Regulation 10: The Health and Well-being Standard : Physical Health, Mental Health, Medication, Health Plans & Healthy Lifestyles

1. The single question behind Regulation 10

Regulation 10 asks whether children's physical, mental and emotional health is supported, and whether the home helps them understand and take increasing responsibility for their own health. The standard covers a wide range of needs: routine health care, mental and emotional well-being, medication, long-term conditions, disability, sexual health, substance use, and the child's growing independence in managing their own health.

The DfE Guide describes well-being as a multi-dimensional concept. It is not just the absence of illness. It includes physical health, mental and emotional health, social well-being, and the child's sense of themselves. This means a home that only thinks about health when a child is ill or has an appointment is not fully meeting the standard.

Child-centred question

Does this child understand their own health needs, and are they developing the confidence and skills to manage them as they grow?

2. Health plans and health assessments

Regulation 10 requires the home to ensure children receive health assessments and that health plans are in place and followed. For looked-after children, the initial health assessment should happen within 28 days of becoming looked after, and review health assessments should happen at least annually, or more frequently for children under five. The home's role is to ensure these happen, to follow the health plan, and to share relevant information with health professionals.

A health plan is only useful if it informs daily care. If the plan says a child needs support with sleep, anxiety, or a long-term condition, staff need to know what that means for their work. A health plan filed in the office that staff have not read or understood does not meet the standard.

3. GP and dental registration

Regulation 10 requires children to be registered with a GP and a dentist. The DfE Guide says this should happen promptly after admission. For children who move between areas, the home should ensure registration is transferred rather than allowing the child to fall through the gap. A child who is not registered with a GP cannot access routine health care, and a child who is not registered with a dentist may miss dental problems until they become serious.

The practical test is whether the home can say, for each child: who is their GP? When did they last see a dentist? When is their next appointment? If the answer is that nobody knows, or that registration has lapsed, the standard is not being met.

4. Health appointments and advocacy

The home's role is not just to book appointments. It is to ensure the child actually attends, that the child is supported during the appointment, and that any recommendations are followed. The DfE Guide says staff should support children to understand their health needs and to participate in decisions about their health.

This is where Regulation 5 connects. If a child is on a CAMHS waiting list for months, or if a health appointment is repeatedly cancelled by the provider, the home should not simply note the delay. Regulation 5 requires the home to engage with and, where necessary, challenge the wider system. A home that records that CAMHS has not responded but does nothing about it is not meeting the overarching standard.

5. Physical health

Physical health covers routine care: immunisations, vision and hearing checks, growth and development, skin conditions, and the management of minor illnesses. It also covers responding to health concerns promptly. A child who is unwell should see a health professional, not be told to wait and see if it gets better unless that is appropriate medical advice.

The DfE Guide says homes should promote healthy lifestyles, including nutrition, exercise, and sleep. This is not about enforcing a regime. It is about helping children develop healthy habits that will serve them throughout life. A home where children eat poorly, get no exercise, and have no sleep routine may be meeting the child's immediate wishes but not supporting their long-term well-being.

6. Mental and emotional health

Regulation 10 explicitly covers mental and emotional well-being. The DfE Guide says children in care are more likely to experience mental health difficulties, and that homes should be alert to signs of distress, anxiety, depression, self-harm, and other mental health needs. The home's role is to notice, to support, and to help the child access specialist services when needed.

This does not mean staff need to be mental health professionals. But they do need to understand that a child's behaviour may be communicating distress, and that responding to the behaviour without understanding the underlying need may make things worse. A child who is withdrawn, angry, or self-harming needs support, not just behaviour management.

7. CAMHS and specialist services

Many children in residential care need access to CAMHS or other specialist mental health services. The home's role is to refer, to support the child through the process, and to follow any recommendations. The DfE Guide says homes should work closely with health services and should advocate for children when services are not delivered promptly.

A common challenge is waiting times. A child may wait months for a CAMHS assessment. During that time, the home should not simply wait. It should provide emotional support, use de-escalation and relationship-based approaches, and consider whether other support is available. It should also escalate, using Regulation 5, if the wait is putting the child at risk.

8. Self-harm and suicide risk

Self-harm and suicide risk are serious concerns for some children in residential care. The home should have clear procedures for responding to self-harm, for assessing suicide risk, and for ensuring the child gets appropriate professional support. This is not an area for improvisation. Staff need training, clear protocols, and access to professional advice.

The home should also think about how it supports a child after a self-harm incident or a suicide attempt. The immediate crisis may pass, but the underlying need remains. A child who has self-harmed needs ongoing support, not just an incident report and a return to normal routines.

9. Sexual health and relationships

The DfE Guide says homes should support children's sexual health and relationships education in an age-appropriate way. This includes helping children understand their bodies, relationships, consent, and safe sexual practices. It also means the home should not avoid these conversations because they are uncomfortable.

For some children, particularly those who have experienced sexual abuse or exploitation, this is a sensitive area. The home's approach should be trauma-informed: not avoiding the topic, but also not pushing the child faster than they can manage. Professional support may be needed, and the home should work with the child's social worker and health professionals.

10. Substance use

Some children in residential care may use alcohol or drugs. The home's response should be proportionate and informed. The DfE Guide says homes should help children understand the risks of substance use and should support children who are using substances to reduce harm and access help.

A purely punitive response may drive the behaviour underground rather than addressing it. The home should balance safety with a harm-reduction approach, working with the child's social worker and health professionals where appropriate.

11. Medication and Regulation 23

Medication management is covered in detail in the Hub's dedicated Regulation 23 resource. The key point for Regulation 10 is that the home must ensure children receive their prescribed medication safely, that medication is stored and administered properly, and that the child is supported to understand what they are taking and why.

The DfE Guide says homes should support children to self-administer medication where appropriate and safe. This connects to the broader requirement under Regulation 10 to help children take increasing responsibility for their own health. A child who will soon leave care needs to understand their own medication, not rely on staff to manage it for them.

12. Long-term conditions and disability

Some children in residential care have long-term health conditions or disabilities. The home's role is to ensure the condition is managed, that the child has access to appropriate specialist services, and that the child is supported to understand and manage their condition as they grow.

This may involve working with specialist nurses, attending regular appointments, managing equipment or adaptations, and ensuring staff are trained to support the child's specific needs. The home should not accept a placement it cannot meet. If a child has complex health needs, the home needs to be confident it can provide the right support before agreeing to the placement.

13. Children understanding their own health

Regulation 10 requires the home to support children to understand and take increasing responsibility for their own health. This is a gradual process. For younger children, it might mean helping them understand why they need to see a dentist. For older children, it might mean supporting them to make their own appointments, manage their own medication, and understand their own health history.

This is particularly important for children approaching adulthood. A child who leaves care without understanding their own health needs, without knowing how to register with a GP, or without knowing their own medical history is being set up to struggle. The home should think about health independence as part of transition planning, not as something that happens automatically at 18.

Child-centred question

When this child leaves care, will they know how to look after their own health? Will they know their medical history? Will they know how to register with a GP and make appointments?

14. When health services are delayed

Regulation 5 runs across all the Quality Standards, and it is particularly relevant to health. Children in residential care often struggle to access health services promptly. CAMHS waiting times, specialist assessments, and even routine appointments can be delayed. The home cannot deliver these services itself, but it should not simply accept the delay.

The home should escalate, advocate, and document. It should contact the social worker, the IRO, the commissioning authority, and the health service. It should record what it has done and what response it has received. If a child's health is deteriorating while they wait, the home should treat that as a safeguarding matter, not just an administrative delay.

15. What Ofsted may explore

The SCCIF evaluates the overall experiences and progress of children. Inspectors may explore Regulation 10 through conversations with children and staff, observation of daily life, and reading of health records. They may look at whether children's health needs are being met, whether the home is advocating for children when services are delayed, and whether children are developing health independence.

Evidence may include: health plans and whether they are followed; GP and dental registration; medication records; mental health support; the home's response to health delays; and children's own understanding of their health. Inspectors may also consider how the home supports children with long-term conditions or disabilities.

16. Questions for the Registered Manager and Deputy

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