Promoting health and hygiene
1.14 Animals in the setting
Policy Statement
Children learn about the natural world, its animals and other living creatures, as part of the Early Years Foundation Stage curriculum. This may include contact with animals, or other living creatures, either in the setting or in visits. We aim to ensure that this is in accordance with sensible hygiene and safety controls.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.3 Supporting learning
3.3 The learning environment
4.1 Play and exploration
4.4 Knowledge and understanding of the world
Procedures
We have no plans to have animals in the setting as pets.
On occasions parents bring pets to the pre-school when delivering or collecting their child. It is the parent’s responsibility to ensure that the animal is secured and poses no risk to the children.
If animals or creatures are brought in by visitors to show the children they are the responsibility of the owner.
The owner carries out a risk assessment, detailing how the animal or creature is to be handled and how any safety or hygiene issues will be addressed.
Mini beasts in the garden
Children are encouraged to explore the world around them and whilst playing in the garden may discover min-beasts.
Children are encouraged to respect these creatures.
Children wash their hands after handling min-beasts
Visits to farms/ animal sanctuaries
Before a visit to a farm a risk assessment is carried out - this may take account of safety factors listed in the farm’s own risk assessment which should be viewed.
The outings procedure is followed.
Children wash their hands after contact with animals.
Outdoor footwear worn to visit farms are cleaned of mud and debris and should not be worn indoors.
Legal framework
The Management of Health and Safety at Work Regulations 1999
www.opsi.gov.uk/SI/si1999/19993242.htm
Further guidance
Health and Safety Regulation…a short guide (HSE 2003) HYPERLINK "http://www.hse.gov.uk/pubns/hsc13.pdf" www.hse.gov.uk/pubns/hsc13.pdf
1.15 Administering medicines
Policy statement
While it is not our policy to care for sick children, who should be at home until they are well enough to return to the setting, we will agree to administer medication as part of maintaining their health and well-being or when they are recovering from an illness.
In many cases, it is possible for children’s GP’s to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the setting. If a child has not had a medication before, it is advised that the parent keeps the child at home for the first 48 hours to ensure no adverse effect as well as to give time for the medication to take effect.
These procedures are written in line with current guidance in ‘Managing Medicines in Schools and Early Years Settings; the manager is responsible for ensuring all staff understand and follow these procedures.
The key person is responsible for the correct administration of medication to children for whom they are the key person. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures. In the absence of the key person, the manager is responsible for the overseeing of administering medication.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures
Children taking prescribed medication must be well enough to attend the setting.
Only medication prescribed by a doctor (or other medically qualified person) is administered. It must be in-date and prescribed for the current condition.
Children's prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children.
Parents give prior written permission for the administration of medication. The staff receiving the medication must ask the parent to sign a consent form stating the following information. No medication may be given without these details being provided:
full name of child and date of birth;
name of medication and strength;
who prescribed it;
dosage to be given in the setting;
how the medication should be stored and expiry date;
any possible side effects that may be expected should be noted; and
signature, printed name of parent and date.
The staff member who is receiving packed lunches will receive any medicines. It is their responsibility to inform the supervisor. The parent will asked to sign a consent form at this time.
The administration is recorded accurately each time it is given and is signed by staff. Parents sign the record book to acknowledge the administration of a medicine. The medication record book records:
name of child;
name and strength of medication;
the date and time of dose;
dose given and method; and is
signed by key person/manager; and is verified by parent signature at the end of the day.
We use the Pre-school Learning Alliance’s publication Medication Record for recording administration of medicine and comply with the detailed procedures set out in that publication.
Storage of medicines
All medication is stored safely in a locked cupboard or refrigerated. Where the cupboard or refrigerator is not used solely for storing medicines, they are kept in a marked plastic box.
The child’s key person is responsible for ensuring medicine is handed back at the end of the day to the parent.
Medicines are stored in the kitchen, on a designated shelf. If the medicine requires refrigeration, it is stored in the fridge, clearly marked that is a medicine for administration to a named child only.
The child’s key worker and supervisor should be notified if a child needs any medication and they are responsible for ensuring the medicine is administered and returned to the parent at the end of the session
Two members of staff sign to say the medicine has been administered
If the administration of prescribed medication requires medical knowledge, individual training is provided for the relevant member of staff by a health professional.
If rectal diazepam is given another member of staff must be present and co-signs the record book.
No child may self-administer. Where children are capable of understanding when they need medication, for example with asthma, they should be encouraged to tell their key person what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication.
Children who have long term medical conditions and who may require on ongoing medication
A risk assessment is carried out for each child with long term medical conditions that require ongoing medication. This is the responsibility of the manager alongside the key person. Other medical or social care personnel may need to be involved in the risk assessment.
Parents will also contribute to a risk assessment. They should be shown around the setting, understand the routines and activities and point out anything which they think may be a risk factor for their child.
For some medical conditions key staff will need to have training in a basic understanding of the condition as well as how the medication is to be administered correctly. The training needs for staff is part of the risk assessment.
The risk assessment includes vigorous activities and any other nursery activity that may give cause for concern regarding an individual child’s health needs.
The risk assessment includes arrangements for taking medicines on outings and the child’s GP’s advice is sought if necessary where there are concerns.
A health care plan for the child is drawn up with the parent; outlining the key person’s role and what information must be shared with other staff who care for the child.
The health care plan should include the measures to be taken in an emergency.
The health care plan is reviewed every six months or more if necessary. This includes reviewing the medication, e.g. changes to the medication or the dosage, any side effects noted etc.
Parents receive a copy of the health care plan and each contributor, including the parent, signs it.
Managing medicines on trips and outings
If children are going on outings, staff accompanying the children must include the key person for the child with a risk assessment, or another member of staff who is fully informed about the child’s needs and/or medication.
Medication for a child is taken in a container clearly labelled with the child’s name, name of the medication, Inside the container is a copy of the consent form and a card to record when it has been given, with the details as given above.
On returning to the setting the card is stapled to the medicine record book and the parent signs it.
If a child on medication has to be taken to hospital, the child’s medication is taken in a sealed container clearly labelled with the child’s name, name of the medication. Inside the box is a copy of the consent form signed by the parent.
As a precaution, children should not eat when travelling in vehicles
This procedure is read alongside the outings procedure.
Legal framework
Medicines Act (1968)
Further guidance
Managing Medicines in Schools and Early Years Settings (DfES 2005)
HYPERLINK "http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf" http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf
.16 Managing children with allergies, or who are sick or infectious
(Including reporting notifiable diseases)
Policy statement
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.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.2 Inclusive practice
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures for children with allergies
When parents start their children at the setting they are asked if their child suffers from any known allergies. This is recorded on the registration form.
If a child has an allergy, a risk assessment form is completed 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.
This form is kept in the child’s personal file and a copy is displayed where staff can see it.
Parents train staff in how to administer special medication in the event of an allergic reaction.
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.
Currently, all lunches that contain egg are asked to be labelled.
Insurance requirements for children with allergies and disabilities
The insurance will automatically 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 your insurance provider must be obtained to extend the insurance.
At all times the administration of medication must be compliant with the Welfare Requirements of the Early Years Foundation Stage and follow procedures based on advice given in Managing Medicines in Schools and Early Years Settings (DfES 2005)
Oral Medication
Asthma inhalers are now regarded as "oral medication" by insurers and so documents do not need to be forwarded to your insurance provider.
Oral medications must be prescribed by a GP or have manufacturer’s instructions clearly written on them.
The group must be provided with clear written instructions on how to administer such medication.
All risk assessment procedures need to be adhered to for the correct storage and administration of the medication.
The group 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 your insurance provider.
Life saving medication & invasive treatments
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).
The setting 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 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.
Copies of all three letters relating to these children must first be sent to the Pre-school Learning Alliance Insurance Department for appraisal (if you have another provider, please check their procedures with them). Confirmation will then be issued in writing confirming that the insurance has been extended.
Key person for special needs children - children requiring help with tubes to help them with everyday living e.g. breathing apparatus, to take nourishment, colostomy bags etc.
Prior written consent from the child's parent or guardian to give treatment and/or medication prescribed by the child's GP.
Key person to have the relevant medical training/experience, which may include those who have received appropriate instructions from parents or guardians, or who have qualifications.
Copies of all letters relating to these children must first be sent to the Pre-school Learning Alliance Insurance Department for appraisal (if you have another provider, please check their procedures with them). Written confirmation that the insurance has been extended will be issued by return.
If you are unsure about any aspect, contact the Pre-school Learning Alliance Insurance Department on 020 7697 2585 or email [email protected].
Procedures for children who are sick or infectious
If children appear unwell during the session – have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – the supervisor calls the parents and asks them to collect the child, or send a known carer to collect on their behalf.
If a child has a temperature, they are kept cool, by removing top clothing, sponging their heads with cool water, but kept away from draughts.
In extreme cases of emergency the child should be taken to the nearest hospital and the parent informed.
Parents are asked to take their child to the doctor/ nurse/ pharmacist before returning them to nursery; the nursery can refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.
After diarrhoea, parents are asked to keep children home for 72 hours.
The setting has a list of excludable diseases and current exclusion times. The full list is obtainable from www.hpa.org.uk/servlet/ContentServer?c=HPAweb_C&cid=1194947358374&pagename=HPAwebFile and includes common childhood illnesses such as measles.
Reporting of ‘notifiable diseases’
If a child or adult is diagnosed suffering from a notifiable disease under the Public Health (Infectious Diseases) Regulations 1988, the GP will report this to the Health Protection Agency.
When the setting becomes aware, or is formally informed of the notifiable disease, the manager informs Ofsted and acts on any advice given by the Health Protection Agency.
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.
Single use vinyl gloves are worn when changing children’s nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.
Soiled clothing is rinsed and either bagged for parents to collect.
Spills of blood, urine, faeces or vomit are cleared using mild disinfectant solution and mops; cloths used are disposed of with the clinical waste.
Tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit are cleaned using a disinfectant.
Nits and head lice
Nits and head lice are not an excludable condition, although in exceptional cases a parent may be asked to keep the child away until the infestation has cleared.
On identifying cases of head lice, all parents are informed and asked to treat their child and all the family if they are found to have head lice.
Further guidance
Managing Medicines in Schools and Early Years Settings (DfES 2005)
http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf
1.17 Nappy changing
Policy statement
No child is excluded from participating in our setting who may, for any reason, not yet be toilet trained and who may still be wearing nappies or equivalent. We work with parents towards toilet training, unless there are medical or other developmental reasons why this may not be appropriate at the time.
We make necessary adjustments to our bathroom provision and hygiene practice in order to accommodate children who are not yet toilet trained.
We see toilet training as a self-care skill that children have the opportunity to learn with the full support and non-judgemental concern of adults.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.2 Inclusive practice
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures
Staff only will be allowed to change children or help in the toilet area.
No volunteers, students or parents will be allowed to change children
Staff will inform other members of staff that they are going to attend to a child
Key persons undertake changing young children in their key groups; back up key persons change them if the key person is absent.
Changing areas are warm and there are safe areas to lay children to have their bottoms cleaned.
Each young child has to provide their nappies or ’pull ups’
Pre-school will provide gloves, changing mat, wipes and disposal bags.
Gloves are put on before changing starts and the areas are prepared
The changing mat is cleaned before and after use.
All staff are familiar with the hygiene procedures and carry these out when changing nappies.
Young children are encouraged to take an interest in using the toilet; they may just want to sit on it and talk to a friend who is also using the toilet.
They should be encouraged to wash their hands and have soap and towels to hand. They should be allowed time for some play as they explore the water and the soap.
Anti-bacterial hand wash liquid or soap should not be used for young children.
Key persons are gentle when changing; they avoid pulling faces and making negative comment about ‘nappy contents’.
Key persons do not make inappropriate comments about young children’s genitals when changing their nappies
Older children access the toilet when they have the need to and are encouraged to be independent.
Nappies and ’pull ups’ are disposed of hygienically; they are disposed of in the outside bin
If a change of clothes is required, a child’s own clothes will be used. If pre-school clothes have been used, parents will be notified by letter and encouraged to returned laundered as soon as possible.
A book will be kept in the changing box documenting details of the change, i.e.
Date of change
Time of change
Name of child
Name of staff member
Nature of contents, i.e. Soiled/ wet
NB If young children are left in wet or soiled nappies/’pull ups’ in the setting this may constitute neglect and will be a disciplinary matter. Settings have a ‘duty of care’ towards children’s personal needs.
1.18 No-smoking
Policy statement
We comply with health and safety regulations and the Welfare Requirements of the EYFS in making our setting a no-smoking environment - both indoor and outdoor.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.1 Respecting each other
3.2 Supporting every child
Procedures
All staff, parents and volunteers are made aware of our no-smoking policy.
We display no-smoking signs.
The no-smoking policy is stated in our information brochure for parents.
We actively encourage no-smoking by having information for parents and staff about where to get help to stop smoking if they are seeking this information.
Staff who smoke do not do so during working hours. Unless on a break and off the premises.
Staff who smoke during their break make every effort to reduce the effect of the odour and lingering effects of passive smoking for children and colleagues.
Parents are encouraged not to smoke outside whilst waiting to collect their children, and are reminded that a dropped cigarette butt constitutes littering and can incur a penalty fine.
Legal framework
The Smoke-free (Premises and Enforcement) Regulations 2006
www.opsi.gov.uk/si/si2006/20063368.htm
The Smoke-free (Signs) Regulations 2007
www.opsi.gov.uk/si/si2007/20070923.htm
1.19 Food and drink
Policy statement
This setting regards snack and meal times as an important part of the setting's day. Eating represents a social time for children and adults and helps children to learn about healthy eating. We promote healthy eating using resources and materials from the Pre-school Learning Alliance campaign Feeding Young Imaginations. At snack and meal times, we aim to provide nutritious food, which meets the children's individual dietary needs.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.1 Respecting each other
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
3.4 The wider context
4.4 Personal, social and emotional development
Procedures
We follow these procedures to promote healthy eating in our setting.
Before a child starts to attend the setting, we find out from parents their children's dietary needs and preferences, including any allergies. (See the Managing Children with Allergies policy.)
We record information about each child's dietary needs in her/his registration record and parents sign the record to signify that it is correct.
We regularly consult with parents to ensure that our records of their children's dietary needs - including any allergies - are up-to-date. Parents sign the up-dated record to signify that it is correct.
We display current information about individual children's dietary needs so that all staff and volunteers are fully informed about them.
We implement systems to ensure that children receive only food and drink that is consistent with their dietary needs and preferences as well as their parents' wishes.
We display the menus of snacks for the information of parents.
We take care not to provide food containing nuts or nut products and are especially vigilant where we have a child who has a known allergy to nuts.
Through discussion with parents and research reading by staff, we obtain information about the dietary rules of the religious groups to which children and their parents belong, and of vegetarians and vegans, and about food allergies. We take account of this information in the provision of food and drinks.
We require staff to show sensitivity in providing for children's diets and allergies. Staff do not use a child's diet or allergy as a label for the child or make a child feel singled out because of her/his diet or allergy.
We organise meal and snack times so that they are social occasions in which children and staff participate.
We use meal and snack times to help children to develop independence through making choices, serving food and drink and feeding themselves.
We have fresh drinking water constantly available for the children. We inform the children about how to obtain the water and that they can ask for water at any time during the day.
We inform parents who provide food for their children about the storage facilities available in the setting.
We give parents who provide food for their children information about suitable containers for food.
In order to protect children with food allergies, we discourage children from sharing and swapping their food with one another.
For children who drink milk, we provide whole pasteurised milk.
Packed lunches
Our children are required to bring packed lunches, we:
ensure perishable contents of packed lunches are refrigerated or contain an ice pack to keep food cool;
inform parents of our policy on healthy eating;
inform parents of whether we have facilities to microwave cooked food brought from home;
encourage parents to provide sandwiches with a healthy filling, fruit, and milk based deserts such as yoghurt or crème fraîche where we can only provide cold food from home. We discourage sweet drinks and can provide children with water or diluted fresh fruit juice;
discourage packed lunch contents that consist largely of crisps, processed foods, sweet drinks and sweet products such as cakes or biscuits. We reserve the right to return this food to the parent as a last resort;
provide children, bringing packed lunches, with plates, cups and cutlery; and
ensure staff mingle with and oversee children who are eating their lunch so that the mealtime is a social occasion.
Legal Framework
Regulation (EC) 852/2004 of the European Parliament and of the Council on the hygiene of foodstuffs
Further guidance
Safer Food, Better Business
www.food.gov.uk/foodindustry/regulation/hygleg/hyglegresources/sfbb/
1.20 First aid
Policy statement
In our setting staff are able to take action to apply first aid treatment in the event of an accident involving a child or adult. At least one member of staff with current first aid training is on the premises or on an outing at any one time. The first aid qualification includes first aid training for infants and young children.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.3 Keeping safe
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
3.4 The wider context
Procedures
The First Aid Kit
Our first aid kit complies with the Health and Safety (First Aid) Regulations 1981 and contains the following items only:
Triangular bandages (ideally at least one should be sterile) - x 4.
Sterile dressings:
a) Small (formerly Medium No 8) - x 3.
b) Medium (formerly Large No 9) – HSE 1 - x 3.
c) Large (formerly Extra Large No 3) – HSE 2 - x 3.
Composite pack containing 20 assorted (individually-wrapped) plasters 1.
Sterile eye pads (with bandage or attachment) eg No 16 dressing 2.
Container or 6 safety pins 1.
Guidance card as recommended by HSE 1.
In addition to the first aid equipment, each box should be supplied with:
2 pairs of disposable plastic (PVC or vinyl) gloves.
1 plastic disposable apron.
a children’s forehead ‘strip’ thermometer.
The first aid box is easily accessible to adults and is kept out of the reach of children.
No un-prescribed medication is given to children, parents or staff.
At the time of admission to the setting, parents' written permission for emergency medical advice or treatment is sought. Parents sign and date their written approval.
Parents sign a consent form at registration allowing staff to take their child to the nearest Accident and Emergency unit to be examined, treated or admitted as necessary on the understanding that parents have been informed and are on their way to the hospital.
Legal framework
Health and Safety (First Aid ) Regulations (1981)
Further guidance
First Aid at Work: Your questions answered (HSE 1997)
HYPERLINK "http://www.hse.gov.uk/pubns/indg214.pdf" www.hse.gov.uk/pubns/indg214.pdf
Basic Advice on First Aid at Work (HSE 2006)
www.hse.gov.uk/pubns/indg347.pdf
Guidance on First Aid for Schools (DfEE)
HYPERLINK "http://www.teachernet.gov.uk/_doc/4421/GFAS.pdf" www.teachernet.gov.uk/_doc/4421/GFAS.pdf
1.14 Animals in the setting
Policy Statement
Children learn about the natural world, its animals and other living creatures, as part of the Early Years Foundation Stage curriculum. This may include contact with animals, or other living creatures, either in the setting or in visits. We aim to ensure that this is in accordance with sensible hygiene and safety controls.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.3 Supporting learning
3.3 The learning environment
4.1 Play and exploration
4.4 Knowledge and understanding of the world
Procedures
We have no plans to have animals in the setting as pets.
On occasions parents bring pets to the pre-school when delivering or collecting their child. It is the parent’s responsibility to ensure that the animal is secured and poses no risk to the children.
If animals or creatures are brought in by visitors to show the children they are the responsibility of the owner.
The owner carries out a risk assessment, detailing how the animal or creature is to be handled and how any safety or hygiene issues will be addressed.
Mini beasts in the garden
Children are encouraged to explore the world around them and whilst playing in the garden may discover min-beasts.
Children are encouraged to respect these creatures.
Children wash their hands after handling min-beasts
Visits to farms/ animal sanctuaries
Before a visit to a farm a risk assessment is carried out - this may take account of safety factors listed in the farm’s own risk assessment which should be viewed.
The outings procedure is followed.
Children wash their hands after contact with animals.
Outdoor footwear worn to visit farms are cleaned of mud and debris and should not be worn indoors.
Legal framework
The Management of Health and Safety at Work Regulations 1999
www.opsi.gov.uk/SI/si1999/19993242.htm
Further guidance
Health and Safety Regulation…a short guide (HSE 2003) HYPERLINK "http://www.hse.gov.uk/pubns/hsc13.pdf" www.hse.gov.uk/pubns/hsc13.pdf
1.15 Administering medicines
Policy statement
While it is not our policy to care for sick children, who should be at home until they are well enough to return to the setting, we will agree to administer medication as part of maintaining their health and well-being or when they are recovering from an illness.
In many cases, it is possible for children’s GP’s to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the setting. If a child has not had a medication before, it is advised that the parent keeps the child at home for the first 48 hours to ensure no adverse effect as well as to give time for the medication to take effect.
These procedures are written in line with current guidance in ‘Managing Medicines in Schools and Early Years Settings; the manager is responsible for ensuring all staff understand and follow these procedures.
The key person is responsible for the correct administration of medication to children for whom they are the key person. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures. In the absence of the key person, the manager is responsible for the overseeing of administering medication.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures
Children taking prescribed medication must be well enough to attend the setting.
Only medication prescribed by a doctor (or other medically qualified person) is administered. It must be in-date and prescribed for the current condition.
Children's prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children.
Parents give prior written permission for the administration of medication. The staff receiving the medication must ask the parent to sign a consent form stating the following information. No medication may be given without these details being provided:
full name of child and date of birth;
name of medication and strength;
who prescribed it;
dosage to be given in the setting;
how the medication should be stored and expiry date;
any possible side effects that may be expected should be noted; and
signature, printed name of parent and date.
The staff member who is receiving packed lunches will receive any medicines. It is their responsibility to inform the supervisor. The parent will asked to sign a consent form at this time.
The administration is recorded accurately each time it is given and is signed by staff. Parents sign the record book to acknowledge the administration of a medicine. The medication record book records:
name of child;
name and strength of medication;
the date and time of dose;
dose given and method; and is
signed by key person/manager; and is verified by parent signature at the end of the day.
We use the Pre-school Learning Alliance’s publication Medication Record for recording administration of medicine and comply with the detailed procedures set out in that publication.
Storage of medicines
All medication is stored safely in a locked cupboard or refrigerated. Where the cupboard or refrigerator is not used solely for storing medicines, they are kept in a marked plastic box.
The child’s key person is responsible for ensuring medicine is handed back at the end of the day to the parent.
Medicines are stored in the kitchen, on a designated shelf. If the medicine requires refrigeration, it is stored in the fridge, clearly marked that is a medicine for administration to a named child only.
The child’s key worker and supervisor should be notified if a child needs any medication and they are responsible for ensuring the medicine is administered and returned to the parent at the end of the session
Two members of staff sign to say the medicine has been administered
If the administration of prescribed medication requires medical knowledge, individual training is provided for the relevant member of staff by a health professional.
If rectal diazepam is given another member of staff must be present and co-signs the record book.
No child may self-administer. Where children are capable of understanding when they need medication, for example with asthma, they should be encouraged to tell their key person what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication.
Children who have long term medical conditions and who may require on ongoing medication
A risk assessment is carried out for each child with long term medical conditions that require ongoing medication. This is the responsibility of the manager alongside the key person. Other medical or social care personnel may need to be involved in the risk assessment.
Parents will also contribute to a risk assessment. They should be shown around the setting, understand the routines and activities and point out anything which they think may be a risk factor for their child.
For some medical conditions key staff will need to have training in a basic understanding of the condition as well as how the medication is to be administered correctly. The training needs for staff is part of the risk assessment.
The risk assessment includes vigorous activities and any other nursery activity that may give cause for concern regarding an individual child’s health needs.
The risk assessment includes arrangements for taking medicines on outings and the child’s GP’s advice is sought if necessary where there are concerns.
A health care plan for the child is drawn up with the parent; outlining the key person’s role and what information must be shared with other staff who care for the child.
The health care plan should include the measures to be taken in an emergency.
The health care plan is reviewed every six months or more if necessary. This includes reviewing the medication, e.g. changes to the medication or the dosage, any side effects noted etc.
Parents receive a copy of the health care plan and each contributor, including the parent, signs it.
Managing medicines on trips and outings
If children are going on outings, staff accompanying the children must include the key person for the child with a risk assessment, or another member of staff who is fully informed about the child’s needs and/or medication.
Medication for a child is taken in a container clearly labelled with the child’s name, name of the medication, Inside the container is a copy of the consent form and a card to record when it has been given, with the details as given above.
On returning to the setting the card is stapled to the medicine record book and the parent signs it.
If a child on medication has to be taken to hospital, the child’s medication is taken in a sealed container clearly labelled with the child’s name, name of the medication. Inside the box is a copy of the consent form signed by the parent.
As a precaution, children should not eat when travelling in vehicles
This procedure is read alongside the outings procedure.
Legal framework
Medicines Act (1968)
Further guidance
Managing Medicines in Schools and Early Years Settings (DfES 2005)
HYPERLINK "http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf" http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf
.16 Managing children with allergies, or who are sick or infectious
(Including reporting notifiable diseases)
Policy statement
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.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.2 Inclusive practice
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures for children with allergies
When parents start their children at the setting they are asked if their child suffers from any known allergies. This is recorded on the registration form.
If a child has an allergy, a risk assessment form is completed 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.
This form is kept in the child’s personal file and a copy is displayed where staff can see it.
Parents train staff in how to administer special medication in the event of an allergic reaction.
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.
Currently, all lunches that contain egg are asked to be labelled.
Insurance requirements for children with allergies and disabilities
The insurance will automatically 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 your insurance provider must be obtained to extend the insurance.
At all times the administration of medication must be compliant with the Welfare Requirements of the Early Years Foundation Stage and follow procedures based on advice given in Managing Medicines in Schools and Early Years Settings (DfES 2005)
Oral Medication
Asthma inhalers are now regarded as "oral medication" by insurers and so documents do not need to be forwarded to your insurance provider.
Oral medications must be prescribed by a GP or have manufacturer’s instructions clearly written on them.
The group must be provided with clear written instructions on how to administer such medication.
All risk assessment procedures need to be adhered to for the correct storage and administration of the medication.
The group 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 your insurance provider.
Life saving medication & invasive treatments
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).
The setting 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 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.
Copies of all three letters relating to these children must first be sent to the Pre-school Learning Alliance Insurance Department for appraisal (if you have another provider, please check their procedures with them). Confirmation will then be issued in writing confirming that the insurance has been extended.
Key person for special needs children - children requiring help with tubes to help them with everyday living e.g. breathing apparatus, to take nourishment, colostomy bags etc.
Prior written consent from the child's parent or guardian to give treatment and/or medication prescribed by the child's GP.
Key person to have the relevant medical training/experience, which may include those who have received appropriate instructions from parents or guardians, or who have qualifications.
Copies of all letters relating to these children must first be sent to the Pre-school Learning Alliance Insurance Department for appraisal (if you have another provider, please check their procedures with them). Written confirmation that the insurance has been extended will be issued by return.
If you are unsure about any aspect, contact the Pre-school Learning Alliance Insurance Department on 020 7697 2585 or email [email protected].
Procedures for children who are sick or infectious
If children appear unwell during the session – have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – the supervisor calls the parents and asks them to collect the child, or send a known carer to collect on their behalf.
If a child has a temperature, they are kept cool, by removing top clothing, sponging their heads with cool water, but kept away from draughts.
In extreme cases of emergency the child should be taken to the nearest hospital and the parent informed.
Parents are asked to take their child to the doctor/ nurse/ pharmacist before returning them to nursery; the nursery can refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.
After diarrhoea, parents are asked to keep children home for 72 hours.
The setting has a list of excludable diseases and current exclusion times. The full list is obtainable from www.hpa.org.uk/servlet/ContentServer?c=HPAweb_C&cid=1194947358374&pagename=HPAwebFile and includes common childhood illnesses such as measles.
Reporting of ‘notifiable diseases’
If a child or adult is diagnosed suffering from a notifiable disease under the Public Health (Infectious Diseases) Regulations 1988, the GP will report this to the Health Protection Agency.
When the setting becomes aware, or is formally informed of the notifiable disease, the manager informs Ofsted and acts on any advice given by the Health Protection Agency.
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.
Single use vinyl gloves are worn when changing children’s nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.
Soiled clothing is rinsed and either bagged for parents to collect.
Spills of blood, urine, faeces or vomit are cleared using mild disinfectant solution and mops; cloths used are disposed of with the clinical waste.
Tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit are cleaned using a disinfectant.
Nits and head lice
Nits and head lice are not an excludable condition, although in exceptional cases a parent may be asked to keep the child away until the infestation has cleared.
On identifying cases of head lice, all parents are informed and asked to treat their child and all the family if they are found to have head lice.
Further guidance
Managing Medicines in Schools and Early Years Settings (DfES 2005)
http://publications.teachernet.gov.uk/eOrderingDownload/1448-2005PDF-EN-02.pdf
1.17 Nappy changing
Policy statement
No child is excluded from participating in our setting who may, for any reason, not yet be toilet trained and who may still be wearing nappies or equivalent. We work with parents towards toilet training, unless there are medical or other developmental reasons why this may not be appropriate at the time.
We make necessary adjustments to our bathroom provision and hygiene practice in order to accommodate children who are not yet toilet trained.
We see toilet training as a self-care skill that children have the opportunity to learn with the full support and non-judgemental concern of adults.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.2 Inclusive practice
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
Procedures
Staff only will be allowed to change children or help in the toilet area.
No volunteers, students or parents will be allowed to change children
Staff will inform other members of staff that they are going to attend to a child
Key persons undertake changing young children in their key groups; back up key persons change them if the key person is absent.
Changing areas are warm and there are safe areas to lay children to have their bottoms cleaned.
Each young child has to provide their nappies or ’pull ups’
Pre-school will provide gloves, changing mat, wipes and disposal bags.
Gloves are put on before changing starts and the areas are prepared
The changing mat is cleaned before and after use.
All staff are familiar with the hygiene procedures and carry these out when changing nappies.
Young children are encouraged to take an interest in using the toilet; they may just want to sit on it and talk to a friend who is also using the toilet.
They should be encouraged to wash their hands and have soap and towels to hand. They should be allowed time for some play as they explore the water and the soap.
Anti-bacterial hand wash liquid or soap should not be used for young children.
Key persons are gentle when changing; they avoid pulling faces and making negative comment about ‘nappy contents’.
Key persons do not make inappropriate comments about young children’s genitals when changing their nappies
Older children access the toilet when they have the need to and are encouraged to be independent.
Nappies and ’pull ups’ are disposed of hygienically; they are disposed of in the outside bin
If a change of clothes is required, a child’s own clothes will be used. If pre-school clothes have been used, parents will be notified by letter and encouraged to returned laundered as soon as possible.
A book will be kept in the changing box documenting details of the change, i.e.
Date of change
Time of change
Name of child
Name of staff member
Nature of contents, i.e. Soiled/ wet
NB If young children are left in wet or soiled nappies/’pull ups’ in the setting this may constitute neglect and will be a disciplinary matter. Settings have a ‘duty of care’ towards children’s personal needs.
1.18 No-smoking
Policy statement
We comply with health and safety regulations and the Welfare Requirements of the EYFS in making our setting a no-smoking environment - both indoor and outdoor.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.1 Respecting each other
3.2 Supporting every child
Procedures
All staff, parents and volunteers are made aware of our no-smoking policy.
We display no-smoking signs.
The no-smoking policy is stated in our information brochure for parents.
We actively encourage no-smoking by having information for parents and staff about where to get help to stop smoking if they are seeking this information.
Staff who smoke do not do so during working hours. Unless on a break and off the premises.
Staff who smoke during their break make every effort to reduce the effect of the odour and lingering effects of passive smoking for children and colleagues.
Parents are encouraged not to smoke outside whilst waiting to collect their children, and are reminded that a dropped cigarette butt constitutes littering and can incur a penalty fine.
Legal framework
The Smoke-free (Premises and Enforcement) Regulations 2006
www.opsi.gov.uk/si/si2006/20063368.htm
The Smoke-free (Signs) Regulations 2007
www.opsi.gov.uk/si/si2007/20070923.htm
1.19 Food and drink
Policy statement
This setting regards snack and meal times as an important part of the setting's day. Eating represents a social time for children and adults and helps children to learn about healthy eating. We promote healthy eating using resources and materials from the Pre-school Learning Alliance campaign Feeding Young Imaginations. At snack and meal times, we aim to provide nutritious food, which meets the children's individual dietary needs.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.4 Health and well-being
2.1 Respecting each other
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
3.4 The wider context
4.4 Personal, social and emotional development
Procedures
We follow these procedures to promote healthy eating in our setting.
Before a child starts to attend the setting, we find out from parents their children's dietary needs and preferences, including any allergies. (See the Managing Children with Allergies policy.)
We record information about each child's dietary needs in her/his registration record and parents sign the record to signify that it is correct.
We regularly consult with parents to ensure that our records of their children's dietary needs - including any allergies - are up-to-date. Parents sign the up-dated record to signify that it is correct.
We display current information about individual children's dietary needs so that all staff and volunteers are fully informed about them.
We implement systems to ensure that children receive only food and drink that is consistent with their dietary needs and preferences as well as their parents' wishes.
We display the menus of snacks for the information of parents.
We take care not to provide food containing nuts or nut products and are especially vigilant where we have a child who has a known allergy to nuts.
Through discussion with parents and research reading by staff, we obtain information about the dietary rules of the religious groups to which children and their parents belong, and of vegetarians and vegans, and about food allergies. We take account of this information in the provision of food and drinks.
We require staff to show sensitivity in providing for children's diets and allergies. Staff do not use a child's diet or allergy as a label for the child or make a child feel singled out because of her/his diet or allergy.
We organise meal and snack times so that they are social occasions in which children and staff participate.
We use meal and snack times to help children to develop independence through making choices, serving food and drink and feeding themselves.
We have fresh drinking water constantly available for the children. We inform the children about how to obtain the water and that they can ask for water at any time during the day.
We inform parents who provide food for their children about the storage facilities available in the setting.
We give parents who provide food for their children information about suitable containers for food.
In order to protect children with food allergies, we discourage children from sharing and swapping their food with one another.
For children who drink milk, we provide whole pasteurised milk.
Packed lunches
Our children are required to bring packed lunches, we:
ensure perishable contents of packed lunches are refrigerated or contain an ice pack to keep food cool;
inform parents of our policy on healthy eating;
inform parents of whether we have facilities to microwave cooked food brought from home;
encourage parents to provide sandwiches with a healthy filling, fruit, and milk based deserts such as yoghurt or crème fraîche where we can only provide cold food from home. We discourage sweet drinks and can provide children with water or diluted fresh fruit juice;
discourage packed lunch contents that consist largely of crisps, processed foods, sweet drinks and sweet products such as cakes or biscuits. We reserve the right to return this food to the parent as a last resort;
provide children, bringing packed lunches, with plates, cups and cutlery; and
ensure staff mingle with and oversee children who are eating their lunch so that the mealtime is a social occasion.
Legal Framework
Regulation (EC) 852/2004 of the European Parliament and of the Council on the hygiene of foodstuffs
Further guidance
Safer Food, Better Business
www.food.gov.uk/foodindustry/regulation/hygleg/hyglegresources/sfbb/
1.20 First aid
Policy statement
In our setting staff are able to take action to apply first aid treatment in the event of an accident involving a child or adult. At least one member of staff with current first aid training is on the premises or on an outing at any one time. The first aid qualification includes first aid training for infants and young children.
EYFS key themes and commitments
A Unique Child
Positive Relationships
Enabling Environments
Learning and Development
1.3 Keeping safe
1.4 Health and well-being
2.2 Parents as partners
2.4 Key person
3.2 Supporting every child
3.4 The wider context
Procedures
The First Aid Kit
Our first aid kit complies with the Health and Safety (First Aid) Regulations 1981 and contains the following items only:
Triangular bandages (ideally at least one should be sterile) - x 4.
Sterile dressings:
a) Small (formerly Medium No 8) - x 3.
b) Medium (formerly Large No 9) – HSE 1 - x 3.
c) Large (formerly Extra Large No 3) – HSE 2 - x 3.
Composite pack containing 20 assorted (individually-wrapped) plasters 1.
Sterile eye pads (with bandage or attachment) eg No 16 dressing 2.
Container or 6 safety pins 1.
Guidance card as recommended by HSE 1.
In addition to the first aid equipment, each box should be supplied with:
2 pairs of disposable plastic (PVC or vinyl) gloves.
1 plastic disposable apron.
a children’s forehead ‘strip’ thermometer.
The first aid box is easily accessible to adults and is kept out of the reach of children.
No un-prescribed medication is given to children, parents or staff.
At the time of admission to the setting, parents' written permission for emergency medical advice or treatment is sought. Parents sign and date their written approval.
Parents sign a consent form at registration allowing staff to take their child to the nearest Accident and Emergency unit to be examined, treated or admitted as necessary on the understanding that parents have been informed and are on their way to the hospital.
Legal framework
Health and Safety (First Aid ) Regulations (1981)
Further guidance
First Aid at Work: Your questions answered (HSE 1997)
HYPERLINK "http://www.hse.gov.uk/pubns/indg214.pdf" www.hse.gov.uk/pubns/indg214.pdf
Basic Advice on First Aid at Work (HSE 2006)
www.hse.gov.uk/pubns/indg347.pdf
Guidance on First Aid for Schools (DfEE)
HYPERLINK "http://www.teachernet.gov.uk/_doc/4421/GFAS.pdf" www.teachernet.gov.uk/_doc/4421/GFAS.pdf