Health and safety in an early years setting. Laws and first aid

(k2h23) 9 a.

• safety gate : open doorways and stairs – to avoid any child falling downstairs or going in to a room where you cant supervise them
• socket covers : in all visible plug sockets – to avoid any electric shock from a child putting fingers in socket
• window catches : if the windows were accessible to children – to avoid any falling from windows
• cupboard catches : on all cupboards accessible to children. – to avoid children getting materials they should not have
• Cooker guard : when cooking is being done. – to avoid any scalds or burns from a child reaching onto the cooker
• Safety harness : outdoor use, pushchairs and highchairs. – to avoid any falling out of highchairs or pushchairs, also a harness when outdoor walking to avoid a missing child or accidents in the road.

Animals can leave faeces, this should be cleaned and disinfected around the area. They also carry infections and fleas and these must be treated before allowing a child to come into contact with an animal.

Plants can be poiseness and others such as nettles can sting and scratch, regular checks should be made in the area.

Sand pits should be checked to see if they are contaminated and if so this should be removed from the area and replaced with new sand.

Outdoor spaces should be fenced off , to avoid children wandering off, also avoiding strangers and animals to access the area  The fences and gates should be checked upon entering and leaving the premises. Dustbins should be out of the reach of children, especially in the summer time where they attract wasps and flies.

(k2h24) 10 a

To avoid cross contamination must always wash hands after using the toilet ,changing nappies, handling animals and before handling food. To dispose of any waste, ie dirty nappies correctly they must be placed in a bag and then incinerated or placed in a refuse bin,bodly fluids would need to be cleaned up using a iodine cleaner .Never use food or drink that has a risk of being contaminated. Always wear gloves whilst changing nappies and carrying out first aid ,keep cuts and grazes covered, to minimise the risk of such infections like aids ,hiv and hepititis.

(k2p25) 11 a

 

It is important to follow the adult child ratios as this is one of the standards that cover the safety of children in England and Wales.

b.

• 0-2 one adult to 3 children.
• 2-3 one adult to 4 children
• 3-5 one adult to 8 children.
• 5-7 one adult to 8 children.

(k2h26) 12 a

I would supervise children by ensuring I could see all the children. I would keep moving around the setting so that I could see all activity .I would ensure that all the equipment was being used correctly.  I would also check that the children were not getting over excited, and also  if a child was tired I would encourage them to rest .I would also make myself aware of the risks of injury to the children according to there age needs and abilities.

b.

Any activity a child does has some risk attached, even something as simple as painting. If the activity is well planned and organised with thought given to possible dangers the risk of accidents or injuries should be minimal.

The secret is to balance the risk of activity against the benefit to the safety of the child. This is known as risk assessment.

FIRST AID FOR INFANTS AND CHILDREN

(k2h27) 13

             

FIRT AID : accidents and emergencies.

An emergency is whenever someone is injured or has taken ill or is in danger First aid is the help that will be given to the injured or ill.

The first aid kit can be located within the supervisors office.

The contents of the first aid kit include :

• Eye bandages
• Medium sterile dressings
• Sterile eye pads
• Triangular bandages (sling)
• Wound dressings
• A range of plasters in different sizes
• Crepe bandage
• Large sterile dressing
• Cotton wool
• Non alcoholic cleansing wipes
• Tape
• Disposable gloves
• Tweezers
• Safety pins
• Scissors.

The appointed first aider is Mrs Rogers.

Basic first aid: assessing the situation:

Keep calm   1 .assessing the casualty

• DANGER    are you or the casualty in danger ?
• RESPONSE    is the casualty conscious?
• AIRWAY   is the airway open?
• BREATHING   is the casualty breathing? If not get someone to dial 999.
• Act on your findings and call for help.

CASUALTY CONSCIOUS, BREATHING PRESENT:

•  treat any injuries , call for help if needed.

CASUALTY UNCONSCIOUS, BREATHING PRESENT:

• Treat for any life threatening injuries, place in the recovery position, call for help

   

                     RECOVERY POSITION

• Turn the casualty onto his/her side
• Lift the chin forward and adjust the hand under the cheek as necessary.
• Check the casualty cannot move forward or backwards.
• Check the casualties breathing  and pulse continuously
• Note if you suspect back or neck injury place your hands either side of face, gently lift jaw to open airway ,taking care not to tilt the casualties neck. If the casualty is a baby, less than a year old then with the baby in your arms ,make sure head is tilted downwards to prevent choking. Take the baby with you at all times.

RECOVERY POSITION FOR A CHILD

• With the child on their back place legs straight

• Take the arm nearest to you and place it at right angles to the childs body,elbow bent, palm uppermost

• Bring their other arm across the chest place the back of their hand alongside the childs opposite cheek

• Keeping hold of the hand take hold of the leg furthest away from you by the knee, lift and bend it so that the foot is flat on the floor

• Move your hand to the thigh and pull the leg toward you

• Remove your hand from holding their hand tilting their head to open the airway

• Re check breathing

Take hold of the childs uppermost leg and bring knee upwards and form

a right angle with the hip this prevents the child rolling onto their front

• Monitor breathing and pulse

• Check pulse in lower arm to check circulation not impaired

UNCONSCIOUS INFANT

• Open infants aiways

• Check for breathing and circulation, check for bleeding and injuries

• Hold the infant in the recovery position

RECOVERY POSITION FOR INFANT

• Cradle the infant in your arms with the head titled down,this position prevents the infant from inhaling vomit and choking on their tongue

• Monitor breathing, pulse and levels of response until medical aid arrives

CASUALTY UNCONSCIOUS AND NOT BREATHING.

• Open airway and call for help.

                   OPENING THE AIRWAY

• Open the airway by tilting the head ,remove any obvious obstruction.
• Look and listen and feel for breathing.
• Keep the chin held up and place in the recovery position.
• Call for help.

BLEEDING.

Bleeding from wounds should be controlled as follows.

• Elevate the wound.
• Press on the wound
• Apply a dressing
• If there is a foreign body in the wound leave it and press around the wound to stop the bleeding. Do not try and remove ,as it may make the wound worse.
• Treat the casualty for shock ,reassure the casualty and keep him or her warm .lay them down, lower the head ,raise the head and loosen tight clothing.

WHEN A CHILD IS BLEEDING

• Reassure the child and encourage the child to relax.
• Do not move the child unnecessarily
• Do not give food or drink
• Retain normal body heat by giving a blanket or coat.
• If serious or doubt ring an ambulance

PROCEDURE FOR  TREATING A CHILD WHO IS CHOKING

• Encourage them to cough ,this is a natural reaction where there is an obstruction to the airway
• Do not perform blind finger sweeps at the mouth as this may further impact the foreign body or damage soft tissue of the mouth and airway
• Ask the child to cough
• Perform up to 5 back slaps – position child face down over your knees with their head lower than chest –   up to 5 back slaps to the middle of back in between shoulder blades. If this fails proceed with chest thrusts.

CHEST THRUSTS

• Position the child in face up position
• Perform uo to 5 chest thrusts at a rate of 20 per minute – this procedure is similar to chest compressions only more vigorously
• Re check mouth after 5 back slaps and 5 chest thrusts, remove any foreign body. Open airway –reassess breathing
• If breathing place in the recovery position.
• If not breathing  - commence resuscitation. – perform 5 ventalations ,each of which makes the chest rise and fall ,if the airway is still obstructed repeat the sequence as follows

FOR A CHILD BETWEEN ONE AND EIGHT

• Repeat the procedure as above but substitute 5 chest thrusts with 5 abdominal thrusts every alternate cycle.

• Procedure for performing abdominal thrusts – if conscious –

• Stand behind child place arm around upper part of childs abdomen just under the rib cage and clench fist

• Pull sharply inwards and upwards with the aim of producing sudden expulsion of air, together with the foreign body, from the airway

• Repeat up to 5 times if necessary

• REMEMBER TO ALTERNATE CYCLES OF 5 BACK SLAPS, 5 CHEST THRUSTS AND 5 BACK SLAPS AND 5 ABDOMINAL THRUSTS

• Repeat cycles until – airway is cleared or child breathes spontaneously

PROCEDURE FOR TREATING AN INFANT WHO IS CHOKING

• Perform up to 5 back slaps

• Position the infant over your arm face down, legs either side of your elbow with the head low

• Give up to 5 back slaps between the shoulder blades

• If the obstruction is not cleared turn the infant uppermost keeping their head low

• Use two fingers on the chest turn the infant uppermost keeping their head low

• Use two fingers on the chest mid nipple line and press up to five times at the rate of one every 3 seconds

• If object is still not cleared call 999 and send for medical aid. Continue with treatment until the ambulance personnel take over.

• DO NOT USE ABDOMINAL THRUSTS ON AN INFANT AS THEY MAY CAUSE IRREVERSIBLE DAMAGE TO THEIR ABDOMINAL CONTENTS. PERFOM BACK SLAPS AND CHEST THRUST ONLY.

• Repeat sequence of 5 back slaps and 5 chest thrusts until airway is cleared or infant breathes spontaneously.

ASTHMA – RECOGNISING AN ATTACK

• CHILD HAS DIFFICULTY BREATHING, ESPECIALLY OUT

• WHEEZING

• DIFFICULTY IN SPEAKING

• POSSIBLE COUGHING WHEN BREATHING OUT

• BLUENESS AROUND MOUTH, NOSE AND EARLOBES

• DISTRESS AND ANXIETY

• SHORT, BARKING COUGH

• A WHISTLING TYPE NOISE WHEN BREATHING IN

RECOGNISING CROUP

• DIFFICULT, DISTRESSED BREATHING

HEAD INJURIES

CONCUSSION

• THE CHILD MAY BECOME UNCONSCIOUS FOR A SHORT TIME

• ON RECOVERY LEVELS OF RESPONSE COULD IMPROVE IF NO COMPLICATIONS ARE PRESENT

• TEMPORARY LOSS OF SHORT TERM MEMORY

• PALE ,COLD AND CLAMMY SKIN

• MAY SUFFER FROM A GENERAL HEADACHE

SHOCK

• PALE SKIN, COLD TO TOUCH

• SWEATING

• RAPID PULSE

• SHALLOW AND RAPID BREATHING

• NAUSEA AND POSSIBLE VOMITING

• RESTLESSNESS AND AGITATED

• DIZZY AND UNCONSCIOUSNESS

ANAPHYLATIC SHOCK

• RASH

• RED BLOTCHES

• SWELLING

• EYES WATERY AND PUFFY

• ITCHY

• THROAT AND NOSE BECOME ITCHY

• SNEEZING

• SERVERE ALLERGIC REACTION

• RASH

• RED BLOTCHES

• SWELLING OF THE SKIN

• SKIN HARD AND HOT TO TOUCH

• VOMITING

• SWELLING OF EYES AND LIPS AND TONGUE

• BREATHING DIFFICULT

• DIZZINESS

• DIARRHOEA

CONVULSIONS

• VIOLENT MUSCLES TWITCHING, CLEANCHED FISTS ARCHED BACK

• FEVER

• TWITCHING OF THE FACE

• DROOLING OF THE MOUTH

• LOSS OF IMPAIRED CONSCIOUSNESS

PROCEDURES AFTER AN ACCIDENT OR EMERGENCY.

The child should have a record card with emergency contact numbers of parents , grandparents, or other relatives .They should be people who are easily contacted, and who in turn can contact parents if necessary. The person in charge must get in touch with the emergency contact as soon as possible and tell that person about the incident, and where the child is being taken to, if the child has to go to hospital before the parents arrive someone the child knows well should go to the hospital with them. Even a minor accident should be entered in the accident book .The accident may need to be reported to the health and safety executive. A full report is needed. In any incident the person in charge should look at what happened to see what could be done to prevent a similar incident happening again.

In an accident report you will need to include some information.

It should have the childs name, the date and time of accident or incident .where the accident occurred, nature of injury, treatment given. A signature of person attending to child ,a witness if possible, and this must be shown to parents or carers the same day so they can sign it.

 

(K2h28) 14 a.

You will encounter children with different dietary needs and it is important that you understand what can affect a childs dietary requirments. The following can affect a childs diet.

Medical conditions such as diabetes means that the pancreas cannot regulate the bodys sugar levels. Coeliac disease is another medical condition which means children cannot absorb their food normally. Some children children go into anaphylactic shock if they eat certain foods.

b.

There are many types of allergic reactions these include blotchy red skin, swelling of the face and neck, breathing problems.

c.

There are many foods that can give an allergic reaction. These include lactose which is found in milk, histamine which is found in strawberries and ripe tomatoes, tartazine which is found in yellow food colouring ,some drinks and sweets also contain it, nuts which could be in many foods.

(k2h29) 15 a.

In the workplace parents are asked to keep their children at home if they have any infection so that the nursery can alert other parents, and make careful observations of any child who seems unwell. Parents are asked not to bring a child who has been vomiting or had diarrhoea until at least 24 hours has elapsed since the last attack .If the children of nursery staff are unwell, the children will not accompany their parents or carers to work in the nursery. Cuts or open sores whether adults or children, will be covered with a sterile dressing. If a child is on prescribed medication the following procedures must be followed.

If possible, the childs  parents will administer medicine ,if not, then medication must be clearly labelled with childs name ,dosage and any instructions.

Where local regulations require it guidance will be sought from ofsted before people other than parents agree to administer medicines.

Written information will be obtained from the parent, giving clear instructions about the dosage ,administration of the medication and permission for a member of staff to follow the instructions .

All medicines will be kept in a lockable cupboard.

A medication book will be available to log in  :

•  name of child receiving medication :times that the medication should be administered
• date and time when medication is administered together with a signature of the person who has administered each dose.

The nursery will ensure that the first aid equipment is kept clean , replenished and replaced as necessary. Sterile items will be kept sealed in their packaging until needed.

b.

A  member of staff would be able to recognise an unwell child by their behaviour and appearance.

(k2h30) 16 a

• Flood
• Fire
• lost child
• Accidents
• Gas leak
• bomb

 b.

LOST CHILD PROCEDURE

• keyworker would immediately inform supervisor
• the supervisor would check the register to see if the child had been collected
• All staff would be advised to check all nursery premises immediately, ensuring that all exits were thoroughly checked.
• The surrounding areas would also be thoroughly checked
• The nursery manager, supervisor would calmly inform the childs parents, if necessary arrange for the parent to be collected if transport was a problem
• The nursery manager, supervisor would then have to contact the police, giving a detailed account of the incident

• The nursery manager, supervisor would then discipline staff and investigate the incident ensuring that a risk assessment was carried out immediately to prevent a re occurrence.

FIRE PROCEDURE

• Person finding the fire to shout ‘fire fire’

• Groups in the messy room are to leave the building as quickly as possible using the nearest fire exit, indicated by the sign

• Groups in all the main rooms will leave the building as quickly as possible using the nearest exit

• Caterpillars and butterfly rooms congregate at area in front of caterpillars entrance. busy bees and gloworms, congregate at the area in front of busy bees entrance. Busybee staff to assist in evacuating gloworms

• Supervisor checks that the building is cleared

• Duty register staff collect registers and proceed to venue point

• All staff will do a head count for each group

• Supervisor will check register

SECURITY PROCEDURE

 

• All children are supervised by adults at all times and will always be in sight of an adult.
• All adults are aware of the system in operation for childrens arrivals and departures and an adult will be at the door during these times.
• Children will leave the group only with authorised adults.
• Safety checks are made outdoors ,indoors everyday.
• Outdoor space is securely fenced
• A register of both adults and children is completed as people arrive so that a complete record of all those present is available in an emergency
• Whenever children are on the premises at least two adults are present
• Children who are sleeping are checked regularly
• Internal safety gates are used as necessary
• The premises are checked before locking up at the end of the da

(k2s31) 17 a.

Physical, emotional ,sexual, neglect ,bullying ,harassment, absence of care, absence of supervision.

PHYSICAL ABUSE

 

• unexplained  ,recurrent injuries or burns.
• Wearing clothes to cover injuries
• Refusal to undress for games
• Bald patches of hair
• Repeated running away
• Fear of medical examination
• Aggression towards others
• Fear of physical contact, shrinking back if approached

                 

                   EMOTIONAL ABUSE

• Delayed development
• Sudden speech problems, stammering etc.
• Low self esteem( im stupid ,ugly worthless)
• Fear of any new situation
• Neurotic behaviour(rocking ,twisting hair, self mutilation)
• Extremes of withdrawal or aggression

                   NEGLECT    

• Constant hunger
• Poor personal hygiene
• Constant tiredness
• Poor state of clothing
• Unusual thinness
• Untreated medical problems
• No social relationships
• Stealing food
• Destructive tendencies

                   SEXUAL ABUSE

• Sexual knowledge or behaviour that is inappropriate to the childs age
• Medical problems such as chronic itching, pain in the genitals, venereal diseases
• Depression, self mutilation ,suicide attempts, running away, overdoses, anorexia
• Personality changes such as becoming insecure or clinging
• Regressing to younger behaviour patterns such as thumb sucking or bringing out discarded cuddly toys
• Sudden loss of appetite or compulsive eating
• Being isolated or withdrawn
• Inability to concentrate
• Lack of trust or fear of someone they know ell such as not wanting to be alone with a babysitter, childminder
• Starting to wet or soil again day or night
• Worried about clothing being removed
• Suddenly drawing sexually explicit pictures
• Trying to be the ultra good, or perfect , over reacting to criticism

                   

                   BULLYING AND HARRASMENT

• Emotional (not speaking, excluding, tormenting ,ridicule ,humiliation
• Physical bullying including pushing ,kicking, hitting ,pinching and other forms of violence
• Verbal bullying including name calling ,sarcasm, spreading rumours ,persistent teasing
• Racist bullying ,racial taunts, writing graffiti and gestures
• Sexual bullying involving unwanted physical contact or abusive comments
• Homophobic bullying including hostile or offensive action against lesbians ,gay males or bisexuals, or those thought to be
• Depression ,low self esteem ,shyness, poor academic acheivment   isolation ,threatened or attempted suicide ,running away

                    ABSENCE OF SUPERVISION

• Children allowed to stay at home without adult supervision under the age of 10
• Children allowed out overnight without the parents knowing there whereabouts under the age of 14

                    ABSENSE OF CARE

• Hunger
• Dirty clothes
• Not having medical care when needed
• Unclean home
• No dental check ups

(k2s32) 18

If a child has grown up with a parent, carer or adult who are substance abusers a child would be very vunerable to abuse. A child could possibly have rejection , physically abused,bullied and possible neglect. This could have a long term effect on the child and possibly the child could turn to alcohol, drugs or even suicide.

(k2s33) 19

A safe working practice would be to exclude known abusers , and all staff would need to have a thourough police check before starting any kind of employment with children.

(k2s34) 20.

• Teach children how to keep themselves safe
• Encourage them to share worries about abuse with their friends and a trusted adult
• Make sure they know that being abused is never there fault and that abuse is never right
• Promote services such as CHILDLINE or the NSCPP child protection helpline to older children.

(k2s35)21

  It is important that children know the simple rules and boundaries for their behaviour. Studies show that children can be very confused by adult rules and often do not understand what they have done wrong .If they are punished they will be angry and upset and will not know how to behave next time in the next situation. All children need a routine that applies to meals, bedtimes and playtimes. but the routine needs to be responsive to special events .These rules need to be simple to understand, and more importantly all adults need to know them and keep them. think how you could turn negative commands into positive guidelines for positive behaviour? Think about children in your setting .who do you think of when asked who the naughty ones are? who is known as the clumsy child, or the class joker or the clever one, or the helpful one? It is very easy to stereotype people – put them into boxes according to how we expect them to behave .if you are naughty and the only way to get attention is when you are naughty ,what will you do ? it doesn’t take much imagination to come up with the answer .what were you stereotyped as at school?

(k2d36) 22  

• All adults in the nursery will ensure that the rules are applied consistently, so that children have the security of knowing what to expect and can build up useful habits of behaviour.
• All adults will try to provide a positive model for the children with regard to friendliness ,care and courtesy
• Adults in the nursery will praise and endorse desirable behaviour such as kindness willingness to share
• We will take positive steps to avoid a situation in which children receive adult attention only in return for undesirable behaviour.

When children behave in unacceptable ways:

• Physical punishment, such as smacking and or shaking will be neither used nor threatened
• Children will never be sent out of the room by themselves
• Techniques intended to single out and humiliate individual children such as the naughty chair will not be used.
• Children who misbehave will be given adult support in seeing what was wrong and working towards a better pattern .this support will be provided by the childs  keyworker.
• Where appropriate this might be achieved by a period of time out with an adult
• In cases of serious misbehaviour ,such as racial or other abuse, the unacceptability of the behaviour and attitudes will be made clear immediately ,but by means of explanations rather than personal blame.
• In any case of misbehaviour ,it will always be made clear to the child or children in question that it is the behaviour and not the child that is unwelcome
• Adults will not shout ,or raise their voices in a threatening way
• Adults in the nursery will make themselves aware of, and respect, a range of cultural expectations regarding interactions between people
• Any behaviour problems will be handled in a developmental appropriate fashion, respecting individual childrens level of understanding and maturity
• Reaccuring problems will be tackled by the whole nursery, in partnership with the childs parents, using objective observation records to establish an understanding of the case
• Adults will be aware that some kinds of behaviour may arise from a childs special needs.

(k2h38) 23  

It is important to reward positive behaviour as this will encourage children to behave positively. this means praising  and encouraging the behaviour that you want ,and giving children attention when they are behaving well. it is far preferable to be told you are doing well and someone is proud of you, than to be told off and told you are useless.

24. (k2s1118)

Legislation ,guidelines and policys which form the basis for action to safe guarding children are : the children act, health and safety act, national standard act –under 8 –daycare and childminding, childrens rights act.

Dawn Rogers

4th September 2006