SICKNESS AND MEDICINES POLICY

Sickness and Medicines Policy

At The Crown Nursery we promote the good health, including oral health, of all children who attend.  We have clear policies and procedures for managing sickness and medicines and these are expected to be adhered to in order that everybody in the school community is kept safe and well.  This policy must be implemented and includes information on;

  • how to respond to children who are ill or infectious
  • how to prevent the spread of infection
  • what action to take if children are ill
  • procedures for administering medicine

These are shared with all staff, parents and carers and are accessible on The Crown Nursery website (see also the Covid Behaviour Policy).

Sickness

To help keep all children healthy and minimise infection, we do not expect children to attend nursery if they are unwell. If a child is ill it is in their best interest, and those of the nursery community, to be at home with parents/carers rather than at nursery.

To minimise the spread of any infection we must all follow these procedures;

  • If a child becomes ill during the nursery day, we contact their parents/carers and ask them to pick up their child as soon as possible. During this time we care for the child in a quiet, calm area with their key person, wherever possible.
  • Should a child have an infectious disease, such as sickness and diarrhoea, they must not return to nursery until they have been clear for at least 48 hours. This is the guidance given to us by Public Health England and is in place to protect other children in the nursery.
  • We exclude all children on antibiotics for the first 24 hours of the course, in case the child has an allergic reaction (unless this is part of an ongoing care plan to treat individual medical conditions e.g. asthma). We have the right to refuse admission to a child who is unwell. This decision will be taken by the manager on duty and is non-negotiable.
  • We make information about head lice available and all parents are requested to regularly check their children’s hair. If a parent finds that their child has head lice we would be grateful if they could inform the nursery so that other parents can be alerted to check their child’s hair.
  • We notify Ofsted as soon as possible (always within 14 days) if we have a child or staff member with food poisoning.
  • We inform all parents if there is a contagious infection identified in the nursery, to enable them to spot the early signs of this illness.
  • We thoroughly clean and sterilise all equipment and resources that may have come into contact with a contagious child to reduce the spread of infection.
  • The nursery is professional cleaned twice and week and staff disinfect all services twice daily to prevent the spread of infection.
  • Children will be expected to follow all hand washing and hygiene routines while in nursery. Children will wash hands/use antibacterial gel as they enter nursery, before and after eating, at regular intervals during the day and before they leave nursery.
  • We ask children to follow the catch it and bin it mantra when in nursery. So if they have a cold, they will be asked to use tissues and to dispose of them straight away. If children need to cough or sneeze, they will be supported to use a tissue or crook of their arm and then wash their hands. Children will be sensitively and appropriately reminded not to touch their face, mouth, nose or eyes while at nursery.
  • We understand that social distancing is more difficult for younger children and in some cases not appropriate as children may need comforting throughout the day. We will however, keep different age groups separate as much as possible and will encourage the children to keep a little distance from each other and staff wherever possible.

Meningitis procedure

If a parent informs the nursery that their child has meningitis, the nursery manager will contact the Infection Control (IC) Nurse for their area. The IC Nurse will give guidance and support in each individual case. If parents do not inform the nursery, we will be contacted directly by the IC Nurse and the appropriate support will be given. We will follow all guidance given and notify any of the appropriate authorities including Ofsted if necessary. 

Serious Illness/Incident

If a child becomes severely ill or has a serious incident an ambulance must be called immediately.  Staff MUST NOT transport a sick child to the hospital in their own vehicle.

Staff must inform management staff immediately and must remain calm at all times.  Whilst waiting for the ambulance, parents/carers must be informed.  Once the hospital that will be attended is known, staff must inform parents and arrange to meet them there. The most appropriate staff member must accompany the child to hospital, this should be their key worker if possible.  They should take any relevant information with them such as registration forms, relevant medication records and the child’s comforter. 

All staff must consider children the remaining children and ensure they are adequately cared for.  Staff should be redeployed if necessary, and children may need to be temporarily grouped together.  Staff must also be aware of how all children may be affected by a serious incident.  They may need comforting and reassurance to help them feel safe and secure.

Medication

  • Prescription medicine will only be given to the child named on the bottle for the dosage stated. 
  • Medicines can only be given if they have been prescribed by a doctor, dentist, nurse or pharmacist
  • Medicines must be in their original containers
  • Staff must check all details on the label. They must be confident that the details have not been tampered with and must ensure that the medicine has not passed its expiry date.  All prescription medications should have the pharmacist’s details and notes attached to show the dosage needed and the date the prescription was issued.
  • Parents/carer should hand over the medication to the most appropriate member of staff who will then note the details of the administration on the medication form and another member of staff will check these details
  • Parents/carers must also sign the medication form once it is completed
  • Parents/carers must complete the medication form for the administration of each and every medication. However, we will accept written permission once for a whole course of medication or for the ongoing use of a particular medication under the following circumstances:
  1. The medication form is only acceptable for that brand name of medication and cannot be used for similar types of medication, e.g. if the course of antibiotics changes, additional written permission must be given and a new form will need to be completed
  2. The dosage on the written permission is the only dosage that will be administered. We will not give a different dose unless a new prescription is produced and a new medical form is completed
  3. Parents must notify us IMMEDIATELY if the child’s circumstances change, e.g. a dose has been given at home, or a change in strength/dose needs to be given.
  • The nursery will not administer a dosage that exceeds the recommended dose on the instructions unless accompanied by written instructions from a relevant health professional such as a letter or changed prescription from a doctor or dentist
  • The parent must be asked when the child has last been given the medication before coming to nursery and the staff member must record this information on the medication form. Similarly when the child is picked up, the parent or guardian must be given precise details of the times and dosage given throughout the day. The parent’s signature must be obtained
  • At the time of administering the medicine, a senior member of staff will ask the child to take the medicine, or offer it in a manner acceptable to the child at the prescribed time and in the prescribed form. (It is important to note that staff working with children are not legally obliged to administer medication)
  • If the child refuses to take the appropriate medication then a note will be made on the form and parents/carers will be informed
  • Where medication is “essential” or may have side effects, a discussion with the parent/carer will take place to establish the appropriate response.

Non-prescription medication

  • The nursery will not administer any non-prescription medication containing aspirin
  • The nursery will only administer non-prescription medication for a short initial period, dependant on the medication or the condition of the child. After this time medical attention should be sought
  • If the nursery feels the child would benefit from medical attention rather than non-prescription medication, we reserve the right to refuse nursery care until the child is seen by a medical practitioner
  • If a child needs liquid paracetamol (Calpol) or anti-histamine (Piriton) during their time at nursery, parental permission must first be obtained (see registration requirement form – permission to administer non-prescription medicine)
  • On the ‘permission to administer non-prescription medicine’ form, parents/carers can consent to their child being given liquid paracetamol or anti-histamine in particular circumstances such as an increase in the child’s temperature or a wasp or bee sting. This form will state the dose given, the circumstances in which this can be given e.g. the temperature increase of their child, the specific brand name or type of non-prescription medication and a signed statement to say that this may be administered in an emergency only if the nursery cannot contact the parent
  • An emergency nursery supply of fever relief (Calpol) and anti-histamines  (Piriton) will be stored on site. This will be checked at regular intervals by the designated trained first aider to make sure that it complies with any instructions for storage and is still in date.  It will be stored in a safe container, out of the reach of children
  • If a child does exhibit the symptoms for which consent has been given to give non-prescription medication during the day the nursery will make every attempt to contact the child’s parents. Where parents cannot be contacted then the nursery manager will take the decision as to whether the child is safe to have this medication based on the time the child has been in the nursery, the circumstances surrounding the need for this medication and the medical history of the child on their registration form. Giving non-prescription medication will be a last resort and the nursery staff will use other methods first to try and alleviate the symptoms, e.g. for an increase in temperature the nursery will remove clothing, use fanning, tepid cooling with a wet flannel. The child will be closely monitored until the parents collect the child
  • For any non-prescription cream for skin conditions e.g. Sudocream, prior written permission must be obtained from the parent and the onus is on the parent to provide the cream which should be clearly labelled with the child’s name
  • If any child is brought to the nursery in a condition in which he/she may require medication sometime during the day, the manager will decide if the child is fit to be left at the nursery. If the child is staying, the parent must be asked if any kind of medication has already been given, at what time and in what dosage and this must be stated on the medication form
  • As with any kind of medication, staff will ensure that the parent is informed of any non-prescription medicines given to the child whilst at the nursery, together with the times and dosage given
  • The nursery DOES NOT administer any medication unless prior written consent is given for each and every medicine.

Antibiotics

Children should stay at home for the first 24 hours of starting a course of new antibiotics.  This is in case the child develops an allergic reaction.  Thereafter the child is able to attend, provided they are well.

Injections, pessaries, suppositories

As the administration of injections, pessaries and suppositories represents intrusive nursing, The Crown Nursery staff will not administer these.

Staff medication

All nursery staff have a responsibility to work with children only where they are fit to do so. Staff must not work with children when they are infectious or too unwell to meet children’s needs. This includes circumstances where any medication taken affects their ability to care for children, for example, where it makes a person drowsy. If any staff member believes that their condition, including any condition caused by taking medication, is affecting their ability they must inform the manager and seek medical advice. The manager will decide if a staff member is fit to work, including circumstances where other staff members notice changes in behaviour suggesting a person may be under the influence of medication. This decision will include any medical advice obtained by the individual or from an occupational health assessment.   Where staff may occasionally or regularly need medication, any such medication must be kept in a locked container in the nursery office.  It must be labelled with the name of the member of staff and should not be touched by anyone except for the named person or in the case of an emergency.

Storage

All medication for children must have the child’s name clearly written on the original container and kept in a closed box, which is out of reach of all children.

Any antibiotics requiring refrigeration must be kept in a fridge inaccessible to children.

Emergency medication

Emergency medication, such as inhalers and EpiPens, will be within easy reach of staff in case of an immediate need, but will remain out of children’s reach.  All staff will receive annual training on how to use emergency medication eg EpiPens correctly.