(including illness and allergy management)

A high percentage of staff at ABC Studio Childcare are always First Aid trained. We have many members of staff with full Pediatric First Aid qualifications.

• All staff should familiarize themselves with the First Aid boxes and know who the appointed First Aider is for their area. Lists are displayed in each room and a full list is kept in the main office.

Risk Assessments

General risk assessments are filled out for everyday use and are reviewed when necessary. Copies of these are kept in the office for reference.

Risk assessments for activities are assessed on a daily basis and recorded. Detailed risk assessments are carried out for all activities occurring off the premises. All members of staff going on the outing are made aware of the risk assessment.

Accidents & Incidents

All accidents occurring to staff or children must be reported to the Management Team. The Accident book/form is completed by the member of staff that was in attendance. In the Nursery, parent/carers are then informed at the end of the day and asked to sign the accident/incident slip before being given a copy to take home.

Head injuries, deep cuts and broken limbs are reported by the Management Team to parents immediately. RIDDOR would also need to be notified when applicable, as well as Ofsted. When a child bumps their head, medical advice of how to monitor a child is attached to the accident form which is sent home.

The following procedures will be followed in the event of:

Major Accident (at all times the staff must wear gloves):

• The Management Team will assess the situation and decide whether the child needs to go immediately to hospital or whether the child can wait for the parent/main carer to come.

• If the child can wait for the parent/main carer to come, then the parent/main carer will be contacted and the child will be made as comfortable as possible, and a member of staff will stay with them until the parent/main carer arrives. It will then be for the parent/main carer to decide whether to go to the hospital or not.

• If the child needs to go straight to hospital, an ambulance will be called. Then the parent/main carer will be contacted and arrangements will be made to meet the parent/main carer at the hospital. A member of staff will accompany the child to the hospital.

• Life threatening conditions such as Epilepsy and Anaphylaxis as well as any severe cuts, severe bumps and major falls should be referred to the Emergency Services.

• If the parent/carer cannot be contacted and local medical opinion advises that emergency treatment is necessary, then the member of staff will sign consent for it.

• A report of the accident will be recorded on an accident form.

Minor Accident (at all times the staff must wear gloves):

• The member of staff on duty assesses the injury and if necessary the Management Team is called.

• The injury is then treated.

• The child is then resettled and observed.

• Staff record the accident/incident.

• In the Nursery, parent/carers are then informed at the end of the day verbally and asked to sign the accident/incident slip before being given a copy to take home. 

• The health and safety officer/Management Team/DSL’s regularly checks for patterns of accidents/incidents.

• Please see appendix for cold compress procedure followed by staff

Hygiene Procedure

• Staff must always wear gloves when administering First Aid

• Spillage of blood or body fluids must always be cleared up immediately and disposed of in a yellow bio-hazard bag which is then to be placed with the other clinical waste in the separate bin outside.

• Surfaces must be disinfected immediately

• First Aid kits are regularly checked by nominated person/s in each room who completes a check list

Outings (off-premises)

First Aid box, contact forms, risk assessments and at least one charged mobile phone to accompany staff on all outings. Please also see Outing and Visits Policy.

Health/Illness and Emergency

It is our policy to encourage and promote good health and hygiene for all the children in our care. This includes monitoring the children for signs and symptoms of communicable diseases such as chickenpox, measles, mumps, rubella, meningitis, hepatitis, diarrhoea, vomiting and fevers of 101oF/38oC or over.

With the welfare of the sick child in mind and in the interests of the remaining children at ABC Studio Childcare, if in the opinion of the staff a child is ill, then the parent/carer will be contacted and requested to collect him/her as soon as possible. 

The Management Team must be convinced that the child has returned to good health before re-admitting them.

In the case of a serious accident or illness occurring then the parent/carer will be contacted immediately along with the medical professional and the appropriate action taken. In the unlikely event of the parent not being available, the senior staff member will assume charge and if necessary take the child to hospital along with all relevant details.

Illness/communicable disease as recommended by Public Health England.

ABC Studio Childcare refers to appropriate guidance from Public Health England as well as specific advice issued by the Local Authority and NHS. This advice can be updated/altered according to the extent of an outbreak both within the setting, locally or nationally.

Minimum Periods of Exclusion for most common illnesses:

Temperature - If a child has a temperature, they must remain at home. They should not return to the Nursery l until they have had at least 24 hours of a normal temperature

Vomiting/Diarrhoea - The child must not return to the Nursery until 48 hours after the last episode of sickness/ diarrhoea

Conjunctivitis - Keep at home for a minimum of 1 day to administer medication; longer if eyes still weeping

Chickenpox - One week and until all spots have crusted over

Impetigo - Until lesions are crusted and healed, or 48 hours after starting antibiotic treatment

Ringworm of body - Seldom necessary to exclude provided treatment is being given

Scarlet fever - Child can return 24 hours after starting appropriate antibiotic treatment

Threadworm - Need not be excluded once appropriate treatment has been given

Medication – guidance for parents

Only staff who have completed the full paediatric first aid course are able to administer medication (unless there is an emergency and no one else available) to children provided adequate information is provided but there is no legal obligation for them to do this.

Medicines should only be taken to the Nursery when essential; that is where it would be detrimental to a child’s health if the medicine was not administered during the nursery day.

If a child requires medication for a chronic or temporary condition, parents should request that their GP prescribe a dosage which allows for the administration of the medication outside of nursery hours. However, we recognise that there may be times when this is not possible.

Parents are required to complete a permission form for each type of medication. The child must remain at home during the first 48 hours of taking antibiotics. This is to ensure that the child has no adverse reaction to the medication.

We will only accept medicines that have been prescribed by a doctor, dentist, nurse prescriber or pharmacist prescriber. Medicines should always be provided in the original container as dispensed by a pharmacist (labelled with the child’s name) and include the prescriber’s instructions for administration.

Asthma pumps and containers of medication must be labelled by the prescriber on the pump/container (not just the box). Parents are also very welcome to come (by prior arrangement) into the Nursery to administer medicines. It is the responsibility of the parent to deliver and collect the medicine from the office each day.

All medication is kept out of the reach of children. In the unlikely event of an accidental overdose of medicine, a senior member of staff would telephone for appropriate advice and inform the parents immediately.

Staff responsibilities for medication

When accepting medication, the form teacher/office staff must:

• Check that the medication is prescribed and has the name of the child on the printed label from a pharmacist.

• Check that the medication is in the original container with a spoon/syringe.

• Check that the dosage on the form matches what is on the prescribed label.

• Check the parent has completed and signed the whole medication form.

• Give the completed medication form and medication to the key worker

If it is a long-term (more than 2 weeks) medication the key worker must:

• Copy the form to ensure that the medication is added to the long-term medication list and given to the Nursery Manager.

• The Nursery Manager to enter a calendar reminder to email parents to remind them to provide a replacement 4 weeks before the expiry date with an additional reminder 2 weeks before. It is however the responsibility of the parent to re-new medication before the expiry date.

When administering medication teachers/office staff must:

• Only administer medication (unless it is an emergency) if you have up to date paediatric first aid qualification.

• Check the medicine has the correct name on and matches the instructions of the medication sheet.

• Where possible, the administration should be witnessed by others.

• The dose must be recorded on the back of the medication form (additional sheets can be added).

• This should be photocopied after the last dose each day and the photocopy is given to parents at pick up (original placed in file in office).

• When the medication has finished, the medication must be returned to parents to dispose.

• The completed medication form should be returned to the office to be scanned to the pupils file

Long Term Medication/Serious Health Conditions

It is the parent’s responsibility to declare any long-term medication/serious health conditions as part of the admissions paperwork. Failure to do so, could delay the child starting. This is so the Management Team can organise a meeting to collate all details and if applicable, write a care plan that will need to be agreed in advance of the start date. All medication must be on site by the start date.

If a child is diagnosed with an allergy whilst already at the setting, parents must be directed to arrange a meeting with the Nursery Manager. The care plan must be agreed and confirmed with parents and signed/dated by the Nursery Manager. Care plans must be reviewed annually and/or when there are any changes to the medication/plan. If new medication is provided, the parent must be directed to the office to update the long-term medication form and the Nursery Manager will update the care plan (changing the date on the care plan and file name).

All rooms have copies of care plans in place across ABC Studio Childcare which shows who has life threatening conditions.

Auto-injectors

Staff re-fresh their training at least annually on how to administer different types of auto injectors. We currently have three types of auto-injectors and the training videos can be viewed here:

• EpiPen - https://vimeo.com/119454238

• Jext Pen - https://www.youtube.com/watch?v=HF5a2j7mHr8

• Emerade - https://www.youtube.com/watch?v=G7PUsftg9ls

Staff ensure that:

• Auto-injectors are stored out of direct sunlight

• Auto-injectors and medication are kept inside the zip wallet and include a copy of the care plan, a pen and record of medication sheet

• Designated person in each room check the bag and contents regularly (at least once a month to ensure all medication is correct and undamaged)

• When going off site, one adult (qualified first aider) carries the zip wallet at all times (not leaving it unattended) or in direct sunlight

Management of food allergies/intolerances

When a child joins the Nursery, parents are asked to complete a health form.

It is the parent’s responsibility to update medical information in writing as and when it changes.

We can cater for allergies/intolerances once we received confirmation in writing from your GP/Hospital. Parents will then be invited to meet the Nursery Manager.

We may require a two to three week notice period if a child requires an alternative menu. This to ensure that we have been able to meet parents to discuss the child's needs, meet with kitchen staff to discuss the possibility of alternatives and then update and brief all staff.

It may therefore mean that the parent may need to provide food for your child in the interim.

Staff responsibilities when managing food allergies/intolerances:

• Kitchen staff are responsible for ensuring the food is suitable for the child and not contaminated

• Kitchen staff will follow the master ingredients list and menu and inform the Nursery Manager before any ingredients are substituted or changed

• Kitchen staff will serve their meals on a special plate, cling film it used the provided label stating the child’s name, day and dietary requirement.

• Kitchen staff will double check this on the meal booklet which summarises all requirements as well as day of attendance.

• The kitchen staff will check on each other and sign once the allergy plates have been prepared.

• Kitchen staff will notify the Nursery Manager immediately if there are missing labels.

• All staff (kitchen, rooms and dining hall) are responsible for requesting parents update of any dietary changes in writing.

• Staff in the rooms/dining hall are responsible for double-checking with the kitchen to ensure children’s dietary meals are suitable, as well as checking with the kitchen staff when in any doubt

• Staff in the rooms/dining hall are responsible for supervising that the children only eat the food served to them

• Staff must inform any incidents/concerns relating to the food prepared to the Nursery Manager immediately

Specific protocols at meal times in the Nursery:

Every room has a booklet including details of any allergies/intolerances.

Before any snacks or meals are served to the child:

• the member of staff will refer to the checklist

• they will ensure the food does not contain any of the allergy triggers

• they will tick off, and then sign the checklist to confirm it has been noted

• senior staff in each room will hold an allergy review meeting once a month

Staff will check all meals against the allergy/intolerance list before they are served, including Breakfast, Snacks, Lunch and Tea.

The allergy checklist is a tick list that the member of staff will sign and date once checked.

Menus

Menus are displayed and distributed to the parents regularly.

Appendix - Cold Compress Procedure for Staff

Most minor bumps should be treated with cold water and a paper towel. Disposable cold compresses should only be used if there is a visible/possible swelling and no broken skin.

When using a disposable cold compress, please follow this procedure:

• Adult to activate, facing away from a child

• Adult to check that the pack is intact after activation (no tears/ leaks)

• Adult to put a tissue between the ice pack and skin

• Adult to supervise the child whilst they have the cold compress

• Adult to ensure no other child shares an ice pack

• Adult to dispose of the cold compress

If the disposable ice pack appears to be damaged or if pack splits:

• Alert another member of staff to notify management team

• If material has come into contact with skin or eyes, wash immediately

• Management team member/person on duty in office to inform parents immediately

• Parents advised to seek medical advice immediatelly

• If reaction to substance is severe, follow normal emergency procedures