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 childhood illnesses such as but not limited to; coughs, colds, chicken pox, diarrhoea, vomiting and temperatures above the norm. We request that parents and carers ensure that children are well enough to attend nursery and to participate in the full usual day to day activities whilst at nursery, including garden and adventure walks. Whilst our team endeavour to care for the children in the setting to the best of their ability, it is important to note that they are not medical professionals and therefore unable to look after unwell children.
Children who are unwell
It is at the Head of Nurseries discretion whether to allow a child into nursery. If they are showing signs of illness, even if there is no exclusion period or this is after any exclusion period has passed or if a doctor has stated that they are not infectious, The Head of Nursery will need to consider the demeanour of the child and whether they are well enough to participate in full nursery activities. They must also consider whether allowing a sick child into the nursery would affect the staff ratios, as children who are unwell may require continual one to one attention; we do not provide this care. If we allow a child showing signs of illness, or who has recently recovered from an illness into nursery then we will monitor them regularly and will contact parents to ask that they are collected if they become unwell again.
The nursery staff must consider the welfare of the unwell child in mind and the best interests of the other children in the nursery. If a child is considered by staff to be too unwell to be cared for at nursery, then the parent/carer will be contacted. They will be asked to collect their child as soon as they are able to (ideally within two hours, travel commitments taken into consideration). The child will be made as comfortable as possible until collection and as much time and attention will be given to them as necessary, without having an adverse effect on the care of the other children. This may include support from the Head of Nursery or staff from other rooms.
In the case of a sudden or serious illness, the Head of Nursery is informed immediately and will then contact the parent/carer and/or emergency contacts and appropriate action will be taken. At all times the staff will remain calm and endeavour to reassure the child until the parent/carer arrives.
Please do not bring children who are unwell into the nursery as they will be sent home upon arrival. This includes Children that have had Calpol before entering the premises as this could mask symptoms of an illness or infectious diseases.
When parents are co-parenting or parallel parenting, both parents will be called simultaneously, However, on occasions it may be impossible to contact a parent/carer in an emergency, we will make every effort to contact the next named person and so on until we have made contact, failing this, parents/carers are required to provide the Head of Nursery with signed permission at registration for the setting to act in their absence as loco parentis.
Parents/carers are required to inform the nursery in the event of an accident/sudden illness. If a child does not attend the setting and we have not heard from the parents by 10 am that day, we will call and email to ensure the child is ok and the reason for the absence.
Vomiting and Diarrhoea
If a child is unwell and vomits and or has one bout of diarrhoea (watery loose stool) whilst at the setting, then their parents will be contacted immediately and will be asked to collect their child from the setting ideally within two hours in order to prevent further spread of illness (travel commitments taken into consideration). Health Protection Agency advise that any child or team member who has a case of vomiting and or diarrhoea will be required to be away from nursery for 48 hours from the last solid bowel movement and or vomiting episode. If a child has vomited or had diarrhoea at home, we do require the children to not come into nursery and to follow the above exclusion requirements.
If a child has 2 loose bowel movements (not diarrhoea) then the parents will also be required to collect their child and exclusion for 24 hours from the last solid bowel movement.
The team are aware of the difference between posseting and vomiting, looser stools compared to diarrhoea.
The NHS currently states there is no link between teething and diarrhoea and so therefore will not link stools to teething.
Exclusion Periods
In some cases, an exclusion period from the setting may apply. Nursery staff must be satisfied that the child is in good health before allowing the child back into the nursery. These exclusions are also in place to keep the child, children of the setting, team and family members safe who use the setting.
Infectious Illness Reporting
If a child has an illness, we would request that the parents contact the nursery as soon as possible so we can communicate this to all staff and parents, as well as the Health Protection Agency and Ofsted if it is a notifiable disease.
Injections
If your child has had their childhood immunisations, we ask you to keep them off nursery for the first 24hrs. This is due to children having high temperatures after injections and some children having allergic reactions to them. We request that children are not returned to nursery on the day of having their injections as the site of the injection is sore and the child may have side effects from the injection.
Broken bones
Should a child have suffered a serious injury resulting in a sprain, bone break / fracture or similar injury then the situation will be assessed to see if the nursery can safely manage the child’s care while still recovering. Children will be allowed into the nursery setting at the discretion of the Head of Nursery after at least 24 hours at home following any hospital admission with regards to broken bones. Our insurance provider may also need to be contacted before the child can attend the setting to ensure that all safety procedures and risk assessments are put in place to keep the child and other children on site safe and to prevent further harm or injury.
Medications
Parents are responsible for providing all prescription medications. General permission for the administration of Calpol is included in the “Getting to know you” form on the kinderzimmer app. Please also see our Medications and Administration Policy.
Antibiotics
If a child has been prescribed antibiotics for the first time, they will be required to stay at home for 48 hours following the first dose in case of allergic reaction or intolerance to the antibiotics. If a child has been prescribed antibiotics and they have had the same type of antibiotics before, then they are able to return after the first dose has been given as long as the child is well in themselves and not suffering with a fever.
Rashes
If a child is presenting with a rash, the parents/carer will be contacted for the child to be collected as soon as reasonably possible and asked to see a medical professional. If a pharmacist or medical professional clears that the rash is not contagious or need further medical treatment the child can return to the nursery. The team are not medical professionals which is why they are unable to judge if a rash needs further medical care or not.
If a child presents with a rash that does not blanche upon pressure or wet glass test, we will call emergency contacts and contact 111 and follow medical advice from 111. The child will be required to be collected immediately.
High Temperatures
Should your child develop a temperature whilst at nursery you will be contacted and asked to collect your child immediately.
“A normal temperature in babies and children is about 36.4C, but this can vary slightly from child to child, A fever is a high temperature of 38C or more”
Staff can administer Calpol whilst the child is awaiting collection, should permission to do so be given over the phone. In addition, children will be offered fluids to keep them hydrated, they will be kept comfortable, ensure that clothing is in appropriate and loosened if able to do so, and kept out of draughts. If we are unable to speak with all emergency contacts after 30 minutes and the child’s temperature does not subside, the team will act in loco parentis and will administer Calpol to support the child’s welfare and to prevent febrile convulsions. Written permission will have already been sought on the kinderzimmer app during registration. (Please see Medication and Administration Policy)
Children must be free of high temperatures for a minimum 24 hours and be well enough to attend before returning to nursery.
We ask parents to not bring their child to nursery if they have had a temperature in the night and or morning.
If a child is sent home on two days within the same week with a feverish temperature, we will require them to seek medical attention before being able to attend back at the setting.
Children who present with a temperature will have a team member remain with them until they are collected, their temperature will be taken and monitored every 10 minutes, children will not be put to sleep or given food during this time. NHS guidance regarding fever and children will be followed. Temperature monitoring and medication administration will be recorded immediately on the kinderzimmer app.
Allergic reactions
If a child has a pre diagnosed allergy at the setting, and has an allergic reaction, the care plan will be followed, however once antihistamines or epi pen have been administered the child will be required to go home immediately for closer observation and supervision.
If a child displays symptoms in line with an allergic reaction and is not already diagnosed we will contact all emergency contacts and with permission administer Piriton to ensure the reaction does not continue. Written permission will already have been sought are registration on the kinderzimmer app. The child will also be required to be collected and advised to see a medical professional for further assessment.
Emergency contacts
Should your child become unwell, and we are unable to contact parents/carers or emergency contacts, we always have an emergency supply of liquid paracetamol (Calpol) that can be administered if your child’s temperature is 38 degrees – this will be administered to prevent convulsions and any prolonged suffering to your child. If your child is allergic to paracetamol, you MUST inform the setting upon enrolment or as soon as you are aware of this.
We take our guidelines on exclusion periods from nursery for illnesses from the NHS website, and Health Protection Agency who are trained in communicable diseases.
PLEASE NOTE: This is not an exhaustive list, but contains the most common exclusions. Parents should always seek medical advice from their GP or accident and emergency department regarding the specific symptoms of their child.
