies and young children have tragically died and yes, I know, they haven't died in buggies or prams or in childminding settings, but DfE has decided to change all practice.

Inspectors report they have been into childminding settings where children sleep on the childminder's bed, in a bouncy chair, on a shared sofa or in a dirty pram. They have seen babies put down to sleep in unsuitable hallways and buggies that are used for sleep stacked in front of fire doors. Change had to happen and it is huge for many providers.

Do some training

It is not a requirement - but it is recommended that you do some safer sleep training from a trusted source.

There is a course on the Lullaby Trust website, your Local Authority might have some training and Childcare.co.uk gold members can watch a recorded Safer Sleep Update webinar on the changes.

If you have staff, make sure they engage with training as well and understand the changes.

It's not just about having a training certificate in the CPD file or sitting in front of a PowerPoint. You need to be confident that everyone in your setting can put the training into action. Check during supervisions that assistants in the setting can, for example, explain safer sleep procedures and talk confidently about the changes they have made.

Set up the sleep environment

Review whether you have suitable sleep spaces available - for example, a cot or travel cot, Moses basket (where age-appropriate) or mattress on the floor (if suitable for the child's age). There are BSEN numbers on the Lullaby Trust website and in DfE 'Frequently Asked Questions' guidance.

From now onwards, you have to use a cot, travel cot etc - not a buggy or pram unless you are on an outing and then, when you get back, you will need the sleep spaces set up because you have to transfer them.

DfE has also made a decision that sleep coracles cannot be used for babies under the age of 1, so any in use will need to be removed immediately and replaced with cots.

Check that the cot mattress fits the space correctly (firm, flat, waterproof), don't put anything else in the cot except a well-fitting sheet and lightweight tucked in blanket (if needed) and monitor the room temperature (16-20°c recommended). Babies must be placed on their backs to sleep - no exceptions. Once they can roll back and front, you can leave them to find their own position but still put them down on their back.

Consistent practice

It is important to be consistent as you make changes. For example, you might need to make changes to your daily routines, so the same thing is happening every day for the child. If they are struggling, you will need to be consistent to help them with the transition. Think about how outings are planned - if you come back from an outing with a child who is asleep and try to transfer them and they always wake up, leaving them tired later - can you tweak the times?

You will also need to consider how younger and older children's needs are balanced. You might find that you need to redesign your setting and set up a room divider to allow older children space to play (check floor space) as well as changing your routines.

If a baby is finding the transition hard and needs more time with you to settle, think about what older children are doing at this time. They can't be in front of screens because of the new screen guidance that will be linked in the EYFS from September - they will need to be busy playing and as soon as you are finished settling the baby, you will need to go back to interacting with them.

Some babies are used to motion and will struggle to sleep in a different space - some use extra blankets or toys to hold or suck - some are used to parents putting a muslin over their heads. These practices need to be stopped immediately. You should introduce the empty space, keep to regular routines, use the same comfort cues (well fitting sleep sacks might help mimic a cosy buggy) and allow for extra settling time (not easy if you have older children to care for at the same time).

Involve parents, so routines are as consistent as possible between home and the setting.

Childcare.co.uk has a useful webinar about reviewing your Daily Routines without resorting to extra screen time.

Supervision

You might find the change in supervision requirements tricky, especially if you have babies under the age of 6 months because they will need to be with you - and you might have older children who need your attention. You cannot use a sling or bouncy chair for babies - they must be in an empty cot and in your sight and hearing (no monitor for under 6m).

For other sleeping babies and children over 6 months, think about how often you will check them (visual to check breathing and touch the neck to check temperature), whether you will record observations (not required by the EYFS) and what type of sleep monitor you will use (must have video and audio). You must be able to explain to your inspector how you know a sleeping child remains safe.

Risk assessment

You will need to update your safer sleep risk assessment, but it is up to you whether the risk assessment is in writing or not. Your risk assessment might include how you have stopped routine buggy sleeping, changed sleep locations, reviewed your supervision arrangements and thoughts about how you will manage routines and outings with sleeping children.

The risk assessment must also consider, for example, the location of fire doors and how to get children out in an emergency, fire safety, window and blind safety, trailing cables etc - none of these were an issue when babies and children slept in buggies in the garden.

If you do want to retain outside sleeping, Childcare.co.uk has some guidance.

The important point is that the risk assessment is updated to reflect what actually happens now.

Working with parents

You will need to keep parents updated with any changes you are making. Let them know how things are going at each stage and ask them to monitor their child's routine and sleep at home - for example, they might be struggling during the day, but happy at home or older children might comment about the changes. Share how children are adapting in the setting and remind parents that it's a process and their child might take time to adjust. If parents have any questions, you might find it useful to download and share the Lullaby Trust guidance booklet with them.

Reflective practice

As part of your self-reflection and action planning, you might want to make notes about the changes you have made and think about what is working well, what has been challenging and whether the changes have improved sleep. Is there anything else that needs to be reviewed? If you have an unplanned inspection and you are not quite there yet, you will need to talk about your next steps.

You will find that your confidence will grow through reflection, rather than expecting everything to work immediately.

During inspection

For an Ofsted inspection, the emphasis is less on whether the transition has been perfect and more on whether you understand the new requirements, have reflected on your practice and adapted thoughtfully. The inspector will grade safer sleep across the safeguarding, children's welfare and wellbeing and leadership and governance inspection areas, so think about how you can demonstrate that children's safety and wellbeing has been central to your decision-making throughout the process.