2(a),(b) One written and verified reference from a past employer, or in its absence, from a reputable source was unavailable for one staff member recently employed
Provider's corrective action:
These references were present on the day and were all located in one poly pocket. We acknowledge that going forward documents will be more visible for inspection purposes
Regulation 20 — Facilities for rest and play
1. There was no rest area available for the children in room 224
Provider's corrective action:
New soft seating was purchased to create rest area and daily checks to ensure all relevant equipment in rooms
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. It was observed there were no window restrictors on two open velux windows in room 224. A child had the potential to gain access to the windows and therefore this posed a potential risk of harm. The inspector took immediate corrective action and closed both windows and brought it to the attention of staff in the room and to the management team at the feedback meeting at the conclusion of the inspection. 2. The toilet seat in the designated ‘boys’ cubicle in the sanitary area between rooms 204 and 208 had become detached from the toilet and was observed on the floor; this posed a potential injury risk due to the lack of stability for a child if/when using the toilet. 3. Daily risk assessments were not completed for each room environment in order to identify and manage risks that may arise; this was contrary to the manager’s morning check list that stated, ‘staff are equipped with daily risk assessments in each room’. 4. The floor covering on two steps of the stairs leading to room 224 was missing the floor seal thus exposing the edges; this was a potential trip hazard. 5. A tube of nappy cream and was observed on the sink unit and a box with nappy creams was observed stored on a low level shelf under the nappy change unit in the sanitary area on the main corridor; these were accessible to a child. Infection Control: 6. The following infection control risks were observed in the sanitary area between rooms 204 and 208: • There was no hot water dispensed from the mixer tap in the disabled access toilet to facilitate hygienic hand washing. • The rolls of toilet paper were observed placed on top of the radiators in the designated ‘boys’ and ‘girls’ cubicles and not in the wall mounted dispensers; this was inadequate for infection control purposes. • Two insert toilet seats and the main toilet seat were observed on the floor of the ‘designated ‘boys’ cubicle. 7. The nappy changing pr ocedure observed for six nappy changes were not carried out to mitigate against the potential risk of cross infection as observed by the following: • Handwashing was not completed by the staff member before commencing the nappy change procedure on two occasions. • Two staff members did not wash their hands after completing nappy changing on two occasions. • A child’s hands were not washed prior to being brought back to the care room following nappy changing. • A staff member did not remove the apron and gloves until the end of the nappy changing procedure. This contaminated the clean nappy and child’s clothing and created a risk of cross infection. • A staff member did not secure the single use disposable apron which was not adequate to protect clothing for infection control purposes. • A staff member was observed not to use the foot pedal mechanism to open the lidded nappy bin and instead handled the lid to open it. • A staff member used the foot pedal mechanism to open the lidded nappy bin however pushed down the contents into the bin with their hand. 8. The plastic aprons worn for nappy changing procedures were spilling out from the storage shelf and trailing on the floor in the nappy change area on the main corridor and posed a risk of cross infection. 9. Wall mounted dispensers were not in place for the hygienic dispensing of the rolls of blue paper towels which were observed lying on work surfaces in the nappy change are as beside room 221 and the sanitary area along the main corridor. 10. The foot pedal operated bin in the nappy change area beside room 211 was observed to be placed against the container with the single use disposable aprons used by the staff for nappy changing procedures and posed a risk of cross infection due to its close proximity. 11. There was no documentary evidence available that the sterilising solution used for the immediate sterilisation of mouthing toys and soothers was appropriate. The information on the back of the container referred to its use for floors, walls, cutlery and crockery. 12. The sterilising container was not used correctly as the weighted grid was not placed on top of the items being sterilised. The items were not fully submerged in the sterilising fluid and therefore not sterilised. This was a non-compliance on inspection carried out 11/04/2022. 13. Staff stated that i tems removed from the sterilising solution were washed under running water; this practice compromised the infection control method of sterilisation being used. Safe Sleep: 14. Two cot mattresses, in cots located in the sleep room on the main corridor, did not have a recognised safety label in place. 15. The environmental temperatures in sleep room 222 used for children aged 1-2 years and the sleep room on the main corridor used to facilitate sleep during the day , were not maintained between the required temperature of 16⁰-20⁰ Celsius and 18⁰- 22⁰Celsius (sleep room 222) for safe sleep purposes and to reduce the risk of sudden infant death as observed by the following: • The temperature in sleep room 222 was recorded at 24.7⁰ Celsius at 13:40hours and 22.5⁰ Celsius at 14:00 hours. • The temperature in the sleep room on the main corridor was recorded at 24.5⁰ Celsius at 13:21 hours and 22⁰ Celsius at 13:55 hours. It is acknowledged that immediate controls were put in place when requested by the inspector, however, the room temperatures did not reduce sufficiently despite the measures implemented over the course of an hour and half while children and babies were sleeping. 16. There was no documentary evidence available that sleep room environmental temperatures for the two sleep rooms were being routinely monitored on a daily basis. An environmental sleep room record was observed on the wall in sleep room 222. The last entry recorded was on 4 August 2023. Action submitted by the Registered Provider General Safety: Corrective Action 1/2/4/5.Window restrictors put in place on ceiling Velux windows, new toilet seat installed and hazard tape installed on steps and all creams now stored in sealed lid boxes; completed 22nd May 2024. 3. Room specific Daily Risk Assessments completed for each room, bathrooms, changing areas and common areas. Preventive Action 1. All windows rechecked in creche to ensure that restrictors were in place and no further risks identified. 2. Full check on all children and staff toilets to ensure no seats loose or missing, daily Bathroom Check List. 3. All rooms have room and equipment specific Daily Risk Assessment sheets and checked each day by Management. 4. New flooring ordered for this area, due for installation first week in July and all floor coverings checked each day on Room Daily Risk Assessment sheets and Managers Daily Check Sheets. 5. Full review of Nappy Changing Policy and Infection Control Policy will all staff. Infection Control: Corrective Action 6. Plumber has amended the hot water mixer, completed 22nd May 2024, toilet rolls all inserted into wall mounted dispensers and hook placed on wall and children’s toilet seats sprayed and cleaned after each use and placed in individual storage bag. 7. Full review and refresh of Nappy Changing Policy with all staff members. 8/9.Apron, glove and blue roll dispensers purchased 22nd May 2024 and installed 27th May 2024. 10. Foot pedal bin relocated 21st May 2024. 11. Sterilising solution is appropriate for mouthed toys and soothers. 12/13. Existing containers replaced with Steamer. Preventive Action 6. Daily checks to ensure hot water heater is working; policy on infection control and toileting redistributed to all staff to ensure toilet paper is placed in dispensers going forward and added to daily check sheet. 7. Weekly nappy changing observations with all staff members at Nappy Changing time. 8/9/10.All aprons, gloves and blue roll now dispensed from containers going forward. Bathroom and nappy changing area checks daily. 11. Technical Data Sheet available in each room (sterilising solution). 12/13. All mouthing toys, soothers etc to be sterilised in Steamer Unit only going forward. Safe Sleep: Corrective Action 14. These are safety mattresses. 15/16. Portable Air Con units in sleep rooms and temperature Check Sheets located in each sleep room. Preventive Action 14. Specification sheet on hand for future inspection. 15. Full wired Air Con units to be installed July 2024 in all sleep rooms 16. Daily and weekly Management checks. Supporting documentation submitted General Safety: Photograph x 4 Document x 2 Infection Control: Photograph x 7 Document x 2 Safe Sleep: Documents x 2 Photograph x 1 Summary Comment The written response and documentary evidence submitted has been assessed by the Early Years Inspectorate. Regulatory compliance is met for Regulation 23
Regulation 29 — Premises
1. There was a strong malodour in the designated ‘boys’ toilet cubicle located in the sanitary area between rooms 204 and 208; this created an unpleasant environment for children. 2. The paint work on the wall mounted radiator in the ‘boys’ toilet cubicle had a significant area of rust at its base and required repainting/repair. 3. A wooden panel beneath the sink unit in the sanitary area on the main corridor was broken and observed hanging onto the floor exposing a crawl type space that had a build-up of dirt and debris and an area of lodged water and required repair should a child gain access to the area. 4. There were three unfilled holes with rough edges observed on the walls on the left-hand side in the sanitary area outside room 224 and were accessible to a child
Provider's corrective action:
Corrective Action 1. Plumber has fixed small leak at back of toilet. 2. Radiator painted 22nd May 2024. New radiators to be installed July 2024. 3. Opening on wooded panel screwed closed 22nd May 2024. 4. Holes refilled and wall painted. Preventive Action 1/2/4. Daily check sheet and maintenance issues reported to Management. 3. Full refit of changing area to be completed 1st week of July 2024
Found compliant: Regulation 11, 15, 25, 26, 27, 28.