Promoting health and hygiene

1.17 Managing children with allergies, or who are sick or infectious

(Including reporting notifiable diseases)

Policy statement

We promote health through awareness of individual children’s allergies and preventing contact with the allergenic substance and through preventing cross infection of viruses and bacterial infections.

Procedures for children with allergies

• When parents start their children at the pre-school they are asked if their child suffers from any known allergies. This is recorded on the admission form.
• If a child has an allergy, an Individual Care Plan (ICP) 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.
• If medication is provided, a copy is kept in their medication box.

• Parents advise staff in how to administer medication in the event of an allergic reaction, if applicable. In the case of an epipen requirement, staff would receive specialist training.
• No nuts or nut products are used within the pre-school.
• Parents are made aware so that no nut or nut products are accidentally brought in, for example in lunch boxes.

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 [we/I] ensure that the administration of medication is compliant with the Safeguarding and Welfare Requirements of the Early Years Foundation Stage.

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 and have instructions clearly written on them.
• The pre-school 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 pre-school 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.
• For 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.

We would consult with our insurance company to establish which documentation they require. Confirmation must be issued in writing confirming that the insurance has been extended.

For children with special needs (ie. children requiring help with tubes to help them with everyday living e.g. breathing apparatus, to take nourishment, colostomy bags etc.), the pre-school must have:

–     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. An ICP would be in place.

We would consult with our insurance company to establish which documentation they require. Written confirmation that the insurance has been extended must be issued before the child can attend.

If we are unsure about any aspect, we will contact our insurer.

Procedures for children who are sick or infectious

• If children appear unwell during the day – have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – the office staff or pre-school leader 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, if necessary. The parents are informed.
• Temperature is taken and monitored before collection by parent/guardian.
• In extreme cases of emergency an ambulance would be called and, if necessary, the child would be taken to the nearest hospital. The parents/carers would be informed.
• We refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.
• Where children have been prescribed antibiotics, parents are asked to keep them at home for a minimum of 48 hours before returning to pre-school.
• After diarrhoea, parents are asked to keep children home for a minimum of 48 hours and a solid stool has been passed.
• After sickness, parents are asked to keep children home for a minimum of 48 hours.
• The setting has a list of excludable diseases and current exclusion times. The full list is obtainable from www.hpa.org.uk/web/HPAwebFile/HPAweb_C1194947358374 and includes common childhood illnesses. A copy is available from the office and, in addition, is displayed in poster form in the utility room.
• Parents are advised of any contagious or infectious diseases of conditions that have been reported to us.
• Some activities such as sand and water play, play dough and self-serve snacks where there is a risk of cross contamination may be suspended for the duration of any outbreak.

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 Public Health England.
• When the setting becomes aware, or is formally informed of the notifiable disease, the Administration Manager informs Ofsted and acts on any advice given by the Health Protection Unit.
• The Health Protection Unit are informed if a significant number of cases of sickness, diarrhoea or infectious illnesses are reported.

HIV/AIDS/Hepatitis

• HIV virus, like other viruses such as Hepatitis, (A, B and C) are spread through bodily fluids.

Hygienic Procedures for Dealing with Bodily 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 gloves are used for cleaning/sluicing clothing after changing.
• Soiled clothing, when necessary, is rinsed and bagged for parents to collect or dispose of.
• Spills of blood, urine or faeces are cleared using an antibacterial solution and mops; cloths used are disposed of. Vomit is covered with cat litter and then cleared with a designated scoop, placed in a double bag and disposed of.
• Tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit are cleaned using an appropriate cleaning solution.

Nits and head lice

• Nits and head lice are not an excludable condition.
• When head lice are detected a parent or carer is informed and advised to treat as early as possible to avoid spreading to other children or staff.
• We would suggest that all members of the family are treated if they are found to have head lice. Information leaflets are available in our parent room and reception area.

Other useful Pre-school Learning Alliance publications

• Good Practice in Early Years Infection Control (2009)
• Medication Administration Record (2013)

This policy now has a bi-annual review period and, as such, will be reviewed and signed off at a management committee meeting of Cullompton Pre-School each year, as shown below.