Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: 1. During observation of nappy changing, the inspector observed that one staff member did not sanitise the changing mat after changing two children’s nappies. This practice poses a risk of the spread of infection and is at variance with the services nappy changing procedure which was on display in the changing area. 2. A staff member was observed to lift the lid of the pedal bin with their hand to dispose of waste, contrary to hygiene and infection control protocols requiring use of the foot pedal. Action submitted by the Registered Provider
Provider's corrective action:
Infection Control: All staff members in the Wobbler room have completed infection control training with an external training company and will renew the training on an annual basis
(d) International police vetting was not available for 3 adults who required it
Provider's corrective action:
The registered provider provided the following response: Corrective and Preventive Action Each staff member has now provided the central registry of criminal records form. The service are now just waiting on the translations. The service will add the need for this document to all Job descriptions going forward
Regulation 15 — Record of pre-school child
The 12 records reviewed did not contain the required information outlined under Regulation 15(1) (b) and (c). One of the reviewed did not contain the information required under point (g)
Provider's corrective action:
The registered provider provided the following response: Corrective and Preventive Action The service has added start date and end dates to the child record forms. The service is having a full review of the forms currently on file to ensure all details are up to date. New forms are now in place
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. Some doors within the service within and adjacent to the Butterfly room were not secured, and posed the risk of children accessing areas of the service unsupervised posing a risk of harm or injury as follows: - Older children were observed accessing the sanitary area in the hallway alone. The door from the external courtyard into the service was opened and unlocked posing the risk of a child exiting unsupervised. - A door in the Butterfly room leading to a small external garden used for planting was unlocked and accessible to the children. Unused equipment and materials were stacked at a height in the area including ladders, sandpits, shovels, tables, and a hose pipe which were all accessible to the children. - An unlocked door in the Butterfly room which lead to two internal storage rooms and an external courtyard was accessible to the children. Hazardous materials equipment and substances were in reach of children including a kettle, bleach, cleaning products, cables, and large waste bins. 2. The meat served to the children for the main meal was served in slices. Some younger children were observed gagging and struggling to break pieces of the meat off to chew posing a potential choking hazard to a child. 3. A piece of artificial grass in the outdoor play area was missing creating a foothold in the surface posing a potential trip hazard to a child. Infection Control: 4. Some staff members were observed sanitising their hands following nappy changing as opposed to handwashing which is at variance with the nappy changing policy in place in the service and poses the risk of cross contamination. 5. Play equipment and materials were observed being stored in the Wobbler nappy changing room posing the risk of cross contamination. 6. In the Wobbler room, the covering on a ball pool and a children’s sofa was torn exposing internal foam and could not be effectively cleaned. 7. Sticky tape which had been placed around the sink in the children’s play kitchen was coming away and contained heavy accumulations of dirt and debris which could not be effectively cleaned. 8. One of the cot mattresses in use during the inspection had no waterproof covering posing the risk of cross contamination. Administration of Medication: 9. Sample of medication administration records were review during the inspection which did not contain the necessary details to ensure medication is administered safely to a child as follows: - There was no evidence to show that a second staff member was present to witness medication being administered to a child on some records. - There was no evidence recorded that pre-consent from children’s parent/guardian had been obtained prior to medication being administered, and no evidence to show that some parents had been informed that their child had received medication in the service. 10. A child attending the Senior Monties room on the day of inspection required an auto adrenaline injector in the case of an emergency for a severe allergy. Three staff members working in the care room during the inspection were unaware of where the child’s medication and the associated care plan was located in the care room. Staff were unable to detail when the medication should be administered to the child and outlined they had not read the child’s care plan during discussions with the inspector posing a risk of harm to the child in the case of an emergency. This was found non-compliant on the last inspection of the service. The corrective and preventive actions submitted by the provider did not prevent the re-occurrence of the non-compliance. Action submitted by the Registered Provider The registered provider provided the following response:
Provider's corrective action:
General Safety: 1. The hall area is monitored by a camera. The office is manned. The garden area they have access to is suitable for the age group and the there is a large gate with a dig lock so children cannot exit the premises. The small external garden area has been cleared and is out of use until the service can get the store area properly secure. A digit lock has been fitted between the butterfly room and the two storerooms. 2. Meat will now be cut by the cook in the kitchen before arriving to the room. 3. There are works to be completed on the drains in the garden over the next few months, until then the service will cover this with a suitable outdoor mat and add this to the garden. Staff will attend a facilitating safe snack and mealtimes course. Surface checks have been added to the garden checklist. Infection Control: 4. Nappy changing policy and hand washing policy have been reviewed with the team. 5. Room cleared of all non-essentials. 6. Ball Pool and children’s sofa replaced. 7. Kitchen replaced. 8. Cot mattress replaced with waterproof mattress. All mattresses are now waterproof. Administration of Medication: 9. The service has fully transitioned to using an online application for medicine administration. This means parents must complete the form before the service can accept any medication for their child. The parents will receive this form in real time as medication is given and can complete their parts as necessary. 10. The service has booked anaphylaxis and auto adrenaline injector training for the team. The service have also added an additional step to the care room checklist to ensure everyone in the room is aware of the care plans in the room