(2) The minimum ratio of adults to children was not maintained at all times during the inspection in the Junior building as specified in column (3) of Part 1 of Schedule 6 as there were 26 children aged from 1 to 3 years of age being cared for by 4 adults when 5 adults were required. For example. • Toddler / Toddler Senior rooms at sleep time from 12.13 to 1.00pm 1 adult was caring for 11 children aged between 23 months to 3years of age. • Wobbler room at sleep time from 12.15 to 1.00pm 2 adults were caring for 11 children. Six children were asleep in cot room 1, three children were asleep in cot room 2, one child was awake, and one child was asleep on a floor bed in the Wobbler care room, all aged between 1 year to 2 years of age
Provider's corrective action:
(2) In response to the non-compliances the service has stated that two new staff members have been hired to assist in the Junior building. Lunch breaks have been adjusted in order to ensure that sleep rooms are adequately staffed while children sleep
Regulation 19 — Health, welfare and development of child
Basic Needs: 1. At mealtime the basic needs of children in the Wobbler room were not adequately facilitated by staff as the following practices were observed during the inspection. • At 10.56 am, staff did not demonstrate awareness and responsiveness to a child’s hunger cues at lunch time. As a result, the child was fed on the prompting of the inspector. On the child’s completion of their meal their bowl was removed, and additional food was only made available on the request of the inspector. • The nutritional needs of a child in the Wobbler room were not met on the day of inspection. Staff did not actively promote and encourage the child in their care to experience new tastes and textures at mealtimes. Although staff were aware of the child’s preferences, the food type chosen would not sustain a child in full day care and there was no care plan in place to address this. 2. Routine nappy changing in the Junior Building was scheduled to take place at 10.15 am and 2.30pm, this did not meet the comfort needs of the children. When nappy changing was completed the time and information recorded in the electronic application that was shared with parents did not accurately reflect the times of actual nappy changes and events that occurred while the children attended the service. Incorrect recording of care practices can impact the ongoing consistency of care to children throughout the day. 3. Outdoor play was not made available to all children in the Junior building. Outdoor play was not included in the daily schedule documented in the Wobbler room. Children need regular outdoor play to enable them to explore and develop their gross motor skills of walking and running. Supporting Relationships: 4. At lunch time five children in highchairs were positioned with their backs to their six friends seated at the table at dinner time. This did not create a social environment. 5. Staff in the Junior building did not accurately communicate and record on the electronic tablet a child’s wellness and episodes of ill health that occurred while they attended the service. As a result, the parents of the child were not informed of their child’s health while attending the service. Environment: 6. In the Wobbler room and Room 3 areas of interest such as play kitchens and home areas were poorly resourced with supporting equipment to enhance and assist with the development of the children play opportunities. 7. .The environment of the Wobbler room while a child slept was not conducive to their sleep needs. Staff did not ensure that the room was dimmed to create a restful space. 8. . Adult chairs were not available in the Wobbler room to enable staff to adequately comfort and assist children during mealtimes. As a result, it was observed that during dinner time two staff members sat on a toy storage unit and a windowsill while assisting five children in highchairs
Provider's corrective action:
1. In response the service has stated that nutrition care plans have been put into place for children who have food preferences and staff have been updated during the staff meetings. Staff have undergone in-house training on basic needs of the child. 2. To address the non-compliance the Junior building nappy changing roster has been updated and discussed at the staff meeting. Staff have been re-trained on the electronic application used by the service. It should be noted that nappies may not always be entered into the system at real time as immediate attention goes to the children, the tablet is filled in as accurately as possible. 3. The outdoor play roster has been updated and discussed at the staff meeting. Staff have also been retrained on the importance of play, to include outdoor play. 4. Following the inspection highchairs are now positioned in a social circle. Staff discussion and in-house training on the importance of social interactions for children during mealtimes has taken place. 5. Staff have retrained on infection control and issued with a copy of the infection control policy during the staff meeting. 6. In response to the non -compliance m ore equipment and supplies were purchased for the room . Areas of Interest implemented into the room and discussed in staff meeting. 7. Following the inspection the child now sleeps in a smaller sleep room . Sleep plans and safe sleep policy discussed at staff meeting. 8. In response additional chairs have been purchased for the wobbler room and more chairs are now available to the wobbler room staff
Regulation 22 — Food and drink
1. The practice of offering children additional food at lunch time or an alternative healthy food was not observed by the inspectors in the Junior and Senior buildings
Provider's corrective action:
1.To address the non-compliances a discussion was held at a staff meeting to ensure that an alternative option is available to children. Alternative option is now on the menu daily
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. In the Toddler senior room at 1.08pm the inspector observed one child on a low bed alone, leading to a risk of safety. 2. In the Wobbler room at 2.22pm, the inspector observed a child drinking a bottle lying flat on the floor and had to intervene to request the staff in the room, to lift the child into a more upright position due to a risk of choking. 3. There was evidence to demonstrate that regular and routine risk assessments were not completed by staff in the care rooms or outdoor area to reduce the potential risk of injury to a child. For example. • In Cot room 1, a trailing flex from a monitor was accessible which staff had identified as a risk to children but had not removed the hazard. • In the Wobbler room a blind cord was loose and not secured. • In the outdoor area in the Senior building protective tape surrounding two metal poles was torn and loose posing a potential trip hazard or ingestion of loose material by children. • During sleep time, cot room 1 was observed to be congested with equipment. This is not an appropriate storage area as it could potentially reduce staff access to children in the event of an emergency. Infection Control: 4. The procedures and practice of handwashing and reducing the potential risk of cross infection in the Wobbler room were observed to be at variance with the service policy and best practice guidelines. For example. • At 11.00am before dinner, staff assisted six children to wash their hands in a shared basin of water and soap and then refilled the basin and used it to assist 5 children to wash their hands. Children should be assisted to wash their hands at a sink with warm running water. • A child in the Wobbler room did not have their hands washed after nappy changing. 5.The paper hand towels, and toilet roll used by the staff and children in the service were not always hygienically dispensed as rolls and stacks of paper were provided in the nappy changing area beside the Wobbler room which was subjected to repeated handling. This posed a risk of cross-contamination and was inadequate for infection control purposes. The paper towel dispenser in this area was empty. 6. Materials such as dried foods and cereal for sensory play were stored in the staff sanitary facility. The increased the potential risk of cross infection as play equipment should not be stored in sanitary facilities. Safe Sleep: 7. Two children under two years of age were observed sleeping on low floor beds. Completed documentation was not available to demonstrate that parents had been communicated with, and their written permission was obtained before this practice commenced. This is at variance with best practice sleep guidelines issued to the sector in September 2023. Action submitted by the Registered Provider
Provider's corrective action:
General Safety: 1. To address the non-compliance the service has stated that more staff have been employed and safe sleep retraining, along with a safe sleep discussion at the staff meeting with care plans studied. 2. In response the safe sleep policy was discussed and given to staff at the staff meeting. Safe sleep training has also been given. 3. In response to the non-compliances the service has stated that. • Flex has been removed from the area and safety discussed in staff meeting. • Blind cord repaired and specified in risk assessments. • Tape around poles removed and replaced by maintenance and added to risk assessments. • Equipment removed from cot room 1, discussed at staff meeting and added to risk assessments. Infection Control: 4.In response the handwash basin was removed from the room and infection control training was given to staff, along with Infection control policy distributed and discussed at staff meeting. 5. To address the non-compliances paper towel dispensers have been filled up and toilet roll holders added to each sanitary area. Paper towel dispensers added to cleaning documentation daily schedule. 6. The service has stated that the storage unit has been removed from area and storage of play equipment and sensory materials discussed at staff meeting. Safe Sleep: 7. In response care plans have been completed for the children and best practice sleep guidelines discussed at staff meeting, safe sleep policy distributed, and safe sleep training provided. Children will not be moved to a low floor bed prior to care plans completed
Regulation 24 — Checking in and out and record of attendance
(1) Staff in the service did not ensure that 13 children that left the service at 12pm were signed out of the electronic application when the inspector reviewed the number of children present in the service at 12.13pm
Provider's corrective action:
(1) In response the service has stated that children will be signed out immediately and this was discussed at a staff meeting. Staff will undergo re training on the service electronic application and fire safety
Regulation 29 — Premises
(d) 1. The covering on five chairs used by the children in Room 1 and 2 were worn and torn at the seams leaving foam exposed which created the potential risk of a child choking and was not washable or wipeable. 2. A wash hand basin in the Wobbler sanitary facility was blocked and as a result it created stagnant water
Provider's corrective action:
1. In response new chairs have been purchased and chairs have been added to room risk assessments. 2. Following the inspection maintenance fixed this plumbing issue. Wash basins have been added to risk assessment sheets