Managing children with sickness

Managing Children who are sick, infectious, or with allergies

The Purpose of this Policy

This policy outlines the procedures to be followed in relation to managing those children who are sick, infectious, or who have allergies. The policy always recognises the need for the care and protection of children, and the importance of shared understanding between practitioners to always ensure our children’s good health and well-being.

Policy statement

Sky Little Angels aim to provide care for healthy children by preventing cross-infection of viruses and bacterial infections and promoting 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, continuous cough, diarrhoea, or pains, particularly in the head or stomach, our staff will call the parents and ask them to collect the child or to send a known adult 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 forehead thermometer strip, kept in the first aid box.
If the child’s temperature does not go down and is worryingly high, then we may give them Calpol or another similar analgesic, where parental consent has been provided on the child’s Registration Form and after first obtaining verbal consent from the parent, when possible. This is to reduce the risk of febrile convulsions, particularly for babies. Parents then sign the medication record when they collect their child.
In extreme cases of emergency, an ambulance is called, and the parent is informed.
Parents are asked to take their child to the doctor before returning them to the setting; we can refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.
Where children have been prescribed antibiotics for an infectious illness or complaint, we ask parents to keep them at home for 48 hours before returning to the setting to ensure there is no adverse reaction to the medication.
After diarrhoea, we ask parents to keep children home for 48 hours following the last episode.
Some activities, such as sand and water play, 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.

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 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 using mild disinfectant solution and mops; 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.
[Ensure that children do not share toothbrushes, which are also soaked weekly in sterilising solution.]

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, animal fur, 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., 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 known allergen or allergen 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’ by insurers and so documents do not need to be forwarded to our insurance provider. Oral medications must be prescribed by a GP or have the 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 parent's or guardians' prior written consent. This consent must be kept on file. It is not necessary to forward copy documents to our insurance provider.

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/care plan 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 by the child's GP, a district nurse, a children’s nurse specialist or a community paediatric nurse.
Treatments, such as inhalers or EpiPens are immediately accessible in an emergency.

In the case of children with a specific medical need such as 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 involved with the child must have the relevant medical training/experience, which may include receiving appropriate instructions from parents or guardians.
Copies of all letters relating to the child must first be sent to the insurance provider team for an appraisal.

If we are unsure about any aspect in relation to insurance requirements for children with allergies and disabilities, we contact our insurance provider and follow their procedures and advice