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Illness, Infection & Exclusion

This policy demonstrates the procedures that take place to support the unwell child, as well as our duty to safeguard, prevent and protect the remaining children and staff from contracting a communicable disease, illness, or the spread of infection. Therefore, the Owner/Manager reserves the right to exclude children who they feel are unfit to attend nursery or where they feel that the nursery would not be conducive to their recovery or that one-to-one attention is not practical.

Procedure:

Promoting good health includes monitoring children for signs and symptoms of communicable illnesses such as chickenpox, measles, vomiting and diarrhoea and so forth.

If an unwell or infectious child comes to nursery:
The Owner/Manager or Deputy Manager reserves the right not to accept a child who is unwell when being dropped at the nursery. It is the Manager’s duty to make an assessment, taking into account the validity of the child being at the nursery balanced with safeguarding the other children.

If a child becomes unwell during the nursery day:

The parents/carers will be contacted and asked to collect their child as soon as possible. During this time the child will be cared for by their Key Person or another familiar member of staff. Plenty of fluids will be offered to the child, and any symptoms will be ascertained and treated as appropriate.

 

If a child has an infectious illness, such as sickness and diarrhoea, they cannot return to nursery for at least 48 hours after their last bout of sickness.

 

It is vital that we follow the advice given to us by the London Borough of Waltham Forest and exclude specific contagious conditions, e.g. gastric bugs and chickenpox to protect other children and staff. 

 

If we have a case of a contagious infection in the nursery, we will email parents advising them of the signs and symptoms. The name of the child will not be divulged but we will inform parents in which room(s) the illness or infection is located.

 

Medication will not be administered unless permission has been obtained from the parent/carer that day, stating the dosage and the time the medication should be administered (see below).

 

The Manager or Deputy Manager will be informed of a child who appears to be unwell; if, after staff have done everything they can to make the child more comfortable and there are no signs of improvement, then the Manager will contact the parents to collect their child. The signs and symptoms will be explained, and they will be given a timeframe in which to collect the child.

 

If the Manager is unable to contact the parent they will then go to the next person on the emergency contact list, usually the other parent/carer, continuing down the list of authorised persons as necessary.

 

Should a child’s symptoms seriously deteriorate whilst waiting for their parents, the Manager will be informed. If the Manager feels that it is necessary, they will call for an ambulance. The Manager will then inform the parents to meet them at the local hospital. First Aid will be administered to the child as necessary.

 

Contagious illnesses and other illnesses:
Chickenpox:
Is a virus which initially presents as a cold (runny nose, slight temperature); it is generally when the spots occur that we realise that a child has chickenpox. Children will be excluded and can only return after all the spots have scabbed over, which is generally 5-7 days.

Meningitis:
If a parent informs the nursery that their child has meningitis, the Manager will contact the local public health team. The health team will offer guidance and support for the family and the nursery. If the child develops symptoms whilst at the nursery, the Manager will call the parents as well as an ambulance so that the child can get immediate medical attention. The child will be excluded and will be able to return following medical advice.

 

Febrile convulsions, anaphylactic shock and any other fit or seizure:
If a child has a convulsion of any sort, an ambulance will be called immediately, and the parents will be informed. A child may have a febrile convulsion if they become overly hot and cannot regulate their temperature.

Anaphylaxis typically presents with many different symptoms over minutes or hours with an average onset of 5 to 30 minutes; the most common areas affected include the skin (80-90%) respiratory (70%), gastrointestinal (30-45%). Anaphylaxis is a medical emergency that may require an administration of epinephrine (EpiPen); in extreme cases and if the EpiPen fails to work, then resuscitating measures such as airway management may be needed. Only staff with Epi-pen training will be able to administer the epi-pen.

High Temperatures:

A high temperature is the body’s natural response to fighting infections like coughs and colds; many things can cause a high temperature such as chickenpox or tonsillitis etc. (NHS) Children must be kept at home if they have a high temperature. Children will be sent home if they develop a high temperature at the nursery but will be given medication until parents collect their child.  Children must stay at home for the duration of the high temperature. If a child returns to nursery and has another high temperature they will be excluded the next day. Please see High temperature (fever) in children - NHS (www.nhs.uk) for more information

Diarrhoea and Vomiting:
Children must be kept away from the 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 will commence from then; therefore, if a child is due in the following day, they will not be able to attend. Children should only return to nursery when they no longer have diarrhoea or have stopped vomiting.

 

Conjunctivitis:
Children can still attend the nursery after 24hrs if they have started a course of eye drops (for a bacterial infection).

 

Head lice:
Parents are requested to check their children’s hair on a regular basis. If a parent finds that their child has head lice, they should inform the nursery so that other parents can be alerted to check their child’s hair. Children can still attend nursery, but the child and family’s hair must be treated accordingly

Vulnerable Groups:

There are many infections and illnesses that potentially pose greater risks to vulnerable groups. At Chingford House Nursery, we endeavour to keep up to date with relevant guidance to ensure that we are supporting and protecting the vulnerable staff and children at the nursery.

Administering medication:

We are able to administer medication that is not prescribed such as teething gels/powders, fever relief medication (i.e. Calpol) or creams for skin conditions such as eczema.

 

A temperature can indicate an underlying symptom of an illness; medication such as Nurofen or Calpol will be administered; most of the child’s clothing will be removed to bring down their temperature and the parents will be called to collect them. We will seek medical advice if the temperature exceeds 40˚ before the parents arrive and will call for an ambulance if deemed necessary. The parents will be advised of this.

 

All medication, including prescribed ones such as antibiotics will only be administered with the parent’s written consent; children must be excluded for the first 24 hours to ensure that there are not any adverse reactions and that they start to recover from their illness. Medication such as Calpol or inhalers can be administered as and when necessary. However the parents must indicate this on the original medication form. Staff will administer the medication as signed for by the parents, detailing:

  • The child’s name

  • the name of the medication

  • the dosage

  • the time it should be administered

  • the last time it was administered

  • how long the child will need to be on the medication.

 

A record will be kept, and parents will be asked to sign to acknowledge that the child has received the medication at the end of the day (or at the end of the prescribed period).

 

The Key Person (or familiar adult in their absence) is responsible for administering medication to their Key child; another member of staff will witness when the medication is administered. The staff will follow the directions on the bottle detailing how the medication should be stored (e.g. in the fridge); medicines that do not need to be stored in the fridge will be kept out of the children’s reach. Staff will record how much medication is given as directed by the Doctor (or indicated on the bottle if unprescribed). The expiry date will also be recorded.

 

Nursery staff have the right to refuse to administer any medication with which they feel uncomfortable. Parents/carers must respect the staff’s decision, i.e. a child may be too distressed when administering eye drops; if this is the case, the child may need to be excluded to prevent infection from spreading to the other children and staff or parents may come to the nursery to administer the medication themselves.

 

Training for staff to administer medicines that require technical /medical knowledge:

Some medication may require specialist training or medical knowledge i.e. epi-pen or type 2 diabetes training. The Manager will liaise with the child’s parents and health professionals where appropriate.

 

If training relates to generic medication such as administering Epi-pens, then staff do not have to have training for each individual child. However, some children may require more specific medical intervention, and in these cases, staff will be trained in relation to a particular child’s individual needs.

 

Transporting children to hospital procedure:

If a child’s condition is serious, the Management team will call for an ambulance immediately. Under no circumstances will staff attempt to transport the sick child in their own car unless a parent/carer is present, and the ambulance is very delayed.

 

If the parents do not get to the nursery before the ambulance arrives, the Key Person will accompany the child (as they have the best relationship and will be able to comfort and reassure the child). The Key Person will take contact details, any relevant medical forms, medication and the child’s comforter (if appropriate).

 

Where the child may have an infectious illness, Covid-19 symptoms or injuries/incidences involving blood or other bodily fluid staff must wear an apron & gloves (and a mask for Covid-related concerns).

 

Calling an ambulance:
 

The Manager (or other member of staff) will call 999 and ask for an ambulance, answering all questions honestly and clearly. When asked, the following details will be given:

Chingford House Nursery

22 Marlborough Road

Chingford

London E4 9AL

 

If a child deteriorates to the point where they need CPR, the emergency services will be called again to ensure that they will arrive urgently. A First Aider will then start CPR as appropriate or following instructions from the Operator on the 999 call.

 

A report will be written by the Manager outlining the illness/infection, the symptoms and why the child had to go to the hospital; this information will be kept on file.  The parents will be asked to sign relevant documentation as soon as reasonably possible after returning to the nursery.

 

Staff may be affected by a child’s illness, especially if it results in them going to the hospital, Chingford House Nursery have provisions in place so that staff can talk through any issues they may have.

Notifiable infectious diseases:

The nursery is required to inform appropriate agencies about any infectious or notifiable illnesses. These agencies include Waltham Forest Public Health Team, Ofsted and UK Health Security Agency (formerly Public Health England) where applicable. The nursery will seek consent from the parents before notifying the above agencies, however in extreme and urgent matters, this may not always be the case.

Serious accidents or death:
The nursery is required to inform appropriate agencies about serious accidents or a death at the nursery. We will inform the Local Authority Designated Officer (LADO), the Multi Agency Safeguarding Hub (MASH), Ofsted and the local Public Health Team.

 

If you have any concerns or queries in relation to this policy, then please do not hesitate to speak with Yolande Farrell.

 

Policy created by: Yolande Farrell Manager

Signed off by: Zarkar Akhtar Owner

Date: August 2023

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