Policy statement: When children are not well, they need to be cared for at home by their primary carers. They need time to recover and feel better. At nursery they risk becoming more sick, and are more vulnerable to other infections, viruses or diseases that may be carried by others. If children have been prescribed medication, they must be home from nursery for a minimum of 24 hours after they have begun taking medication, and longer if required (see the Exclusion policy). Having sick children in the nursery also increases the risk of an outbreak in the nursery and puts other children and staff at risk. For these reasons, the following procedures have been put into place to help safeguard sick children and the other children and staff. Children should usually be well for a period of two days, before returning to nursery.

When a child comes to nursery and a staff member suspects they are unwell:

1. Nursery staff will discuss their concerns with the parent/carer immediately
2. If the parent/carers discloses that the child has been unwell, staff should check the exclusion policy to see how long the child should be excluded from the provision, and advise them accordingly
3. If the parent/carer insists that the child is well, a staff member can take the child’s temperature before admitting them to the nursery
4. If the temperature is normal (37oC) the child can be admitted to the nursery, but staff should maintain a high level of supervision, and keep a record of any concerns, if the child becomes sick in anyway, then the child must be sent home
5. Where staff have any concerns in admitting a child, they can refer to the manager, the deputy or the senior practitioner

Signs or indicators that a child may be unwell

Having a high temperature (fever), is one indication that a child is unwell, but not the only indicator. Children may also display one or more of the following, in addition to or instead of having a temperature:

• pain
• ache
• nauseous feeling
• vomiting and/or diarrhoea
• upset stomach (but not diarrhoea)
• tired / drowsy
• not alert / distracted
• upset, unusually emotional
• dizzy
• restless
• coughing
• rash
• discharge from eye, nose, ear or other orifice
• Unusually clingy or reluctant to join in
• Blood present (in urine or faeces, or nose, ear or mouth or on other body parts)
• Goose bumps and/or shivering
• Feeling unusually hot or cold
• Unusually thirsty or refusing food/drink

When a child becomes ill at the nursery

1. Nursery staff will provide comfort and reassurance to the child in a separate room or space away from other children, in order to contain any illness
2. Make immediate contact with the parent/carer and where contact cannot be made the emergency contact will be contacted
3. Parents/carers are expected to arrive within a maximum of 60 minutes to pick up sick children and take them home or to the doctor
4. An incident record should be completed by the staff member who dealt with the situation, by recording all relevant information in the confidential daily dairy in the classroom
5. The incident should be reported to the manager
6. The parent/carer should be advised of the exclusion period once the illness is confirmed
7. In the interest of infection control, the area or room where the child was comforted, whilst waiting to be picked up, should be subject to a deep clean

Children’s normal temperature range is between 36.1 and 37.2. If children are above 37.4 they have ‘fever’. A fever over 38 would usually suggest an infection.

Leaflet on Fever in Children

NHS (UK) Information on Fever in Children

Children with a high temperature 

Children who experience a raised temperature (eg – over 37.4) must be excluded from nursery for a minimum of 48 hours AFTER the temperature has returned to normal. This may mean your child stays off of nursery after they appear ‘well enough’ to attend.

COVID

COVID is still very much a ‘thing’! Rainbow ask every parent to carry out a COVID test on your child, if COVID symptoms present. If you receive a positive result on a COVID test, although there is no legal there is no obligation to isolate, Rainbow require children to stay off nursery for 5 days, in line with Ministry of Health Guidelines.

In addition to a minimum of 5 days exclusion, the child must also be no longer presenting any symptoms. It should be remembered that this is a contagious disease, so if you are a confirmed case it is important to behave responsibly.

Clarification on exclusion periods

Whilst the exclusion periods are usually expressed as hours (eg – 24 hours, 48 hours etc)… to clarify children cannot return to nursery part-way through a nursery day. If for example their exclusion period expires at 12 lunchtime, they may not attend nursery for they afternoon, they need to wait until the next nursery day to attend.