Managing Children who are sick, infectious or have allergies (6.2)

Policy Statement:

At Reepham Nursery School, we provide care for healthy children and promote health through identifying allergies and preventing contact with the allergenic substance and through preventing cross infection of viruses and bacterial infections.

CHANGES TO PROCEDURE DURING THE COVID-19 OUTBREAK :

The DfE states that if anyone becomes unwell with coronavirus symptoms – a new, continuous cough, a high temperature or a loss of, or change to, sense of smell or taste – in an education or childcare setting, “they must be sent home”, and advised to follow government guidance (i.e. to self-isolate for seven days, while all members of their household self-isolate for 14 days).

If it is a child who has fallen ill during a nursery session, the guidance states that they should be moved to a room where they can be isolated behind a closed door with appropriate adult supervision while awaiting collection. The guidance adds that: “Ideally, a window should be opened for ventilation”. If moving to a separate room is not possible, the child should be moved to an area at least two metres away from other people.

The guidance also states that: “PPE should be worn by staff caring for the child while they await collection if a distance of 2 metres cannot be maintained (such as for a very young child or a child with complex needs).”

If a child presents with symptoms; parents are contacted and requested to collect their child and seek diagnosis from GP or take further advice from NHS 111.

If a member of staff has helped an unwell child, the guidance states that they should wash their hands thoroughly for 20 seconds afterwards, but that they are not required to go home unless they develop symptoms themselves or the child subsequently tests positive for coronavirus. If the member of staff does develop symptoms, they are able to access a free coronavirus test – more information on this is available here.

Child’s parents are requested to inform the setting of outcome/diagnosis and keep the child at home for the recommended exclusion period. For cases of suspected Coronavirus, staff and service users must adhere to current Government advice regarding self-exclusion even if no symptoms are present.

For confirmed cases of a notifiable disease and Coronavirus the setting must contact their local HEALTH PROTECTION TEAM (HPT) as soon as possible for further guidance. The Manager will inform the Committee and retain a confidential record.

Acting on the advice of the HPT the setting will either:

-Close for a set period and undertake a deep clean or

-Carry on as usual but also undertake a deep clean

If a notifiable disease is confirmed, the manager immediately will then inform OFSTED within 14 days. CORONAVIRUS IS A NOTIFIABLE DISEASE.

Hand hygiene messages are reinforced and staff are vigilant to any further signs of infection.

The Manager continues to liaise with the HPT and keeps a full record of who is affected, how long they are away and the date which they return.

Procedures for children who are sick or infectious

  • If children appear unwell during the day – for example, if they have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – our manager will call the parents and ask them to collect the child, or to send a known carer to collect the child on their behalf.
  • If a child has a temperature, they are kept cool, by removing top clothing and sponging their heads with cool water, but kept away from draughts.
  • The child’s temperature is taken using a forehead thermometer strip, kept in the first aid box. (Normal temperature range for a child is above 37.5 /(99.5F)
  • In extreme cases of emergency, an ambulance is called and the parent informed.
  • Parents are asked to take their child to the doctor before returning them to the setting; we can refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.
  • Where children have been prescribed antibiotics for an infectious illness or complaint, we ask parents to keep them at home for 48 hours before returning to the setting.
  • After diarrhoea, we ask parents to keep children home for 48 hours following the last episode.
  • Some activities, such as sand and water play, and self-serve snacks where there is a risk of cross-contamination may be suspended for the duration of any outbreak.
  • We have a list of excludable diseases and current exclusion times. The full list is obtainable from

http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1194947358374 and includes common childhood illnesses such as measles.

Reporting of ‘notifiable diseases’

  • If a child or adult is diagnosed as suffering from a notifiable disease under the Health Protection (Notification) Regulations 2010, the GP will report this to Public Health England.
  • When we become aware, or are formally informed of the notifiable disease, our manager informs Ofsted and contacts Public Health England, and acts on any advice given.

HIV/AIDS/Hepatitis procedure

HIV virus, like other viruses such as Hepatitis A, B and C, are spread through body fluids. Hygiene precautions for dealing with body fluids are the same for all children and adults.

We:

  • Wear single-use vinyl gloves and aprons when changing children’s nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.
  • Bag soiled clothing for parents to take home for cleaning.
  • Clear spills of blood, urine, faeces or vomit using mild disinfectant solution and mops; any cloths used are disposed of with the clinical waste.
  • Clean any tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit using a disinfectant.

Nits and head lice

  • Nits and head lice are not an excludable condition; although in exceptional cases we may ask a parent to keep the child away until the infestation has cleared.
  • On identifying cases of head lice, we inform all parents ask them to treat their child and all the family if they are found to have head lice.

Procedures for children with allergies

  • When children start at the setting we ask their parents if their child suffers from any known allergies. This is recorded on the Registration Form.
  • If a child has an allergy, we complete a risk assessment form to detail the following:
    • The allergen (i.e. the substance, material or living creature the child is allergic to such as nuts, eggs, bee stings, cats etc).
    • The nature of the allergic reactions (e.g. anaphylactic shock reaction, including rash, reddening of skin, swelling, breathing problems etc).
    • What to do in case of allergic reactions, any medication used and how it is to be used (e.g. Epipen).
    • Control measures – such as how the child can be prevented from contact with the allergen.
    • Review measures.
  • This risk assessment form is kept in the child’s personal file and a copy is displayed where our staff can see it.
  • Generally, no nuts or nut products are used within the setting.
  • Parents are made aware so that no nut or nut products are accidentally brought in, for example to a party.

Insurance requirements for children with allergies and disabilities

  • If necessary, our insurance will include children with any disability or allergy, but certain procedures must be strictly adhered to as set out below. For children suffering life threatening conditions, or requiring invasive treatments; written confirmation from our insurance provider must be obtained to extend the insurance.
  • At all times we ensure that the administration of medication is compliant with the Safeguarding and Welfare Requirements of the Early Years Foundation Stage.
  • Oral medication:
  • Asthma inhalers are now regarded as ‘oral medication’ by insurers and so documents do not need to be forwarded to our insurance provider. Oral medications must be prescribed by a GP or have manufacturer’s instructions clearly written on them.
  • We must be provided with clear written instructions on how to administer such medication.
  • We adhere to all risk assessment procedures for the correct storage and administration of the medication.
  • We must have the parents or guardians prior written consent. This consent must be kept on file. It is not necessary to forward copy documents to our insurance provider.
  • Life-saving medication and invasive treatments:

These include adrenaline injections (Epipens) for anaphylactic shock reactions (caused by allergies to nuts, eggs etc) or invasive treatments such as rectal administration of Diazepam (for epilepsy).

  • We must have:
  • a letter from the child’s GP/consultant stating the child’s condition and what medication if any is to be administered;
  • written consent from the parent or guardian allowing our staff to administer medication; and
  • proof of training in the administration of such medication by the child’s GP, a district nurse, children’s nurse specialist or a community paediatric nurse.
  • Key person for special needs children requiring assistance with tubes to help them with everyday living e.g. breathing apparatus, to take nourishment, colostomy bags etc.:
  • Prior written consent must be obtained from the child’s parent or guardian to give treatment and/or medication prescribed by the child’s GP.

The key person must have the relevant medical training/experience, which may include receiving appropriate instructions from parents or guardians.

Any queries must be addressed to our insurance company first to ensure that we are covered under the terms of our agreement.

Other useful Pre-school Learning Alliance publications

  • Good Practice in Early Years Infection Control (2009)
  • Medication Administration Record (2013)

 

This Policy was adopted by:  Reepham Nursery School
Held in:  November 2016
Date reviewed:  JUNE 2020

Updated June 2020 – COVID

Signed on behalf of the management committee:  Maria Amies – Chairperson.