Statement of Purpose Appendix 5:

1

Mini Model Day Care

35 Dunowen Gardens

Belfast

BT14 6NQ

Tel No: 028 90 391 653

Mobile No: 07854735446

minimodel@belfastgms.org

Infection Control Policy

Infection Control Policy

Hand Washing

Hand washing is the most important public health measure. Effective hand washing is the mainstay of infection control for most germs amongst children and adults in a nursery setting, regardless of the way germs are transmitted.

hands will be washed after using the toilet and before meals very young children will need assistance in hand washing older children will be supervised during hand washing liquid soap will be used rather than a bar of soap pre-moistened wipes should not be used as a substitute to soap and running water paper towels will be used to dry hands

Accidental Soiling

soiled materials can be scraped off into the toilet wear disposable gloves and disposable aprons when doing this place the soiled clothing in a double bag for parents to launder staff must wash their hands after handling soiled clothing, even if wearing gloves

Nappy Changing

Children’s nappies should be changed at regular intervals in the nappy changing are only; Make note of nappy changes both on chart and in the child’s daily book; Wash your hands before starting changing the child’s nappy; Staff should wear disposable gloves and aprons when changing children; The door leading to the play rom has to be open while attending a child; The child should be made comfortable and placed on the changing mat; Wet/ soiled nappy removed and child cleaned from front to back; Use cream and wipe provided for the particular child by his/her parent only; If you notice extensive rash or spots report it to your supervisor or manager; Secure clean nappy on child; Used nappy and wipes disposed of in the napisan disposal bin; Staff should remove gloves and apron, and dispose of in black bin Wash hands; Wipe child’s hands; Child should be seated safety; Staff should thoroughly clean changing mat and surrounding floor with antibacterial/ sanitising

wipes;

Cleaning of Toilet Area

2

Staff are to ensure that the toilets are clean at the start and finish of the sessions. Additional cleaning should be carried out during the session as necessary.

All toilets are to be cleaned down daily with hot soapy water. This also applied to the toilet seat and handles, sinks, taps and door handles.

If an area becomes contaminated with infected materials i.e. diarrhoea or vomit (not urine), the area will be washed immediately and spillages attended to as they occur.

Toilet paper will be provided for the children at all times Children (age appropriate) will be supervised when going to the toilet Children will be educated on how to wash their hands properly.

Cleaning Materials

Cloths should be disposable or changed daily or as necessary Mops will be washed thoroughly after use in a cleaning equipment sink (not the kitchen sink) with

hot soapy water and left to dry Mops used to clean bodily fluids should be:-

Cleaned with hot soapy water Rinsed with a disinfecting agent Wrung as dry as possible Hung to dry completely

Buckets and basins will be washed out and dried after use. Separate cleaning materials will be used for the kitchen area and the toilets. Colour coding is in place.

Cleaning of Toys, Equipment and Furnishings

Staff will ensure all are cleaned on a regular basis, following the individual rota in each room.

mats will be vacuumed daily and steam cleaned as required (at least once a year) tables and chairs will be cleaned and washed with hot water and detergent daily hard toys will be washed with hot water and detergent and dried (on a monthly basis) additional cleaning will be carried out when required soft toys will be washed I the washing machine at a hot cycle (minimum 60c) and tumble dried water-play toys should be stored day and water tray should be emptied, rinsed and dried out daily

by turning upside down so that no condensation can collect play-dough should be changed weekly or as necessary and children will be discouraged from

putting dough in their mouths in the case of an outbreak of infection, all water play will cease and play dough will be disposed of sane will be sieved on a weekly basis extra care will be given where babies and toddlers are using soft toys and equipment and washed

on a more regular basis

Exclusion of Sick Children See Appendix Exclusion Table etc……3

Parents are required to sign an exclusion of sick children form with the day care. This is vital to minimise the spread of infection within the setting. Please refer to Appendix for details on exclusion period and advice.

Children who are unwell with an infectious disease should not be at Mini Model. The Manager will ensure there is an exclusion contract signed for all children. Once they are better they can return unless they pose a risk to others

If a child falls violently ill whilst at the nursery, the sick child will be cared for in a quite excluded area away from the others.

A member of staff will stay with the child while arrangements are being made for the child’s parent/ carer to be contacted and arrangements made for the child to be sent home.

All staff are required to follow the procedure in order to minimise the spread of infection All staff will cover all cuts, breaks in their skin, scratches or most skin conditions with a waterproof

dressing (without visible air holes) when they are at work. Dressings and plasters will be replaced as often as necessary, and these will be blue if staff, are

involved in preparing food. All staff immunisations will be checked and staff will report symptoms of sickness to the Manager. Staff will observe exclusion periods of infectious diseases and advice will be sought if in doubt. Some infections if caught by a pregnant woman can pose a danger to her unborn child. Chicken pox, rubella, parvovirus – when outbreak of any of these occurs please inform parents

immediately If a female member of staff comes into contact with the above she will contact her Manager and GP

immediately.

Animals in the N ursery

During the year we may have visits from animals and their carers. We also may go on visits to a farm, zoo, wild life park etc.

Children will be supervised at all time around animals Visiting pets will only be in the playroom and the area will be disinfected on their departure. If visiting a farm the Manager will carry out a risk assessment. The leader will check that the farm

has washing facilities adequate and accessible for children. The Manager will check there is: running water, liquid soap and disposable towels.

Children will be warned not to put their faces against the animals or taste the animal’s food. Staff will ensure children wash their hands after being in contact with animals and particularly

before eating or drinking. Snack time will be taken away from the area where the animals are kept. Staff will ensure children wear suitable footwear, i.e. wellington boots and strong shoes. Children’s allergies will be considered prior to the visit (i.e. asthma). Staff will ensure all children will wash their hands thoroughly before departure and that footwear is

as clean as possible from faecal material.

Food Hygiene

Staff will ensure that good hygiene is followed and every precaution is made to minimise infection.

4

Dining tables will be sprayed with anti-bacterial liquid prior to and after snack time. Fridge temperatures will be recorded daily and will be kept at between 5c and 8c, a thermometer

will be kept in the fridge. Separate chopping boards will be used for preparing fruit and snacks. All utensils will be washed thoroughly on a daily basis Tea towels should be laundered at 60c on a daily basis.

Exclusions table and infection control guidancePrevent the spread of infections by ensuring: routine immunisation, high standards of personalhygiene and practice, particularly hand washing, and maintaining a clean environment.

5

Please contact Public Health Agency, Ormeau Avenue Unit, 18Ormeau Avenue, Belfast, BT2 8HS, 02890 311611www.publichealth.hscni.netDiarrhoea andVomiting illness#

Recommended period tobe kept away from school,nursery, or childminders

Comments

Diarrhoea and/orVomiting

E. coli 0157 VTEC

Typhoid* [andparatyphoid*](enteric fever)

Shigella (Dysentery)

RespiratoryInfections

‘Flu’ (influenza)

Tuberculosis*

Whooping cough*(Pertussis)

48 hours from last episode ofdiarrhoea or vomiting (48hrrule applies).

Exclusion is important forsome children. Alwaysconsult with PUBLIC HEALTH AGENCY.

Exclusion is important forsome children. Alwaysconsult with PUBLIC HEALTH AGENCY.

Exclusion may be necessary.

Recommended period tobe kept away from school,nursery, or childminders

Until recovered.

Always consult with PUBLIC HEALTH AGENCY.

Five days from commencingantibiotic treatment or 21days from onset of illness ifno antibiotic treatment.

Exclusion from swimmingshould be for 2 weeks followinglast episode of diarrhoea.

Exclusion applies to young children and those who may find hygiene practices difficult to adhere to. Public Health Agency will advise. Exclusion from swimming should be for 2 weeks following last episode of diarrhoea.

Exclusion applies to young children and those who may find hygiene practices difficult to adhere to. Public Health Agency will advise. Exclusion from swimming should be for 2 weeks following last episode of diarrhoea.

Exclusion (if required) applies to young children and those who may find hygiene practices difficult to adhere to. Public Health Agency will advise. Exclusion from swimming should be for 2 weeks following last episode of diarrhoea.

Comments

SEE: vulnerable children.

Not usually spread from children. Requires quite prolonged, close contactfor spread.

Preventable by vaccination. After treatment non-infectious coughing may continue for many weeks. PUBLIC HEALTH AGENCY will organise any contact tracing necessary.

Rashes/Skin

Athletes foot

Recommended period to be kept away from school, nursery, or childmindersNone.

Comments

Athletes foot is not a serious condition. Treatment

6

Chicken pox

Cold sores,(herpes simplex)

German measles(rubella)*

Hand, foot & mouth

Impetigo

Measles*

MolluscumContagiosum

Ringworm

Roseola (infantum)

Scabies

Scarlet fever*

Slapped cheek/fifthdisease Parvovirus B19

5 days from onset of rash.

None.

5 days from onset of rash.

None

Until lesions are crustedor healed.

5 days from onset of rash.

None.

Until treatment commenced.

None.

Child can return after firsttreatment.

5 days after commencingantibiotics.

None

is recommended.

SEE: vulnerable children and female staff – pregnancy.

Avoid kissing and contact with the sores. Cold sores are generally a mild self-limitingdisease.

Preventable by immunisation (MMR x 2 doses). SEE: female staff - pregnancy.

Contact PUBLIC HEALTH AGENCY if a large number of children are affected. Exclusion may be considered insome circumstances

Antibiotic treatment by mouth may speed healing and reduce Infectious period.

Preventable by vaccination (MMR x 2). SEE: vulnerable children and female staff – pregnancy.

A self limiting condition.

Treatment is important and is available from pharmacist. N.B. For ringworm of scalp treatment by GP is required. Also check and treat symptomatic pets.

None.

Two treatments 1 week apart for cases. Contacts should have one treatment; include the entire household and any other very close contacts. If further information is required contact your Public Health Agency.

Antibiotic treatment recommended for theaffected child.

SEE: vulnerable children and female staff – pregnancy.

Shingles Exclude only if rash isWeeping and cannot becovered.

Can cause chicken pox in those who are not immune i.e. have not had chicken pox. It is spread by very close contact and touch. If further

7

Warts and Verrucae

Other Infections

Conjunctivitis

Diphtheria *

Glandular fever

Head lice

Other Infections

Hepatitis A*

Hepatitis B* and C*

None.

Recommended period to be kept away from school, nursery, or childminders

None.

Exclusion is important. Always consult with PUBLIC HEALTH AGENCY.

None.

None.

Recommended period tobe kept away from school,nursery, or childminders

Exclusion may be necessary.Always consult with PUBLIC HEALTH AGENCY.

None.

information is required contact your Public Health Agency. SEE: vulnerable children and female staff – pregnancy.

Verrucae should be covered in swimming pools, gymnasiums and changing rooms.

Comments

If an outbreak / cluster occurs consult PUBLIC HEALTH AGENCY.

Preventable by vaccination. PUBLIC HEALTH AGENCY will organise any contact tracing necessary.

About 50% of children get the disease before they are five and many adults also acquire the disease without being aware of it.

Treatment is recommended only in cases where live lice have definitely been seen. Close contacts should be checked and treated if live lice are found. Regular detection (combing) should be carried out by parents

Comments

Good personal and environmental hygiene willminimise any possible danger of spread of hepatitis A. SEE: cleaning up body fluid spills andPPE information.

Hepatitis B and C are not infectious through casual contact. Good hygiene will minimise any possible danger of spread of both hepatitis B andC. SEE: cleaning up body fluid spills and PPE information.

8

HIV / AIDS

Meningococcalmeningitis* /septicaemia*

Meningitis*due to other bacteria

Meningitis viral*

MRSA

Mumps*

Threadworms

Tonsillitis

None.

Until recovered.

Until recovered.

None.

None.

Five days from onset of swollen glands.

None.

None.

HIV is not infectious through casual contact. There have been no recorded cases of spread within a school or nursery. Good hygiene will minimise any possible danger of spread of HIV. SEE: cleaning up body fluid spills and PPE information.

Meningitis C is preventable by vaccination. There is no reason to exclude siblings and other close contacts of a case. The PUBLIC HEALTH AGENCY will give advice on any action needed and identify contacts requiring antibiotics.

Hib meningitis and pneumococcal meningitis arepreventable by vaccination. There is no reason to exclude siblings and other close contacts of a case. Always contact the PUBLIC HEALTH AGENCY who will give advice on any action needed and identify contacts requiring antibiotics.

Milder illness. There is no reason to exclude siblings and other close contacts of a case. Contact tracing is not required.

Good hygiene, in particular hand washing and environmental cleaning, are important tominimise any danger of spread. If further information is required contact your Public Health Agency.

Preventable by vaccination. (MMR x 2 doses).

Treatment is recommended for the child and household contacts.

There are many causes, but most cases are due to viruses and do not need an antibiotic.

* denotes a notifiable disease. It is a statutory requirement that Doctors report a notifiable disease to theproper officer of the Local Authority i.e. the PUBLIC HEALTH AGENCY. In addition childcare providers may inform their localPUBLIC HEALTH AGENCY’s office. Childcare regulatory and Education bodies may also wish to be informed e.g. Trust EarlyYears Team’s.Outbreaks: if a school, nursery or childminder suspects an outbreak of infectious disease theyshould inform their Public Health Agency’s office. Advice can also be sought from the school health service.

9

Appendix 1Vulnerable Children**

Some medical conditions make children vulnerable to infections that would rarely beserious in most children, these may include: those being treated for leukaemia or othercancers, on high dose steroids and with conditions which seriously reduce immunity.Schools, nurseries and childminders are usually made aware of such children. They areparticularly vulnerable to some infections eg chickenpox and measles, and if exposed toeither of these the parent/carer should be informed immediately and further advice soughtfrom the GP and PUBLIC HEALTH AGENCY. Some of these children may require additional pneumococcaland influenza vaccinations.

N.B. Shingles is caused by the same virus as chickenpox, anyone who has not hadchickenpox is potentially vulnerable to the infection if they have close contact with a caseof shingles.Female Staff and pregnancy**

If a pregnant woman develops a rash or is in contact with someone with a potentiallyinfectious rash this should be investigated by a doctor. Pregnant women are at risk fromsuch infections from their own children at home as well as in the workplace.

• Chickenpox may affect the pregnancy if a woman has not already had chickenpox. Ifexposed early in pregnancy (first 20 weeks) or very late (the last 3 weeks), the GP andantenatal carers should be informed so that investigations and any treatment that maybe indicated can be initiated, e.g. a blood sample may be taken to check immunity.N.B. Shingles is caused by the same virus as chickenpox, anyone who has not hadchickenpox is potentially vulnerable to the infection if they have close contact with a caseof shingles.

• Rubella (German Measles) If a pregnant woman comes into contact with Germanmeasles she should inform her GP and antenatal carers immediately so thatinvestigations and treatment can be initiated. This infection may affect the developingbaby if a non-immune woman is exposed in early pregnancy.

• Slapped Cheek Syndrome (Parvovirus B19 / Fifth disease) can occasionally affectthe baby. If exposed on the first 20 weeks of pregnancy, inform GP and antenatalcarers immediately for investigation and management.

• Measles if a pregnant woman is exposed to measles she should immediately contacther GP and antenatal carers for investigation and treatment.Female staff should ensure they are immune to measles, mumps and rubella.

**Adapted from Guidance on Infection Control In Schools and other Childcare Settings. (2006) HealthProtection Agency.

10

Appendix 2: Sample letter for dealing with soiled clothing

Date

Dear Parent

Re: Policy for Washing Clothing

This letter will tell you of some changes in our practices.

After receiving advice from the Infection Control Department and Environmental HealthDepartment, we have decided that we can no longer wash or rinse clothing that has beensoiled in a toileting accident/following sickness.

Our new practice will be that that we will place the soiled clothes in a plastic bag and sealthe bag, which will be given to you when you collect your child.

We understand that receiving soiled clothes will not be pleasant. However we have toenforce this practice because when staff wash or rinse soiled clothing, it increases thechances your children, the staff and yourselves may be exposed to germs that causediseases.

This practice aims to protect the health of all our children and staff.

Many thanks for your understanding.

Yours faithfully

_____________________Mini Model Day Care Centre Manager

11

Appendix 3: Sample letter regarding exclusion of sick children

Date

Dear Parent

Your son/daughter ______________ was unwell at Mini Model Day Care.

When children are unwell or have vomiting and/or diarrhoea it is particularly important tokeep them off from nursery/playgroup/crèche/out of school when they have symptoms.Following advice from the Consultant in Communicable Disease Control, Public HealthDepartment we have decided that any child or staff member should remain off (48 hours from the last bout of vomiting and/or diarrhoea) to prevent the spread of the illness.

We know this can be difficult, everyone has obligations and many working parents feelthey cannot afford to stay off. However, it is unfair for parents to knowingly send a childwho has an infection to nursery/playgroup/ crèche/out of school putting other children atrisk. In addition, we have a legal responsibility to safeguard the health and well being ofall children.

We apologise for any inconvenience caused. We hope your son/daughter is feelingbetter soon.

Yours faithfully

________________________Mini Model Day Care Centre Manager

12

13

Appendix 4: Outbreak log sheet (Staff)

14

15

Appendix 5: Outbreak log sheet (Children)

16

17

6: Head LiceWHAT ARE HEAD LICE?They are grey/brown insects, about the size of a match head that live close to the scalp onhumans. Unhatched eggs are hard to spotbecause they are see-through.

WHAT ARE NITS?Nits are the egg cases left behind when the lice hatch out. They are usually pearly whiteand very difficult to remove from the hair because they are glued on.

HOW DO LICE SPREAD?When two heads are touching they can walk along the hair shafts from one head toanother. They don’t jump or fly and can’t get back onto a head from a hat or a comb. Ifthey get cold they can’t move very well.

BUT I’VE SEEN THEM JUMP ON THE COMBThis is probably due to static electricity making them ‘fly’ off the comb.

WHO CAN GET THEM?Anyone with hair. They aren’t fussy about clean or dirty hair. Children tend to get themmore than adults probably because they tend to get closer to each other in socialsituations than adults do.

WHERE DO YOU GET THEM?Anywhere. Parents often assume children get them at school, especially if they detectthem soon after a holiday but they are just as likely to have been caught outside of school.

HOW DO I KNOW IF MY CHILD HAS HEADLICE?The main symptom is itching but you can have head lice for up to six weeks before younotice any itching. The best way to find them early is to check your child’s hair regularly.

HOW DO I DO THAT?The best way is to do it after hair has been washed. When it is still wet put on someconditioner and comb it through with an ordinary comb. Then, using a detection comb (finetooth comb) slot the teeth into the hair at the roots and draw the comb down to the ends ofthe hair. Check the comb for lice every time you do this. Continue until you have checkedthe whole head paying particular attention to the back of the neck, behind the ears andunder the fringe.

HOW OFTEN SHOULD I DO THIS?It is a good idea to get into a routine and do it about once a week. This means you will beable to treat early if you find them which helps cut down on the number of people who willget head lice.

18

Appendix 6

WHAT DO I DO IF I FIND LICE?If you find live i.e. MOVING lice you should check everyone else in the family and treat allof those who have them. Also let people who have been in close contact with anyone withlice know so they can check as well.

WHAT IF I FIND NITS?If you find nits but don’t find lice, don’t treat. Nits will be left behind on the hairs after youhave treated but this doesn’t mean the treatment has failed.

WHAT DO I USE TO TREAT THE LICE?The best way to treat is with a lotion, crème rinse or mousse. These are available onprescription from your GP or over the counter at the pharmacist. Your GP or pharmacistwill advise you on which to use.

HOW DO I USE THE LOTION/CRÈME RINSE/MOUSSE?Treat everyone with lice at the same time so that untreated people don’t reinfect thetreated ones. There will be instructions on how to apply the preparation, and how longto leave it on for, in the box – each of the preparations is slightly different. The advice inthe box is often a bit vague about whether you should use the preparation again but itis advised that the same product is used again 7 days later. The reason for this is thatsometimes the treatment doesn’t kill the unhatched eggs. The eggs that aren’t killed willhatch out within 7 days. So it is a good idea to check everyone’s heads after 3-4 days andremove any lice by hand. Then, to be sure to get rid of them, use the treatment again 7days after the first application. Continue with your weekly checking routine after that.

WHAT IF I KEEP FINDING LICE?There could be 2 reasons for this. It could be because your child has been re-infectedwith lice. Check the whole family again and treat all those with lice again. Remember tospread the word to family and friends. Don’t use more than three treatments with the sameproduct in three weeks. If you still find lice after that ask your GP or pharmacist for advice.The other reason is that the lice were not killed. If you followed the instructions correctlythen this might be because the lice are resistant to the particular treatment you used. Askyour GP or pharmacist what you should use for the next treatment.

WHAT IF I STILL HAVE NITS?Nits (empty egg cases) on their own do not need to be treated. You can remove them byhand or fine tooth combing if you don’t like the look of them.

BUT MY CHILD IS STILL SCRATCHING.People can scratch after treatment but it doesn’t mean they still have lice. Check yourchild’s head to be sure but only treat if you find live lice. The treatments can make the

19

scalp flaky and itchy. Also some people scratch just thinking or talking about lice.

SHOULD I TREAT ‘JUST IN CASE’?No. The treatments are safe but they shouldn’t be over used. They can also make the itching worse.

WHAT IS BUG BUSTING?Bug Busting is a chemical-free method of treating headlice. It depends on checking hair four times,spaced over two weeks, and combing out lice and nits until they are gone. It is time-consuming and probably not as effective as chemical treatments but it can be useful for some families especially If children are reinfected soon after a chemical treatment. More information and Bug Busting kits (£6.45 incl. P&P) areobtainable from: Community Hygiene Concern, Manor Gardens Centre, 6-9, Manor Gardens, London N7 6LA or www.chc.org/bugbusting, or email bugbusters2k@yahoo.co.uk. They also run a helpline (0207-6864321). The kits are now available on prescription.

I’VE HEARD TEA TREE OIL IS GOOD FOR KILLING LICE.There is no evidence that it works and it can irritate your scalp. Nor is there evidence for vodka, electric combs, products sold to prevent reinfection or any other folk remedy.

SHOULDN’T SCHOOL NURSES CHECK CHILDREN’S HEADS?No. School nurses checking heads has not been shown to stop head lice spreading. They won’t be able to identify all children with head lice. It is much better for parents to check their children’s heads regularly (about once a week) as described in this leaflet. However, school nurses are available to give help and advice about head lice to parents.

WHAT ABOUT THE SCHOOL – CAN THEY DO ANYTHING?In the past, schools have sent out ‘alert’ letters but these tend to cause stress to children and parents and sometimes outbreaks of imaginary lice. It is much better to check your child’s head regularly.

SHOULD I KEEP MY CHILD OFF SCHOOL?NO! Lice are unpleasant and people sometimes feel embarrassed if they get them but they are not a health hazard. There is no reason for your child to miss out on their education just because of head lice. Keep alert and spread the word to stop the spread of lice.

Produced by: Department of Health, Social Services and Public Safety (DHSSPS), CastleBuildings, Stormont, Belfast BT4 3SJ, on behalf of the Health and Social Services Boards.email: health.protection@dhsspsni.gov.uk Telephone: (028) 90520083www.dhsspsni.gov.uk

20

February 2003

21

22

Appendix 8: List of Contacts

Public Health AgencyOrmeau Avenue Unit 18 Ormeau AvenueBelfastBT2 8HS02890 311611www.publichealth.hscni.net

Belfast City Council

Cecil Ward Building

4-10 Linenhall Street

Belfast

BT2 8BP

02890 770428

envhealth@belfastcity.gov.uk

Health and Safety Executive (NI)83 Ladas Drive

Belfast

BT6 9FR

02890 243249

hseni@detini.gov.uk23

Appendix 9: Training record sheet

GUIDANCE READ BY:Signature of Staff Member

Printed Name Date Read

24

BibliographyGuidance on Infection Control In Schools and other Childcare Settings. (2006)Health Protection Agency.Guidelines for the control of Infection and Communicable Diseases in nurseries andother Institutional early years Settings in South West London Sector. (2003) SouthWest London Health Protection UnitHealthcare Associated Infections. A guide for healthcare professionals (2006)British Medical AssocaitionKeep it Clean and healthy. Infection Control guidance for Nurseries, Playgroups andother Childcare Settings. (2002)Reckitt Benckiser, Infection Control Nurses Association ICNA, Community Practitioners &Health Visitors Association, Lambeth NHS PCT, Lewisham NHS PCT and Southwark NHSPCT.Mind the Germs. Infection Control Guidance for Nurseries, playgroups and otherChildcare settings.(2006)National Public Health Service for Wales, Community Practitioners & Health VisitorsAssociation, Infection Control Nurses Association.Head Lice – Your Questions Answered (February 2003) ref 161/2002Department of Health, Social Services and Public Safety (DHSSPS), Castle Buildings,Stormont, Belfast, BT4 3SJ.

25