Sickness and Illness - Children’s Policy and Procedures
This policy has been devised to ensure that children who become unwell whilst at the nursery are treated with sensitivity and respect. It is also to help us to protect other children from illness and the spread of infection.
Children should not be left at nursery if they are unwell. If a child is unwell then they will prefer to be at home with their parent(s)/Carer(s) rather than at nursery with their peers.
We will follow these procedures to ensure the welfare of all children within the nursery:
If a child becomes ill during the nursery day, the parent(s) will be contacted and asked to pick their child up as soon as possible. During this time the child will be cared for in a quiet, calm area with their key person or another familiar member of staff within the child’s room.
Should a child have an infectious disease, such as an ear, chest or throat infection, hand foot and mouth or sickness and diarrhoea, they should not return to nursery until they have been clear for at least 48 hours.
It is vital that we follow the advice given to us by our registering authority and exclude specific contagious conditions, e.g. sickness and diarrhoea, COVID 19 and chicken pox to protect other children in the nursery. Illnesses of this nature are very contagious and it is exceedingly unfair to expose other children to the risk of an infection. With a case of conjunctivitis we ask that the child does not return to nursery for 24 hours after starting medication.
If a contagious infection is identified in the nursery, parents will be informed to enable them to spot the early signs of this illness. All equipment and resources that may have come into contact with a contagious child will be cleaned and sterilised thoroughly to reduce the spread of infection.
• It is important that children are not subjected to the rigours of the nursery day, which requires socialising with other children and being part of a group setting, when they have first become ill and require a course of antibiotics. Our policy, therefore, is to exclude children on antibiotics for the first 24 hours of the course.
The nursery has the right to refuse admission to a child who is unwell. This decision will be taken by the manager on duty and is non-negotiable.
Information/posters about head lice are readily available and all parents are requested to regularly check their children’s hair. If a parent finds that their child has head lice we would be grateful if they could inform the nursery so that other parents can be alerted to check their child’s hair.
IF AN UNWELL OR INFECTIOUS CHILD COMES INTO THE NURSERY:
The manager or deputy manager reserves the right not to accept any child who is unwell into the nursery. It is unfair on the child to be here when they need to be with their parent/carers or having one to one attention. It is also unfair to the rest of the children who are here if they are knowingly in contact with an illness or infection.
DIARRHOEA AND VOMITING
All children must be kept away from nursery for a minimum of 48 hours after the last episode of diarrhoea or vomiting. If a child is sent home from the nursery the 48 hours exclusion still applies. Therefore if your child is due in the following day they will not be able to attend. Children should only return to nursery when they are well enough and have regained their appetite.
All children must be kept away from nursery for a minimum of 24 hours or until their fever has returned to normal.
If a child is sent home from the nursery the 24 hours exclusion still applies. Therefore if your child is due in the following day they will not be able to attend. When your child has a temperature of 38 degrees or above they will be asked to have a COVID test or isolate for 10 days whichever option the parent prefers. In the instance that the test comes back negative and the child returns to nursery after 24 hours if the child still has a fever after this point then they will be asked to see a GP before returning. Any child sent home more than once with a high temperature will be asked to see a doctor before returning to nursery to avoid spreading any infections to others. The nursery will not administer any medicine that has not been prescribed by their doctor, pharmacist or dentist e.g.: Calpol, Nurofen etc.
Nursery staff have the right to refuse to administer any medication with which they feel uncomfortable.
Please can all parents respect our staff team’s decisions as our policies are in place to prevent infection from spreading around the nursery.
IF A CHILD BECOMES UNWELL WHILST AT THE NURSERY
If a child begins to show signs or symptoms that could pertain to illness they should firstly be comforted by staff, preferably the key person. This should be in the form of reassurance, both verbal and physical as appropriate, e.g. cuddles.
As soon as a child shows signs of feeling unwell, the child’s key person or room leader should fill in a sickness monitoring form.
If possible the child’s key person should spend one to one time with the child or a member of staff from the child’s room, attempting to find out what is wrong and if necessary administering first aid.
No prescribed medication may be given unless prior permission was obtained from the parent/carer that day and the stated dose is due to be given at that time.
The manager or deputy manager should be informed of any child who appears to be feeling unwell. If, after staff have done everything they can to make the child more comfortable, there is no sign of improvement, then the manager or deputy manager, in conjunction with the child’s key person or Room Leader, will discuss whether or not to contact the parent/carers to come and collect their child. Management must be informed when a member of staff wants to call a parent regarding a sick child.
If it is deemed to be in the best interests of the child to go home, the manager, deputy manager, room leader or key person will ring the parent/carers, getting the number from the child’s information which is held in the contact file’s in the manager’s office. They will explain the signs and symptoms the child is displaying and ask them to come and collect them.
If the manager, deputy manager, room leader or key person is unable to contact the parent/carer they will then go on to the next person on the contact list, usually the second parent/carer, continuing down the list of authorised persons as necessary.
Whilst their parent/carers are being contacted the child should continue to be comforted by members of staff.
Plenty of fluids should be offered to the child and if their temperature is higher or lower than usual this should be addressed immediately. Any other symptoms should be treated as necessary. If a child’s temperature reaches 39 degrees the child’s parents will be called to obtain permission to administer calpol. This does not apply to children who have separate care plans in place.
The child should always be treated with sensitivity and respect as feeling poorly can be distressing and quite frightening for a child. They should have a staff member with them, preferably their key person, until their parent/carer or authorised person arrives to collect them.
The child should have privacy as much as possible and be able to be in a quiet area away from other children, with the staff member. Usually a quiet area can be made in the child’s playroom.
Should a child’s symptoms deteriorate whilst waiting for their parent/carers the manager or deputy manager should be informed immediately.
If the manager or deputy manager feels that it’s necessary, they should call for an ambulance. The manager or deputy manager must then inform the parent/carers to meet them at the local hospital. First aid should be administered to the child as necessary.
TRANSPORTING CHILDREN TO HOSPITAL PROCEDURE
• If the sickness is severe, call for an ambulance immediately. DO NOT attempt to transport the sick child in your own vehicle.
• Whilst waiting for the ambulance, contact the parent and arrange to meet them at the hospital.
• A senior member of staff must accompany the child and collect together registration forms, relevant medication sheets, medication and the child’s comforter. A member of the management team must also be informed immediately.
• Remain calm at all times. Children who witness an incident may well be affected by it and may need lots of cuddles and reassurance too. If you are confident and assertive the child will feel reassured.
CALLING AN AMBULANCE
Dial 999 and ask for an ambulance. Answer all questions honestly and clearly. When asked to give the address and telephone number, use the following details:
Hunnypot Corner Day Nursery LLP
140 Squirrels Heath Road
The manager, deputy manager or key person if possible, will go with the child to the hospital, taking the child’s registration form which includes all their medical details and the consent for medical attention, and any of the child’s special comforters.
Reports should be written up by the manager/deputy manager, and key person and any witnesses to be kept on file. Members of staff will be offered time out and an opportunity to discuss what happened and how they are feeling. Ofsted will also be informed each time an ambulance is called to the nursery.
FEBRILE CONVULSIONS, ANAPHYLACTIC SHOCK AND ANY OTHER FIT OR SEIZURE
If a child has any of the above an ambulance must be called immediately and the same steps taken as above.
Anaphylaxis typically presents with many different symptoms over minutes or hours with an average onset of 5 to 30 minutes if exposure is intravenous and 2 hours for foods. The most common areas affected include: skin (80–90%), respiratory (70%), gastrointestinal (30– 45%), heart and vasculature (10–45%), and central nervous system (10–15%) with usually two or more being involved.
Anaphylaxis is a medical emergency that may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring. Administration of epinephrine (Epipen) may be required and only staff with Epipen training should be called upon to administer such treatment. Children who require an Epi Pen should provide the nursery with two pens in a labeled container so that we always have a spare pen onsite.
All fees are still chargeable during times of sickness.
COVID 19 isolation:
All children displaying any signs and symptoms of COVID 19 will be asked to take a COVID 19 lateral flow test. If they test is negative and the child is well within themselves they can continue to attend nursery as normal. If the child tests positive they will need to isolate for the minimum of 5 days and produce two negative lateral flow tests before returning to nursery. If there is a case of COVID 19 within the child’s household your child will be able to continue to attend nursery as long as they are showing no signs or symptoms of COVID 19 themselves. All COVID 19 absences are still chargeable in line with our original sickness policies and procedures. COVID 19 will not be treated any differently to any other sickness absence. We will continue to update our guidance in accordance to the government guidelines.
First Aid Policy
Our setting is committed to encouraging and promoting good health and to dealing efficiently and effectively with illnesses and emergencies that may arise while children are in our care.
Under duties set out in the Health and Safety (First Aid) Regulations 1981, the setting recognises its responsibilities in providing adequate and appropriate equipment, facilities and personnel to enable suitable first aid to be given at the setting.
At Hunnypot Corner Day Nursery all staff are responsible for First Aid and have up to date First Aid certificates and are responsible for administering basic First Aid when necessary and appropriate. The Manager will ensure that the content of the first aid box is kept up to date.
The Manager will ensure that there is a fully trained First Aider available at all times during sessions at the setting.
The First Aid box will be regularly checked to ensure its contents are up to date, in good condition and fulfil the criteria set out at the most recent First Aid Training.
The box to contain kit should have white cross on a green background.
The box should contain:
A card or leaflet giving general guidance
20 individually wrapped plasters
2 sterile eye pads
4 triangular bandages
6 safety pins
2 large, individually wrapped sterile dressings (unmedicated)
6 medium, individually wrapped, sterile dressings (unmedicated)
2 pairs of disposable gloves
Moist wipes that do not contain antiseptic or alcohol
1 pair of blunt round-edged scissors
1 resuscitation face shield
1 finger bandage and applicator
5 non-adherent dressings
1 role of micropore tape
5 packs sterile gauze swabs
The location of the First Aid box, and the names of qualified first-aiders, will be clearly displayed around the nursery premises.
A First Aid box will be taken on all off-site visits or outings. This is the responsibility of the Manager.
In the Event of a Major Accident, Incident or Illness
The setting requests that parents/carers complete and sign the Emergency Medical Treatment Form, enabling the Manager or any member of staff so empowered, to give permission for emergency medical treatment for their child in the event of a major accident, incident or illness occurring at the setting.
In the event of such an event, the following procedures will apply:
• In the first instance, the Manager will be notified and take responsibility for deciding upon the appropriate action.
• The Manager will assess the situation and decide whether the child needs to go straight to hospital or whether they can safely wait for their parent/carer to arrive.
• If the child needs to go straight to hospital, an ambulance will be called. The parent/carer will also be contacted. A member of staff will accompany the child to the hospital and will consent to medical treatment being given, so long as the Emergency Medical Treatment Form has been completed and sign.
• If the child does not need to go straight to hospital but their condition means they should go home, the parent/carer will be contacted and asked to collect their child. In the meantime, the child will be made as comfortable as possible and be kept under close supervision.
• Parents/carers will be made fully aware of the details of any incidents involving their child’s health and safety, and any actions taken by the setting and its staff. An accident or incident form will be sent across to the parent straight away on the famly app.
• All such accidents or incidents will be recorded in detail and logged in the Accident / Incident Record via the famly app. Parents/carers will be asked to sign in the relevant section of the form to acknowledge the incident or accident and any action taken by the setting and its staff.
• The Manager and other relevant members of staff should consider whether the accident or incident highlights any actual or potential weaknesses in the setting policies or procedures, and act accordingly, making suitable adjustments where necessary.
In the Event of a Minor Accident, Incident or Illness
• In the first instance, the Manager and designated First Aider will be notified and take responsibility for deciding upon any appropriate action. Staff will refer to the ‘First Aid’ book if necessary, to help them to ensure that they are administering the correct first aid.
• If the child does not need hospital treatment and is judged to be able to safely remain at nursery, the First Aider will remove the child from the activities and, if appropriate, treat the injury/illness themselves.
• When the child is feeling sufficiently better, they will be resettled back into the activities, but will be kept under close supervision for the remainder of the day. The parent will be called to inform them of the incident that has taken place.
• At the end of the day, the Manager and First Aider will fully inform the parent/carer of the incident or accident and any treatment given. If the child has had a bump on the head the staff will ensure the parent receives a head injury advice slip on collection.
The Manager and staff understand the dangers posed to children and themselves by over exposure to the sun.
In hot weather, parents/carers are encouraged to provide sunscreen for their children and apply sunscreen in the morning. A store of sun protection should also be kept on the premises. Children will also be encouraged to wear a hat (but can not be forced to) when playing outside in the sun.
When deemed necessary, staff may apply sunscreen to children who cannot do so for themselves, where prior permission has been given by the parent/carer on the Admissions Form.
In hot weather, staff will encourage children to drink water frequently. Staff should also ensure that shady areas out of the sun are always available to children when playing outside.
Infectious and Communicable diseases Policy - Parent information sheet.
There are a large number of illnesses that affect everyday nursery life some of which are indicated below. Any illness that occurs with children in the nursery will be relayed to parents and support and guidance will be given.
This infection appears as a rash consisting of blisters. The blisters if exposed are infectious and anyone with chickenpox should be excluded from work/nursery for five days from the onset of the spots. Pregnant women who have not had chickenpox should seek advice from their doctor if they come into contact with someone who has the virus.
An inflammation of the eye can be caused by numerous infections or it can be caused by an allergy. Eyes may become red and inflamed and there may be a discharge. Parents will be informed of the problem and encouraged to take the child to the doctor or pharmacy to begin treatment children will be excluded from the nursery for 24 hours.
Slapped cheek Syndrome
This infection resembles a ‘slapped cheek’ appearance. The rash involves arms, legs and trunk and children may have a runny nose and cough. The child is most infectious before the rash appears and there is no need for exclusion. This infection can be severe in pregnant women and for people with blood diseases and so need to contact a doctor.
Diarrhoea and vomiting.
Symptoms include abdominal pain, diarrhoea and sickness. Parents will be informed by senior staff after three loose nappies or at the company’s discretion if symptoms are severe, or if the child has vomited. Children will then be excluded from the nursery for 48 hours with no exceptions.
Infection starts with a spot or pimple with a blister on the top (usually yellow or white in colour) usually on the face and is very contagious. Children should be seen promptly by a doctor and must be kept away from nursery until all spots have healed, unless the spots can be covered completely and other children are not put at risk.
This is a fungal infection spread by direct contact from infected persons or animals. Treatment is required as soon as possible but exclusion from the nursery is not necessary.
Please treat your children using wet combing or chemical treatments if live lice are seen. Children do not need to be excluded but parents will be called if lice are noticed at nursery to collect their child and begin treatment.
Measles, mumps and Rubella
These infections are generally rare now but can cause severe problems. Children should be taken to the doctors as soon as possible and nursery contacted.
Hand, Foot and mouth
Rashes develop into small blisters in mouth on hands and feet. Young children are highly susceptible due to close contact. There is generally no treatment given and no exclusion time. But if transmission around the nursery continues or the case is severe then children may be excluded for 48 hours until spots on the hands have cleared.
This is a serious illness involving inflammation of the membranes covering the brain. The signs may include vomiting, drowsiness, headache, fever, stiff neck, discomfort from bright lights and a small purple like rash (which does not disappear under the glass test). Immediate treatment is necessary.
If any child contracts meningitis Hunnypot Corner will liaise closely with the Health Protection Agency to provide information and support for the family and anyone concerned within the nursery.
Chest and throat infections
These infections can be contagious if passed to others through droplets and sneezing. As children of a young age can not cover their noses and mouths when they cough and sneeze we are asking children to be at home for 48 hours after being diagnosed with a chest or throat infection.
This virus is very contagious and children will be advised to be absent for a minimum of 5 days or until they can produce two negative lateral flow test results.
This list is not exhaustive, parents and staff are encouraged to contact local health services if they are in any doubt.
Our staff will administer only those medicines prescribed by a doctor.
A child who has an infection and has been prescribed antibiotics must be excluded from nursery for at least 24 hours after the first dose of medicine.
Vaccination and Immunisation.
Preventing illness is much better than trying to treat it once it has developed. There are now many safe and effective vaccines against potentially fatal illnesses. Some are given routinely to all of the population, others only to individuals thought to be at high risk of certain infections. Children attending nursery should be fully immunised against common childhood infections. Please ensure that your child’s immunisations are up to date. If they are unable to have immunisations due to a specific medical problem, religious belief or preference please advise the nursery of this. Children should be kept at home for 24 hours after receiving their MMR vaccine in case of any reaction. Children are able to attend nursery after receiving the flu nasal spray but will be monitored in case they become unwell after receiving this.
The Manager or other senior staff member will administer all medication, witnessed by a member of staff.
Staff may only administer medication to the child if the request to do so is from the child’s parent or carer and is given in writing at the start of a session, stating frequency and dosage. Parents/carers can make such a request by completing and signing the Administrating Medication Form.
• If the medication involves technical knowledge or training, staff will not administer the medication until training has been received.
The procedure for administering medication at the setting is as follows:
Medication will never be given without the prior request / consent of the parent/carer.
The Manager will administer medication and in the Manager’s absence the designated person in charge. They will also be responsible for ensuring that:
• prior consent is arranged.
• all necessary details are recorded.
• another member of staff acts as a witness to ensure that the correct dosage is given.
• parents/carers sign the Medication Record sheet to acknowledge that the medication has been given.
If for any reason a child refuses to take their medication, staff will not attempt to force them to do so against their wishes. If and when such a situation occurs, the child’s parent/carer will be notified.
Asthma inhalers and insulin should always be labelled with the child’s name and stored in a clearly labelled container at the club.
If there is any change in the type of medication – whether regarding dosage or other changes to the information given on the Administering Medication Form – a new form must be completed.
Full details of all medication administered at the nursery, along with all Administering Medication Forms, will be recorded and stored in the Medication folder.
If a child has not had a medication before or is issued with Anti biotics it is advised that the parents keep the child at home for the first 24 hours to ensure that there are no adverse reactions to the medication.
Storage of medicines
All medicine is stored in a cupboard or refrigerated. Where the cupboard or refrigerator is not used solely for storing medicines, they are kept in a marked plastic box.
Medicine should be handed back to the parent at the end of each day.
For some condition’s medication may be kept at the nursery. The Manager will check that any medication held to administer on an as and when required basis, or on a regular basis, is in date and returns any out-of-date medication back to the parent.
All above procedures must be adhered to for the correct storage and administration of the pump. All staff should be made aware of how to access and administer pumps.
The nursery must have written consent from the child’s parent or guardian allowing staff to administer the medication.
A copy of the child’s care plan must also be given and kept at the nursery.
Staff should undertake training in the administration of such medication.
Parents should insure 2 epic pens are given to the setting to ensure that there is always a spare pen that can be accessed in the case of an emergency.
Calpol will only be given to a child if their temperature reaches over 39 degrees celsius and the child is at risk of convulsion. The parent will be called prior to administration of the Calpol to ensure that no other medication has been given and to gain consent. This will only be done in the most severe cases.
Children should not come in to nursery if they have been given Calpol prior to coming in to nursery as this could mask other infectious diseases or symptoms of COVID 19. This part of the policy does not affect children with specific care plans as their personal care plans will be followed at all times.