Nursery Child Health Policy

This policy has been devised to ensure that children who become unwell whilst at nursery are treated with sensitivity and respect.  It is also to help us protect other children from illness and to help us control the spread of infection.

This policy should be read in conjunction with the Nursery Attendance Policy.

Aims of this policy

• To help parents / carers understand the procedures in place around illness and sickness for children attending the nursery
• To clarify how to contact nursery regarding your child’s absence
• To clarify the procedures staff at the nursery will follow if your child becomes unwell.
• To provide clear information around some common childhood illnesses.

Arriving at nursery unwell

If an unwell or infectious child comes into nursery the Nursery Lead and Nursery Teacher reserve the right to not accept them into session.  It is unfair on the child to be here with us when they will require one to one attention from their parent/carer.  It is also unfair to the rest of the children who are here if they are knowingly in contact with an illness or infection.

If a child becomes unwell whilst at nursery

If a child begins to show the signs or symptoms that could pertain to illness they will firstly be comforted by staff, preferably their key person.  This will be in the form of reassurance, both verbally and physically as appropriate.

As soon as a child shows signs of feeling unwell, the child’s key person or other nursery staff member will begin filling in a sickness monitoring form.

If possible the child’s key person or other familiar adult  should spend one to one time with the child, attempting to find out what is wrong and administering any necessary first aid.  

No prescribed or over the counter medication may be given unless prior permission has been obtained from the parent/carer that day and the stated dose is due to be given at that time.

The Nursery Teacher and / Nursery Lead should be informed of any child who appears to be feeling unwell. If after staff have done everything they can to make the child more comfortable there is no sign of improvement, then there will be a discussion to contact the parent/carers to come and collect the child.

If contact cannot be made with the first named parent/carer on the child's record then the nursery staff will try other contacts in the order they are held on the child's contact information.

Plenty of fluids will  be offered to the child and if their temperature is higher or lower than usual this should be addressed immediately and monitored on the form.

 Any other symptoms should be treated as necessary. The child should always be treated with the utmost sensitivity and respect as feeling poorly can be distressing and quite frightening for a child. They should have a staff member with them, preferably their key person, until their parent/carer or authorised person arrives to collect them. 

The child should have privacy as much as possible and be able to be in a quiet area away from other children, with a staff member. 

Should a child’s symptoms deteriorate whilst waiting for their parents/carers the Nursery Teacher and / or Nursery Lead should be informed immediately. If the Nursery staff feel that it’s necessary, they should call for an ambulance. The Nursery Teacher and / or Nursery lead must then inform the parent/carers and whether or not to meet them at the nursery or the local hospital. First aid should be administered to the child as necessary and as instructed by the 999 call handler.

Absence procedures

Studybugs

Absence can also be reported using the Studybugs Attendance App which is an efficient and secure system for reporting your child’s absence due to illness.  Parents can get the free Studybugs app, or register on the Studybugs website, and use it to tell us whenever their child is ill and unable to attend school.

Get the app or register now 

Notification by phone 

The name and contact details of the school staff member pupils and parents should contact about attendance on a day to day basis is:

Ms Sapphire Davids

attendance@springmeadow.essex.sch.uk 

01255 504528

We thoroughly monitor all absences, and the reasons that are given.

Key Points

We will follow these key procedures to ensure the welfare of all children within the nursery.

• If a child becomes ill during their session in nursery the parent/carer will be contacted and asked to collect their child as soon as possible.  During this time the child will be cared for in a quiet, calm area with their key person or another familiar adult from the nursery setting.
• Should a child have sickness and diarrhoea, they should not return to nursery until they have been clear for at least 48 hours.
• It is vital that we follow the advice given to us by our Local Authority and exclude specific contagious conditions e.g. sickness and diarrhoea and chicken pox to protect other children in the nursery.  Illnesses of this nature are very contagious and it is exceedingly unfair to expose other children to the risk of infection.  
• With a case of conjunctivitis we ask that the child does not return to  nursery for 24 hours after starting medication.
• If a contagious infection is identified in the nursery, parents will be informed to enable them to spot the early signs of this illness.  All equipment and resources that may have come into contact with the contagious child will be cleaned and sterilised thoroughly to reduce the spread of infection.
• It is important that children are not subjected to the rigours of the nursery day which requires socialising with other children and being part of a group setting, when they have first become ill and require a course of antibiotics for the first 48 hours of the course.
• The nursery has the right to refuse admission to a child who is presenting as unwell.  This decision will be taken by the Nursery Teacher and Nursery Lead and is non-negotiable.
• Information about head lice is readily available to all parents / carers and we request that you check your child's hair regularly.  If you find your child does have head lice at any point we would really appreciate it if you could contact the nursery to let us know.
• Ensure your child’s asthma inhaler is in date and with the prescription label on the box showing the child’s name and brought into nursery, these must be signed in using the schools specific medicine in school form.

Transporting Children to Hospital

• If the illness or injury  is severe, staff will call for an ambulance immediately.  No staff member will attempt to transport the sick child in their own vehicle or the school minibus.
• Whilst waiting for the ambulance, contact the parent and arrange to meet them at the hospital or at school whichever fits the situation.
• A senior member of staff must accompany the child and collect together registration forms, relevant medication sheets, medication and the child’s comforter.
•  Remain calm at all times. Children who witness an incident may well be affected by it and may need lots of cuddles and reassurance. If you are confident and assertive the child will feel reassured.

Calling an Ambulance 

• Dial 999 and ask for an ambulance. Answer all questions honestly and clearly. When asked to give the address and telephone number, use the following details: 

Spring Meadow Primary School & ‘School House’ Nursery, 

Pound Farm Drive, Dovercourt, Harwich, Essex, CO12 4LB 

Telephone number: 01255 504528 

• A senior member of staff will go with the child to the hospital if the parent/carer cannot get there in time, taking the child’s registration form which includes all their medical details and the consent for medical attention, and any of the child’s special comforters. 
• Reports should be written up by all staff involved and any witnesses and uploaded onto the CPOMS system. Members of staff will be offered time out and an opportunity to discuss what happened and how they are feeling. 

Procedures & information linked to specific illnesses

Sickness & Diarrhoea

All children must be kept away from nursery for a minimum of 48 hours after the last episode of sickness or diarrhoea.  If a child is sent home from nursery the 48 hours still applies.  Therefore if your child is due in the following day they will not be able to attend.  Children should only return to nursery when they are well enough and have regained their appetite. 

Fever

All children must be kept away from nursery for a minimum of 24 hours or until their fever has returned to normal.

A fever will be considered anything over 38 degrees C and your child’s temperature will be monitored by staff closely using a forehead thermometer every 15 minutes and this will be recorded.  Anything over 38C will result in the staff making contact with the child’s parent/carer and asking for the child to be collected.

If a child is sent home from nursery the 24 hours still applies.  Therefore if your child is due in the following day they will not be able to attend.  The nursery will not administer any medicine unless you sign a consent form that includes prescribed medication and calpol or nurofen etc.

Nursery staff have the right to refuse to administer any medication with which they feel uncomfortable.  Please can all parents and carers respect our staff team's decisions as our policies are in place to prevent infection from spreading around the nursery.

Nits and Head lice

Nits and head lice are not an excludable condition, although in exceptional cases a parent may be asked to keep their 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.

Type 1 & 2 Diabetes

The staff will have training from the Diabetic Nurse Team arranged by the SENCo.  

A full medical care plan will be written in conjunction with the Diabetic nurse team and signed off by them and by the child’s parents/carers.

A personalised plan of care will then be put in place for the child.

Febrile Convulsions, Anaphylactic Shock and any other fit or seizure

 If a child has any of the above an ambulance must be called immediately and the same steps taken as above. 

Anaphylaxis typically presents with many different symptoms over minutes or hours with an average onset of 5 to 30 minutes if exposure is intravenous and 2 hours for foods. The most common areas affected include: skin (80–90%), respiratory (70%), gastrointestinal (30– 45%), heart and vasculature (10–45%), and central nervous system (10–15%) with usually two or more being involved. 

Anaphylaxis is a medical emergency that may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring. Administration of epinephrine (Epipen) may be required and only staff with Epipen training should be called upon to administer such treatment. 

If parent/carers are aware of the child having the need for an Epipen they will have had a meeting with the Inclusion Team to ensure a Medical Care Plan is written and in place for the child.

Meningitis Procedure

If a parent informs the nursery that their child has meningitis, the Nursery Lead will contact the Infection Control Nurse for the area and Ofsted.  The Infection Control Nurse will give guidance and support in each individual case.  If parents do not inform the nursery, we will be contacted directly by the Infection Control Nurse and the appropriate support will be given.

HIV/AIDS Hepatitis procedure

• HIV virus, like other viruses such as Hepatitis A, B and C, is spread through body fluids. Hygiene precautions for dealing with body fluids are the same for all children and adults.
• Single-use vinyl gloves and aprons are worn when changing children’s nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.
• Protective rubber gloves are used for cleaning/sluicing clothing after changing.
• Soiled clothing is rinsed and bagged for parents to collect.
• Spills of blood, urine, faeces or vomit are cleaned using mild disinfectant solution and mops; any cloths used will be disposed of with the clinical waste. We will follow advice from the Health Protection Agency (HPA) guidance, (see attached). 
• Tables and other furniture, furnishings or toys affected be blood, urine, faeces or vomit are cleaned using a disinfectant.

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 will be recorded on the Registration form.

If a child has an allergy, a 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 the 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. Epi-pen)
• Control measures – such as how the child can be prevented from contact with the allergen.

This form is kept in the child’s personal file and a copy is displayed where staff can see it within the kitchen area.  Parents train staff in how to administer special medication in the event of an allergic reaction. Further training will be given to staff if needed. 

No nuts are to be consumed within the Nursery by any one.

Parents are made aware of this upon registration, so that nuts are not brought into the Nursery.

Oral Medication

Asthma inhalers are now regarded as ‘oral medication’ by the insurers and so do not need to be forwarded to the insurance provider.

• Oral medications must be prescribed by a GP or have manufacturer’s instructions clearly written on them.
• The Nursery must be provided with clear written instructions on how and when to administer such medication.
•  All risk assessment procedures need to be adhered to for the correct storage and administration of the medication.
• The Nursery must have the parents or carers prior written consent. This consent must be kept on file.

Key person for special needs children 

Children that require 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 or carer to give treatment and/or medication prescribed by the child’s GP or Paediatric Consultant.
• The key person must have the relevant medical training/experience, which include those who have received appropriate instructions from parents/carers, 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. Written confirmation that the insurance has been extended will be issued by return.
• Written confirmation that the insurance has been extended will be issued by return.

Reporting of ‘notifiable diseases’   

• If a child or adult is diagnosed as suffering from a notifiable disease under the Health Protection (Notification) Regulations 2010, the GP will report this to the Health Protection Agency.
• When the Nursery becomes aware, or is formally informed of a notifiable disease, the Senior Leadership informs The Office for Standards in Education Children’s Services and Skills (Ofsted) and acts on any advice given by the Health Protection Agency.

Insurance requirements for children with allergies or disabilities

The School House Nursery insurance will automatically include children with any disabilities 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 the insurance provider must be obtained to extend the insurance.

This policy links to and should be read in conjunction with:

• SEND policy
• SEN Information Report
• Nursery Attendance Policy
• Child Protection Policy
• Supporting Pupils with Medical Conditions
• Accessibility Plan