Managing children who are sick, infectious, or with allergies

Policy statement

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), or if they develop an unusual or unidentified rash – 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.
• If a child has a temperature, they are kept cool, by removing top clothing and sponging their heads with cool water, but kept away from draughts.
• The child’s temperature is taken using a no touch thermometer (back up forehead strip), kept next to the first aid box.
• 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, including unusual or unidentified rashes.
• We ask that parents take all children with unusual or unidentified rashes to the doctor to be examined and we reserve the right to ask for a written report from the doctor to confirm the rash is not contagious. This is to protect any vulnerable adults or children we may have in our care.
• Where children have been prescribed antibiotics, we ask parents to keep them at home for 48 hours before returning to the setting.
• After vomiting or diarrhoea, we ask parents keep children home for 48 hours following the last episode.
• Some activities, such as sand and water play, playdough 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. The full list is obtainable from

www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities and includes common childhood illnesses such as measles. The ‘spotty book’ has now been replaced by national guidance Managing specific infectious diseases: A to Z – GOV.UK (www.gov.uk)

In the event of an outbreak of an infectious disease or illness, we will adhere to Public Health England guidelines.

Paracetamol based medicines (e.g. Calpol)

The use of paracetamol-based medicine may not be agreed in all cases. We cannot take bottles of non-prescription medicine from parents to hold on a ‘just in case’ basis, unless there is an immediate reason for doing so. We do not normally keep such medicine on the premises as they are not allowed to ‘prescribe’. However, given the risks to very young babies of high temperatures, insurers may allow minor infringement of the regulations as the risk of not administering may be greater. Ofsted is normally in agreement with this. In all cases, parents of children under two years must sign to say they agree to the setting administering paracetamol-based medicine in the case of high temperature on the basis that they are on their way to collect. Such medicine should never be used to reduce temperature so that a child can stay in the care of the setting for a normal day. The use of emergency medicine does not apply to children over 2 years old. A child over two who is not well, and has a temperature, must be kept cool and the parents asked to collect straight away.

Whilst the brand name Calpol is referenced, there are other products which are paracetamol or Ibuprofen based pain and fever relief such as Nurofen for children over 3 months.

We do not have paracetamol based medicines on site and will not administer.

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 we become aware, or are formally informed of the notifiable disease, our manager or deputy informs Ofsted and contacts Public Health England, and acts on any advice given.

HIV/AIDS/Hepatitis procedure

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.
• Bag soiled clothing for parents to take home for cleaning.
• Clear spills of blood, urine, faeces or vomit; any cloths used are disposed of with the clinical waste.
• Clean any tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit using a disinfectant.

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 cases of head lice, we inform all parents ask them to treat their child and all the family if they are found to have head lice.

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.
• If a child has an allergy, we complete a risk assessment form 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 measures.
• This risk assessment form is kept in the child’s personal file and a copy is displayed where our staff can see it.
• A health care plan will also be completed.
• Generally, no nuts or nut products are used within the setting.
• Parents are made aware so that no nut or nut products are accidentally brought in, for example to a party.

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.
• Oral medication:
• Asthma inhalers are now regarded as ‘oral medication’. 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.
• We must have the parents or guardians prior written consent. This consent must be kept on file.
• Life-saving medication and invasive treatments:

These include 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).

• 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.
• Treatments, such as inhalers or Epipens are immediately accessible in an emergency.
• 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.
• The key person must have the relevant medical training/experience, which may include receiving appropriate instructions from parents or guardians.

• If children display any symptoms of Covid 19, parents will be informed and asked to collect following our respiratory policy.

Guidance on infection control in schools and other childcare settings (Public Health Agency) https://www.publichealth.hscni.net/sites/default/files/Guidance_on_infection_control_in%20schools_poster.pdf