6.2 Managing children who are sick, infectious, or with allergies
We aim to provide care for healthy children through preventing cross infection of viruses and bacterial infections and promote health through identifying allergies and preventing contact with the allergenic trigger.
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 – a member of staff will call the parents and ask them to collect the child, or to send a known carer to collect the child on their behalf as soon as possible.
§ If a child has a temperature, they are kept cool, by removing top clothing. If necessary, we will sponge their heads with cool water, ensuring they are kept away from draughts. In the meantime, we will contact the parents to collect their child.
§ The child's temperature is taken using an electronic thermometer kept in the cupboard in the kitchen.
§ If the child’s temperature does not go down and is worryingly high, then in extreme cases of emergency, an ambulance is called, and the parent informed.
§ 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 24 hours after the first dose has been administered before returning to the setting.
§ After sickness and/or diarrhoea, we ask parents 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, which is displayed in the entrance hall. The full list is obtainable from:
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/789369/Exclusion_table.pdf and it 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) (Amendment) Regulations 2020, 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 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.
§ Double bag soiled clothing for parents to take home for cleaning.
§ Clear spills of blood, urine, faeces or vomit using antibacterial spray and mops; and cloths used are disposed of with the clinical waste.
§ Mops are colour coded for different uses and they are kept separate.
§ Clean any tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit using a disinfectant. All cloths are consequently disposed of.
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 a case of head lice, we inform the parents and ask them to collect their child as soon as possible. The child is able to return to Pre-School once they have been treated.
§ All families will be informed that we have a case of head lice; and they will be provided with information on how to treat their child and the rest of their family.
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.
§ A list of all children and their allergies is on display in the kitchen and all staff carry this information on their prompt cards.
§ We have a risk assessment in place detailing what we do when we know a child has an allergy.
§ If a child has an allergy, parents are asked to provide written instructions detailing 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 risk assessment file and a copy is kept in the child’s personal file.
§ We are a no nut Pre-School and therefore no nuts or nut products are used within the setting. We request that no products that state that they may contain peanuts are brought into Pre-School in packed lunches.
§ Parents are made aware so that no nut, nut products, or products containing peanuts are accidentally brought in, for example to a party or in a lunch box.
§ Occasionally, parents may be requested to refrain from including other products in lunch boxes if we become aware of a child with an allergy after they have started with us. Such products will also not be used for snack.
§ All lunch boxes are checked daily by lunch club staff to check for any of these prohibited items.
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. (See administering medicines policy 6.1)
§ 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.
- Medication is stored out of the reach of the children in the kitchen (or in the fridge if required) and it is labelled with the child name and a photograph of the child,
- 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, Jext, Emerade) 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.
- Copies of all three documents relating to. Written confirmation that the insurance has been extended will be issued by return.
§ 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.
- All staff must have the relevant medical training/experience, which may include receiving appropriate instructions from parents or guardians.
- Copies of all letters relating to these children must first be sent to the Pre-school Learning Alliance Insurance Department for appraisal. Written confirmation that the insurance has been extended will be issued by return.
§ If we are unsure about any aspect, we contact the Pre-school Learning Alliance Insurance Department on 020 7697 2585 or email /insert