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C3.1 Children's Health

Children’s Health - Including: Illness and Infection; Sick Children; Administration of Medication; Accidents; First Aid; Head Lice; Sun Protection

Introduction:

Provision of a healthy environment is essential to the wellbeing of children and adults. Good quality care includes taking steps to prevent illness, spread of infection and accidents, being prepared to deal with emergencies if and when they occur and educating children about staying healthy.

Illness and Infection:

The building and all its equipment must be maintained in a clean and healthy manner to prevent illness and the spread of disease. Awareness of how illness spreads and using cleanliness to control its transmission should be the basis of prevention. Toys and equipment should be cleaned regularly. This is especially important when children with an infectious illness have been playing with a toy.

To prevent the spread of infection, kitchen staff should ensure that the following practices are adhered to:

  • Washing up done thoroughly in a dishwasher or in hot water with detergent.
  • Drying up cloths replaced every day with clean ones.
  • Follow the settings guidelines displayed on the walls for kitchen and food only cloths

Different cleaning cloths should be used for kitchen and toilet areas and separate cloths for the floor. All washed/disinfected or renewed regularly. These should be washed and stored separately

Hands should always be washed before and after handling food. Staff involved with the handling of food in the nursery should have completed a Food Hygiene Course. Children should also wash their hands before and after eating and drinking

Other times children and staff should wash their hands include after outside play, after messy play activities. After blowing noses, sneezing and coughing. After toileting and nappy changes and any other personal care that may include coming into contact with bodily fluids such as sick or blood. Hand sanitizer is available but must only be used by adults.

Tissues will be available and children are encouraged to blow and wipe their noses when necessary. These should be disposed of in the bin immediately after use. When coughing and sneezing, children should be encouraged to shield their mouths.

The Environmental Health Officer must be contacted about suspected food related outbreaks. Kitchen staff must ensure cuts and sores are covered up with clean dressings which are changed regularly. This is essential to prevent the spread of infection to the children. The nursery kitchen should have;

  • A refrigerator thermometer to ensure that foods are being stored at the correct temperature. Temperatures should be logged
  • Adequate storage for cold, frozen and dry foods
  • Refuse bins with fitted lids

Good hygiene practice is vital in the prevention of transmission of many infections. Spillages of body fluids must be cleaned up promptly with hot soapy water. Bleach is not to be used in the nurseries whilst children are present. Disposable cloths/paper towels should be used for cleaning such spillages. In the case of bodily fluids coming into contact with skin, it should be cleaned immediately.

Fabrics contaminated with body fluids should be rinsed out in a bodily fluids bucket using the sluice sink in the laundry room. If they are then going to be washed this should be done on the hot cycle in the washing machine, if not then they should be tied up in a plastic bag and sent home.

When a child has contracted an infectious disease, a sign giving parents/carers information about the illness should be posted in a place where it is easy for them to see. The poster should be displayed for a reasonable amount of time to ensure that all parents/carers are informed.

Sick Children:

The nursery does not aim to exclude children from the nursery unnecessarily. The decision of the Childcare Services Managers is final when requesting the exclusion of a child for illness or infection. Decisions will take into account the needs of the child and of the group. Children with infectious or contagious diseases will be excluded for the periods laid down in Public Health England Guidance on Infection Control in Schools and Other Childcare Settings. Should staff suspect that a child has an infectious or contagious disease, they will request that parents consult a doctor before returning the child to the nursery. Public Health England Guidance for periods of exclusion charts is on display on the parent/carer information board in reception for further information.

Sick children cannot be admitted to the nursery. If a child becomes ill at nursery, staff will inform parents or an emergency contact. While awaiting the arrival of parents, the staff will ensure the comfort of the child, taking appropriate action which would include seeking medical advice if necessary. If the child is in danger, the staff will seek medical advice immediately.

If a child feels unwell at nursery, staff will take and record their temperature. If the temperature is high, the child will be undressed to their underwear, given a cold compress and a drink. A member of staff will remain with the child. The temperature will be taken again after 30 minutes and recorded. If there is no change, or it has risen higher, the parents/carer will be called. The nursery staff may feel that the child requires paracetamol whilst they are still in our care. If the child has their own then this will be administered with telephone permission from the parents. If they do not then nursery paracetamol maybe administered. Staff will only do this if parents have agreed to this on their personal details forms and in addition to that verbal permission over the phone. In both cases parents will be asked to sign the medication form when they collect their child.

Children suffering from diarrhoea and vomiting should remain at home until they have been well for 48 hours.

Staff will report any worries about a child’s health to the parents/carers immediately and will record concerns in the child’s running record. Parents are responsible for keeping the nursery informed about the child’s health. OFSTED and the local PHE centre must be informed of any infectious disease contracted by a child registered with the nursery that a qualified medical practitioner considers notifiable.

Administration of Medication:

If a child is well enough to attend, but still requires medication, it may be administered by the childcare staff. We cannot administer medicines and other treatments without signed permission from the parent. Medicines must be marked with the child’s name. Prescription medicines must have the chemists label with full details including the child’s full name. Parents/carers must complete a medication form (GFC11) giving details of the symptoms, medicine, dosage and time; they must also sign to confirm that they have administered the first dose and that the child has not had any adverse reactions. Any unused medicines will be returned to the parent/carer for disposal. We are able to administer prescribed and non-prescribed medication. Where the medication is prescribed nursery staff will follow the guidelines on the label which have been outlined by the Dr even if this differs from instructions given by parents. For non-prescribed medication the guidelines on the label will be followed and dosages will not be exceeded.

If children have emergency medication such as an inhaler which may only need to be used on occasion, a termly medication form will be completed. It is parent/carers responsibility to update the staff of any changes to this. This will be reviewed and completed each term. Some forms of treatment require staff to have instruction from a health care professional, in which case we will ask parents to arrange for the instruction to take place.

Accidents:

All accidents involving children, whilst at Greenfields, should be recorded on an Accident Form which will be checked and signed by a senior staff member. The white top copy is given to the parent and the yellow bottom copy is retained by the nursery for our records. The accident should be reported to the parent/carer, and a full explanation given, on the day that the accident occurred. Parents/carers should then sign as confirmation that they have been informed of the accident. OFSTED must be notified of any injury requiring a doctor/hospital consultation to any child or adult on the premises. Refer to the OFSTED document - Serious Accidents, Injuries and Deaths that Registered Providers Must Notify to OFSTED and Local Child Protection Agencies.

All accidents to children and adults must be recorded detailing:

  • Date, time and place
  • Name of injured person
  • Circumstances of accident
  • Nature of injury sustained
  • Action taken and by whom
  • Confirmation of notification to parents
  • Any witness to the accident

Accident records relating to any incident in which a child has received an injury should be kept by the nursery for their own protection until there is no risk of claim against the registered provider and/or their insurance. Claims for personal injuries can be brought within three years of the incident occurring by the parents and/or by the child itself within three years after he/she reaches 18 years of age.

If an accident involves a head injury, parents/carers will be given an information sheet when asked to sign the accident form. Staff will ring parents/carers if they consider that the child needs to be collected from nursery and cared for at home or if they require medical attention.

When a child arrives at nursery with an injury this will need to be recorded on an Outside Accident Form. The nursery staff will ask the parents for details of the injury and how it occurred. They will also ask about any treatment that was given. It is parent/carers responsibility to inform the nursery about any injuries that have occurred whilst the child has not been at nursery. In the event that parents/carers forget, nursery staff will ask about the injury when the child is collected and complete the form at this time.

First Aid:

It is the policy of Greenfields that all childcare staff be trained in paediatric first aid during their first year at the centre and updated every 3 years. There will be at least one member of staff with a First Aid certificate on the premises at all times. All nursery staff and volunteers should know the procedures for dealing with minor accidents and illnesses. First Aid boxes are available within each room and kitchen and are easily available to all adults but beyond the reach of children. Contents of the first aid boxes should be checked regularly and items should be replaced as necessary.

  • Bumps to any part of the body will be treated with a clean cold compress.
  • Cuts and grazes will be cleaned with sterile gauze, which will then be disposed of. A plaster/dressing must be applied to any open wound.
  • Creams, lotions and antiseptics will not be used on the children.
  • Staff will wear disposable gloves and aprons when administering first aid.

Head Lice:

When a case of head lice is found in the nursery or after school club, the following procedure is implemented:

  • If a child is distressed by the head lice, the parent/carer will be contacted and asked to collect the child as soon as possible. If a child is not suffering, the parent/carer will informed when they collect their child.
  • The parent/carer must treat the head lice effectively at home.
  • Once the child has returned to Greenfields, staff may ask to check the hair before the child is left at the centre.
  • If the child is found to still have head lice the parents will be asked to act upon this on the same day. The child may remain at nursery if the parent is taking action to treat the child as soon as possible.

Sun Protection:

At Greenfields, we want children and staff to enjoy the sun safely. We will work with parents to achieve this through: Education: Information is available for parents/carers explaining why sun protection is important, what we are doing and how they can help.

Planning:

Children will spend more time outside during the hours before 11.00am and after 2.00pm and outdoor play will be limited when the sun is at its hottest around midday.

Shade/Clothing:

We will encourage all children to wear hats. We ask that all parents bring in a hat for their child but do have some available in the nursery for children who need one.

Sunscreen:

We ask all parents to give permission for sunscreen to be applied. Each child should bring a clearly labelled bottle of sunscreen which should be factor 20 or higher. On hot days, parents should apply sunscreen at home before bring children in. Staff will support children to apply sunscreen before each session of outdoor play. For children who do not have their own sunscreen they will be given the nursery sunscreen. This will be shown to parents before it is applied and they will sign to say they are happy for their child to use it. Staff must wash their hands after applying sunscreen to each child