CMS Team - Voluntary Action Waltham Forest
Review date: January 2014
Reasonable efforts are made to keep our information up-to-date and correct, but no responsibility for
its accuracy and correctness, or for any consequences of relying on it, are assumed by Voluntary
Action Waltham Forest.
Sickness at the Nursery Guidelines – General guidelines
…………………………….. is committed to ensuring the Health and Safety of the
children that use its service, its employees and anyone who visits our setting .
We will work with Parents and Carers to promote good health and the avoidance of
sickness while children are in the nursery. We will have agreed ways of dealing with
accidents and sickness on the nursery site.
We will be informed about any health conditions of children that may need attention
while they are in the Nursery. We will have agreed arrangements for supporting children
who need medications.
To ensure that children, families, volunteers and employees are not subjected to any
health risks from other individuals, we will:

Manage attendance at the Nursery with regard to circumstances where there is a
definite risk of spreading illness.

Advise parents and staff about any circumstances in which there may be a risk of
being in contact with infectious diseases.
Medical information and Permissions
When your child enters the Nursery we will ask you to complete a medical
questionnaire. Once your child has had a vaccination or if your child’s medical condition
changes, it will be parents responsibility to let us know, so that we can keep our records
up to date.
If as a parent you do not feel you can agree to emergency care for your child we will
need to discuss with you exactly what you do not want for your child. (E.g. blood
transfusions)
In some cases this may result in the Nursery needing to decide whether we can deliver
childcare for your child as once we provide a place to a child we then have a duty of care
towards them.
Parents / carers will be notified of their child’s injury/illness and will be required to sign
an accident / incident form at all times.
For any major illness or injury parents will be contacted immediately.
First Aid and Emergency Treatments - our policy
All nursery staff are trained and qualified in Paediatric First Aid, which is renewed when
required.
In cases of emergency, basic first aid will be provided by our trained members of staff.
In the case of a serious accidents/incident emergency medical care will be sought from
appropriately trained professionals and parents will be contacted immediately.
Appropriate first aid must be administered for all minor accidents, and the child will be
kept under constant supervision.
Major Accidents
Major accidents e.g. severe head injuries, fractures and difficulties in breathing,
vomiting and unusual drowsiness or where the child appears to be in pain and we do
not know what is wrong. The child must be taken to the accident and emergency
department without delay, accompanied by a member of staff until the parent is able to
arrive at the hospital.
Medication policy
Parents must complete a medicine form when your child is on medication, and
countersigned when you collect your child to confirm that the medication has been
given.
Long term medication
For those children who require medication it is the parent/carer responsibility to ensure
that the nursery has possession of any such medication with clear instructions for
administration and storage. We may ask to see a copy of the medical prescription for
the medication.
Emergency medication
Emergency medication is any medication which must be administered in an emergency
situation, for example, Epi-pens and asthma pumps in the case of severe allergic
reaction or asthma attacks. It is the parent/carer responsibility to ensure that the nursery
has possession of any such medication with clear instructions for administration and
storage.
Non Prescription Medicines
The nursery does not normally administer non prescribed medication to the children in
our care except in the following two instances.
‘One off’ Dose’s of Medication
1) The nursery operates a ‘one off’ dose system which means that fever
reducing/pain relieving medication will be administered to children in the case of
sudden and unexpected raised temperature, for example, as seen in the onset of
the common cold.
2) Children who are teething will be given fever reducing/pain relieving medication
or teething gel when prior consent has been obtained from the parent/carer.
We do not administer anti-biotics, cough medication or regular doses of pain
relieving/fever reducing medication. If children are unwell enough to require these we
ask you to consider if they are well enough to attend the setting.
The nursery staff will also ensure that they have sufficient information and knowledge in order
to care for children with long-term/specific health needs and acknowledge that this may involve
taking advice from parents and medical professionals.
All medication which is not prescribed by a doctor, dentist, nurse or pharmacist will not be
administered to children except in the case of teething and ‘one off’ dose situations.
The nursery will not accept medicines that are not in their original containers and packaging.
All medication will only be administered in adherence to the prescriber’s instructions or in
accordance with the manufacturer’s guidelines. The medication must also be provided with its
original storage instructions. All medication in our possession is stored in a locked medication
cupboard except in the instance where medication must be stored in a fridge. All medication is
clearly labelled with the child’s name and weekly medication cupboard checks ensure that
medication is clearly labelled, stored correctly and in date.
Before any medication can be administered prior written consent must be obtained from the
parent/carer by their completing and signing a Medication Administration Form and/or ‘one off’
dose consent form. Consent for the administration of all medicines must be given beforehand.
Parent/carers will be required to sign their child’s medication form to confirm that they have
been informed that medication has been given.
Infectious diseases
In the case where children are ill parents should keep their child at home until they have
recovered. We do not provide care for children who are unwell, have a temperature, vomiting,
diarrhoea or who have an infectious disease. Parents/carers will be informed if an infectious
disease is confirmed within the setting. Children with mild coughs and sneezes are welcome
into the setting provided they do not have a temperature, are not distressed by their symptoms
and do not pose a serious threat to the other children’s health and well-being.
If the child’s condition deteriorates whilst in our care we will contact the parent/carer and ask
them to take their child home. If the parent/carer has signed a consent form for the ‘one off’
dose we will administer this if it is appropriate to do so.
Sunbeam/Sugar Plum Tree Nursery will contact the child’s GP, NHS Direct or the Emergency
Services for advice or treatment if the child’s condition causes us concern or their condition
deteriorates significantly. We will then endeavour to contact the parent/carer immediately.
If children are infectious children should be kept at home until the recommended exclusion
period has past or until treatment has been established as advised by a qualified
health/medical professional. Parents should refer to the attached Exclusion Advice Sheet.
With regards to diarrhoea parents/carers will be asked to come and collect their child after two
episodes of diarrhoea per day whilst in our care. Children who have vomited on two occasions
per day whilst in the setting will also be sent home. When children have been sent home due
to diarrhoea or vomiting children should be kept at home at least 48 hours or until the
diarrhoea or vomiting has stopped and the child is well after the specified period of time.
Children who have a raised temperature will also be sent home. Parent/carers are required to
keep children home for at least 24hrs after the temperature has stopped.
The local authority’s medical officer for environmental health will be notified of any infectious
diseases that a qualified medical person considers notifiable as outlined in the Infectious
Diseases (notification) Act 1989. OFSTED will also be informed.
Children taken sick at the Nursery
Guidance for Parents
Disease/Illness
Exclusion Period
Chicken Pox
5 days from onset of rash
German Measles (Rubella)*
5 days from onset of rash
Hand Foot and Mouth
Until disease has been fully treated
Impetigo
Until sores are crusted or healed
Measles*
5 days from the onset of rash
Ring Worm
Until treatment commenced (if on exposed
areas such as hands or face must covered by
dressing)
Scarlet Fever
5 days after commencing anti-biotics
Warts and Verrucae
No exclusion required- but must be covered if
on feet
Diarrhoea and Vomiting
48 hours following last episode of diarrhoea or
vomiting
Conjunctivitis
Until treated and eyes are clear
Head Lice
No exclusion usually needed provided
treatment is carried out. However, in cases of
heavy infestation child will be excluded until
fully treated to prevent head lice spreading
Mumps*
5 days from onset of swollen glands
Tonsillitis
None- but child must be seen by GP
Whooping Cough*
5 days from the commencement of anti-biotic
treatment or 21 days from onset of illness if
no anti-biotic treatment prescribed
Influenza (Flu)
Until fully recovered
Athletes Foot
No exclusion period required- but socks must
be worn at all times while in setting
Cold Sores (Herpes Simplex)
No exclusion period required
Scabies
After first treatment
Fifth Disease/Slapped Cheek Syndrome
No exclusion period required
Shingles
Excluded only if rash is weeping and cannot
be covered
Thread Worm
No exclusion period required
Raised Temperature
24 hours since the last episode of raised
temperature
* Notifiable Disease- please refer to medication and unwell child policy
Parents/carers should be aware that the above exclusion information may change and the
Nursery will follow the guidelines issued by the Department for Health/Medical Practitioner
regarding the above diseases or any others not listed.
Consent for ‘One Off’ Dose Administration
I would like my child__________________________________
D.O.B_______________ to be given a ‘one-off’ dose of the age appropriate pain
relieving/temperature reducing medication I have provided in the case of sudden and
unexpected high temperature.
I understand;




That this is strictly a ‘one off’ dose and will not be given to my child in the case of
any longer-term condition that requires regular doses of the medication I have
provided. In which case I will refer to the Medication and Unwell Child Policy.
That in the event that the ‘one off’ dose is required staff will attempt to contact me
to inform me that my child is unwell and to gain verbal consent to give the dose
whilst waiting for me to come and collect my child. If I cannot be contacted I
understand that staff will take this signed document as consent given and will
administer the dose.
That on collecting my child I will be required to sign a medication record sheet to
confirm that I have been informed that the dose has been administered.
That as the person with parental responsibility I have provided a medication
which is suitable for my child to take in the event of sudden and unexpected high
temperature. I confirm that to my knowledge there is no known reason why my

child cannot be given this medication and accept that it is my responsibility to
inform Sunbeam/Sugar Plum Tree should my child’s suitability change or in the
event that any further health issues arise.
In the case where children become unwell and their symptoms cause concern
Sunbeam/Sugar Plum Tree reserve the right to contact my child’s GP, NHS
Direct or the Emergency Services for advice or treatment. In such situations
Sunbeam/Sugar Plum Tree Nursery will endeavour to inform me immediately.
I have;
1. Provided an age appropriate pain relieving/temperature reducing medication that
is clearly labelled with my child’s name.
2. Handed over the medication into the possession of the Nursery in its original
packaging and with its original instructions for safe storage and dose
administration i.e how much to be given and how often.
3. Checked the expiry date and have ensured that the product is not out of date.
I declare that I have parental responsibility for the below named child. By signing
this form I give ……………………………………. permission to administer the below
named medication in the instances listed above and in accordance with the
products instructions for administration. I accept that it is my responsibility to
keep ………………………………………… up to date with any changes my child’s
suitability to be given the medication I have provided. I therefore declare that all
information given is true and accurate at the time of signing.
PARENTS SIGNATURE______________________________PRINT
NAME_______________________
RELATIONSHIP TO CHILD______________________________
DATE___________________________
CHILD’S NAME__________________________________________________
D.O.B______________
NAME OF MEDICATION_____________________________________ EXPIRY
DATE______________
MANAGERS
SIGNATURE____________________________________________DATE__________
___
Guidance for Parents
Below is a list of the most common communicable diseases that young children
experience.
The following information has been produced as a guideline for you but if you are
concerned about your child and unable to get an appointment with your G.P. please
consult a Pharmacist or NHS direct.
If your child is suffering from any of the following infectious illnesses please let a
member of staff know, or contact the nursery on (01603) 773121. Once informed we will
place a notice on the front door of the nursery to ensure that everyone has been notified
of any communicable diseases in the nursery.
1.Diarrhoea and/or Vomiting
Signs and Symptoms As diarrhoea and vomiting is infectious please do not bring your
child back to the Nursery until he/she has been clear of these symptoms for 48 hours.
This is a national policy from OFSTED regarding the care of children under the age of
five years.
2.Measles
Signs and Symptoms
Early symptoms of measles may include a running nose, watery eyes, high temperature
and a cough. Red spots with a white centre may also be seen on the inside of the
mouth, behind the ears and on the face and limbs.
General Medical Advice
As measles is infectious until five days after the appearance of the rash, please exclude
your child from Nursery until the rash has disappeared.
3.Chicken Pox
Signs and Symptoms
Children who suffer with Chicken Pox can display a wide range of symptoms,but usually
they will appear
fretful, suffer with a loss of appetite and have ahigh temperature. A rash will appearon
the trunk, face or limbs, and then small blisters will form which may cause an irritation.
General Medical Advice
Please provide your child with lots of fluids to help them reduce their temperature. You
may find calamine lotion soothes the irritation.
Parents Action
Chicken pox is infectious for up to five days before and not more than fivedays after the
appearance of the last spots. To reduce the risk to others your child must be excluded
from Nursery for up to five days after the appearance of the spots, or until the spots are
dry.
4.Mumps
Signs and Symptoms
Early symptoms of mumps can include swollen glands on one or both sides of the face,
sore throat and a loss of appetite. Your child may also experience difficulty in
swallowing.
General Medical Advice
Mumps can be infectious for up to one week after the facial swelling appears.
Parents Action
Please exclude your child from Nursery for five days from the onset of swelling
Conjunctivitis
This is an infection of the eye or eyes and is generally caused by bacteria, which is
spread by hand to eye contact, or by viruses associated with a cold. The symptoms
include redness, discomfort and discharge from the affected eye. Attention to
scrupulous hand hygiene can prevent spreading of the infection.
Chicken Pox
This is a common infectious disease, which is characterised by a rash (pustules) and
slight fever. The disease is spread by airborne droplets and can be infectious 21 days
before rash appears up until a week after, or until the rash has scabbed and dried.
Gastroenteritis (D&V)
This is an inflammation of the stomach and intestines caused by any of a variety of
bacteria, viruses and other small organisms that have contaminated food or water.
Symptoms include appetite loss, nausea, vomiting, cramps and diarrhoea. The affected
individual can spread the illness when attention is not paid to personal hygiene,
including hand washing.
Measles
This is highly infectious characterised by a rash and fever. It is spread by airborne
droplets of nasal secretions. Infected children can transmit the virus during the 8 to 14
day incubation period and up to one week after the onset of symptoms.
Mumps
This is a viral illness spread by airborne droplets. The chief symptom is inflammation
and swelling of the parotid glands just inside the angle of the jaw. This disease can be
spread to others for about a week before and up to two weeks after the symptoms
appear.
Scabies
This is a skin infestation caused by mites, which burrow into the skin. The mite’s burrow
can be seen on the skin as scaly swellings usually between the fingers and on the wrist.
The infestation causes itching. Scabies is highly contagious during close physical
contact. Specific treatment is required and 24 hours after treatment individual can
attend nursery.
Impetigo
Impetigo is highly contagious. Sensible hygiene precautions prevent the spread of
bacteria and reduce the risk of other people catching it. Impetigo has a characteristic
look to it, with inflamed red lumps leaking pus to form thick yellow crusts. It spreads very
quickly. It is common on the hands and around the mouth and nose. Sever infections
can affect the whole body. To prevent the impetigo returning, keep skin clean and
ensure than any condition causing broken skin (e.g. eczema, nappy rash) is treated
early.
Whooping Cough
This is caused by bacteria, which is spread by airborne droplets. Child is seen as
infectious when presenting with cough (which can have a characteristic whoop),
sneezing, nasal discharge, fever and sore eyes.
Hand, Foot & Mouth
Hand, foot and mouth disease is a common infectious disease, caused by coxsackie
virus. It is a disease mainly of children, especially of toddlers, and is very serious. Hand,
foot and mouth disease is very contagious (easily spread) and is common in children
under 10 years of age. However, adolescents and adults can also be affected. It
features many small blisters (vesicles) in the mouth and on the palms of the hands and
the soles of the feet. These may also appear on other parts of the body. There may be
some difficulty in swallowing, a slight fever and occasionally vomiting.
Scarlet Fever
The disease often starts with a sore throat or a skin infection about 12 hours before the
main symptoms appear. The characteristic symptom of scarlet fever is a fine rash on
the body that feels like sandpaper to touch. It may start in one place, but soon spreads
to many parts of the body, commonly the neck, chest, elbows, inner thighs and groin.
The rash does not normally spread to the face, but the cheeks become flushed and the
area just around the mouth stays quite pale. The overall impression of someone with a
flushed, red face is what gives the disease its name. Other symptoms include:- high
temperature, headache, white coating on tongue (which peels a few days later, leaving
the tongue looking red and swollen – known as strawberry tongue), and a general
feeling of malaise. Scarlet Fever is infectious. It is spread through close physical contact
ocontact with the mucus from an infected person. Very severe infections may cause
high fever, feeling sick and vomiting. Scarlet Fever is a notifiable disease. This means
that your doctor must report any cases to the local health authorities, so they can
monitor the spread of the disease.
Tonsilitis
Tonsilitis, whether due to a virus or bacteria, is spread from person to person by saliva,
hand contact or airborne droplets. The incubation period between picking up the
infection, and its onset is usually between 2 and 4 days. Children may have a sore
throat, pain on swallowing, headache, a feeling of malaise, fever, which may be very
high in young children. Constipation and earache are also common. The tongue may
well be furry and breath unpleasant. It may be difficult to open mouth and speech may
be thickened. Tonsillitis caused be streptococcal bacteria responds well to antibiotic
treatment. This should always be given if the infection is streptococcal.
Antibiotic Treatment/Medicine
Children who are prescribed antibiotic medicine must refrain from Nursery for 24 hours
after the first initial dose. Antibiotics have the potential to cause allergic reaction thus
necessitating close observation by parent/guardian.
GUIDELINES FOR ILLNESSES WHERE CHILDREN ARE ASKED TO REFRAIN
FROM ATTENDING NURSERY
MUMPS
10 days from outset of swollen glands.
24 hours after full course of treatment/until infection has cleared.
SCABIES
Children with impetigo should be kept from nursery until spots have
IMPETIGO
dried up and no longer leaking fluid. With use of antibiotics, impetigo
SKIN DISORDERS
usually heals within a week.
WHOOPING
COUGH
5 days from commencing antibiotic treatment.
DIARRHOEA
After a minimum of 3 soiled nappies, exclusion 48 hours.
VOMITTING
After 48 hours from onset.
HIGH
TEMPERATURE
If we cannot maintain a safe temperature, a child will need to be
collected for his/her own safety.
HAND, FOOT &
MOUTH
There is a short four- to six-day incubation period between exposure
and development of initial symptoms (fever and malaise). A person is
most contagious during the first week of illness.
SCARLET FEVER
Common treatment is a short course of antibiotics. Paracetamol can be
used to bring down the fever. Children should be excluded for five days
after the start of treatment, and kept away from other children as much
as possible.
TONSILITIS
Antibiotic treatment required, exclusion until infection clear.
ANTIBIOTIC
MEDICINE
24 hrs exclusion after initial dose of antibiotic
REVIEW AND EVALUATION
This policy was agreed at a meeting of ……………………… Management Committee
Held on ………………………………..
To be reviewed on ………………………………..
Signed ………………………………………………………………
Chair of Management Committee