Regulation 19 — Health, welfare and development of child
The following observations demonstrated how some appropriate and suitable care practices were not in place: 1. In the cot room adjacent to Acacia, an inappropriate care practice was observed when a child was being supported to settle to sleep. The child was placed in the cot at 12:07 and began moving round from sitting to standing in the cot. The child was not upset. At 12:13 when the child stood, a staff member placed the child back down on the mattress. After a few seconds, the staff member, in a quick movement, took the blanket off the child, picked up the child and placed the child on the floor. The staff member opened the door to the care room and placed the child in the care room, returning to the cot room. This practice had a negative impact on the child who was observed by the inspector to be visibly upset as a result of the quick movement. The child was comforted by the staff member in the care room. The preventive actions submitted by the registered provider following the last inspection of the service on the 05 March 2025 did not prevent the re-occurrence of non-compliance relating to sleep practices. 2. Children in Wobbler Baringo were not provided with spoons to afford them an opportunity to feed themselves at dinner. The children presented with signs that they were developmentally ready to use a spoon and were observed by the inspector to become frustrated while waiting to be spoon fed
Provider's corrective action:
The registered provider stated that: 1. On receipt of information of the above anomalies around sleep practices, this was immediately reviewed by the management team. The staff member received guidance and support regarding appropriate settling and sleep practices and the importance of calm respectful and child-centred interactions at all times. All staff were retrained on the service’s sleep and rest policy to ensure consistent and appropriate practices are followed throughout the service. Management will continue to monitor sleep and rest practices through regular supervision, observations and staff meetings, and management will be more visible on the floor at sleep times. Ongoing support and refresher training will be provided to ensure all staff follow the sleep and rest policy and maintain a nurturing and respectful environment for children. 2. Mealtimes and feeding practices were reviewed with all staff to ensure children are always supported appropriately and safely during meals. Staff were reminded that children must be supervised and assisted in a developmentally appropriate manner at all times. All staff have been retrained on safe feeding and supervision practises, including maintaining close supervision during mealtimes and responding promptly to children's needs management will continue to monitor practices through regular observations supervision and training to ensure the compliance is maintained
Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: 1. It is acknowledged that handwashing was facilitated through the provision of liquid soap, water, and paper towels in some of the sampled rooms. However, in the Wobbler Safari room, effective handwashing was not facilitated which posed a risk of cross contamination. • At 11.37 water was provided in a plastic container from which four children washed their hands in the same water. The water was emptied and refilled and a further group of five children washed their hands in the same water. • A staff member confirmed that after nappy changing children’s hands are wiped with wet cotton wool instead of using soap and warm running water as required. Safe Sleep: 2. Sleep plans, to include a risk assessment, were not available for five children aged 1-2 years who were sleeping on floor beds in Wobbler Cameroon. Sleep plans are required to ensure that a child’s individual needs are met in consultation with parents and that sleep provision is safe and appropriate for the child. Action submitted by the Registered Provider
Provider's corrective action:
The registered provider stated that: Infection Control: 1. The service reviewed infection control and hand-washing procedures immediately with all staff following the inspection. Staff were reminded that effective hand washing must always be carried out using warm running water and liquid soap to reduce the risk of cross contamination. All staff have since been retrained on infection control, hand hygiene and nappy changing procedures to ensure consistent practice across the service. Appropriate hand-washing resources are now monitored regularly throughout the day to ensure there remain fully available in all rooms Safe Sleep: 2. Individual sleep plans and risk assessments were completed and updated for all children sleeping on floor beds. Sleep arrangements were reviewed with parents to ensure each child's individual needs are safely and appropriately met. All staff have been retrained on the service’s safe sleep policy and safe sleep practices, including supervision sleep environments and the completion of individual plans and risk assessments
Regulation 19 — Health, welfare and development of child
A number of inappropriate care practices were observed to not meet the needs of the children and may negatively affect the health, welfare and development of the children on the day of inspection as follows: 1. A child attending the Safari room was observed to have a soiled top and trousers after dinner time which was wet and stained with food residue. The child was placed to bed in a wet vest and when they woke, the stained top and trousers were placed back on the child. 2. The inspectors observed unsuitable care practices around sleep time as follows: • On the day of inspection there were ten floor mattresses available for eleven children requiring sleep. The inspectors observed that the designated sleep time for children from the Madagascar and Safari room were not child led and did not meet the needs of the children present requiring sleep as follows; - At 12:27pm in the Kenya room a child was brought down by an adult from the Madagascar room to have a rest, they were told they could not rest today by a staff member in the Kenya room. When the inspector enquired as to why the child was refused sleep the staff member informed them that the child can only rest on days there are beds available. At 12:31pm a child who did not want to sleep was offered to get up, a bed had become available, no call was made to the Madagascar room to offer a rest time to the child requiring it. - At 11:13am in the Safari room a child was displaying cues of tiredness rubbing their eyes and becoming upset. An adult in the room was observed to inform the other adult in the room that the child was tired. The child was not placed down to sleep until 12:10pm. This non-compliance was present on the last inspection on 4 April 2024. The corrective and preventive actions as stated by the registered provider did not prevent recurrence of this non-compliance. • In the Safari room at 12:38pm one adult was observed to be assisting a child to sleep in a cot, the inspector observed the adult place the child’s head back down 6 times to the mattress when the child tried to sit up, the child placed their foot on the side of the cot and the adult placed it back down on the mattress. Another adult in the room took over to assist the child to sleep at 12:50 and got the child up at 12:55pm
Provider's corrective action:
1. The staff team received comprehensive retraining on the critical importance of prompting good hygiene practices. Ongoing training will be provided on a monthly basis through staff meetings within the centre. 2. Staff have undergone retraining regarding the significance of sleep periods for children. The staff team have also received instructions and direction on effective techniques for assisting children in falling asleep, as well as understanding appropriate and inappropriate behaviours during rest times. In addition, staff have been made aware and a dvised that there are additional floor beds available for children who do not typically require a nap but may need one on an occasional basis. we will continue with training on a monthly basis and provide the appropriate measures and guidance to all members of the team to ensure the correct practices are in line with company policies
Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: 1. The children in the Wobbler Safari room were of an age where they explored toys with their mouths. On the day of inspection, there was no attempt made to remove toys when mouthed in view of staff members present. The toys remained in use between the different children posing a risk of cross infection. This non-compliance was present on the last inspection on 4 of April 2024 and 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. 2. Some nappy changing practices observed during the inspection in the service were inadequate for infection control purposes and at variance with the service’s nappy changing procedure as follows: - One staff member in the Wobbler Acacia room did not wipe down the child after the wet nappy was removed. - One staff member in the Junior Toddler Serengeti room did not wear an apron for the duration of the nappy change. This non-compliance was present on the last inspection on 4 April 2024 and 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non- compliance. Safe Sleep: 1. Nine children aged between 12 and 24 months in the Wobbler Cameroon room were observed sleeping on blue stackable beds on the day of inspection where a standard cot or low-lying bed is required as per the Safe Sleep guidance for children under 24 months. Action submitted by the Registered Provider
Provider's corrective action:
Infection Control: 1. Staff have received further training with practical skill demonstrations conducted on the importance of sterilising mouthed toys. Ongoing monthly training during staff meetings is implemented to ensure that all staff members are well-informed about the necessary procedures and protocols to follow when addressing situations in which children mouth toys. 2. All staff have been retrained on the nappy changing policy whilst highlighting both the practical aspects and the reasons behind this essential practice. Ongoing monthly training during staff meetings is implemented to ensure that all staff members are fully informed and competent regarding the necessary procedures involved in nappy changing. Safe Sleep: 1. The service has placed an order for cocoon floor beds. As per the safe sleep guidance the centre will use the new cocoon floor beds for children from the age profile recommend and or the use of a cot for correct practice use for sleeping children
Regulation 19 — Health, welfare and development of child
1. On the first day of inspection, the sleep needs of two children, aged 1 year, in the Wobbler Acacia room were not met in a timely, child centred manner. Children were observed crying and displaying signs of tiredness at 10:35 and 10:45 respectively. The staff member based in the room was alone with four children and could not leave the room to place the two children to sleep. The staff member was observed phoning for assistance twice. The manager entered the room at 10:55 and the children were then placed to sleep. 2. Water was not accessible to children in the Wobbler Acacia, Wobbler Baringo and Wobbler Kilimanjaro rooms on both days of inspection. Children’s beakers were stored in a cupboard out of reach and sight. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions as stated by the registered provider did not prevent recurrence of this non-compliance. 3. On the second day of inspection, the personal care needs of a child in the Wobbler Acacia room were not met in a timely manner. A child was observed with a runny nose which was not attended to for a period of twenty minutes
Provider's corrective action:
1. Additional part time staff were recruited for the setting to support transitional times such as sleep and rest/toileting times. Staff have received further training regarding calling for assistance and supports required when working alone. A lone worker policy has been put in place for staff that work in rooms alone. The management team will monitor transitional times and ensure support is available, they will ensure that working rooms are supported by a team of two carers and in the event of changes, the team will actively supervise the floor and aid where required. Staff will also receive regular training on this within monthly staff meeting and ongoing training within the centre. 2. All rooms highlighted have re-labelled their beakers with names and photographs. Beakers are now stored on top of the counter where children can see them and gain access. Staff have been re-trained on the importance of water intake for children. The matter will receive regular checks underpinned by training from the management team to ensure that all children have accessibility to fluids throughout the day. 3. Staff discussions were carried out and re-training commenced following the inspection. A training card has been signed off on the importance of caring for children’s hygiene. Ongoing training will be facilitated on the hygiene levels of children in the setting
Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: Inspectors observed a number of practices which posed a risk of transmission of infection within the service: 1. Some nappy changing practices observed during the inspection in the service were inadequate for infection control purposes and at variance with the service’s nappy changing procedure as follows: - Children’s hands were not consistently washed following nappy changes. - Children’s hands were cleaned with wet cotton wool following nappy changes which is not effective for infection control. - Staff did not consistently wash their hands after cleaning the nappy changing mat. - Staff did not consistently clean the nappy changing mat following nappy changes. - A child’s hands were washed during a nappy change and not when the nappy changing procedure was complete. - A staff member was observed to put a new nappy on a child without cleaning the child who had a wet nappy. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. 2. In the Wobbler Acacia room on both days of inspection and in the Toddler Serengeti room on the first day of inspection children’s hands were not washed before dinner. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. 3. The children in the Wobbler Acacia room were of an age where they explored toys with their mouths. On both days of inspection, there was no attempt made to remove toys when mouthed despite the room having a designated box for this. The toys remained in use between the different children posing a risk of cross infection. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non- compliance. 4. In the Wobbler Acacia room, during dinner, a staff member was observed to give a child another child’s beaker. The child had been drinking from their beaker posing a risk of cross contamination. This non- compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. Administration of Medication: 5. Practices in place for a child attending the service requiring emergency medication were contrary to the service policy, posing a potential risk to the health and safety of children. An auto-injector pen was observed loose in a child’s bag on a low hook within reach of the children in the Preschool Madagascar room. The auto-injector pen was not stored in its original packaging and was not stored safely in a secure container contrary to the services medication policy. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. Safe Sleep: 6. Practices in place in relation to safe sleep for children attending the Wobbler Acacia and Wobbler Kilimanjaro rooms were inadequate and contrary to the service’s policy on safe sleep posing a potential risk to the health and safety of children as follows; a. On the first day of inspection, sleep checks were not carried out every 10 minutes in the Wobbler Acacia room contrary to the service’s policy on safe sleep. Between 11:25 and 12:00, one sleep check was carried out on a child, aged 1, who was sleeping in the adjacent cot room. b. On the second day of inspection, sleep checks in the repurposed sleep room where children from the Wobbler Kilimanjaro, Toddler Serengeti, Preschool Kenya and Pre-school Madagascar rooms were sleeping were not sufficient. Individual, physical sleep checks were not carried out on children from the Wobbler Kilimanjaro room who were sleeping in cots. Staff were observed checking children from one end of the room. This non-compliance was present on the last inspection on 19 July 2023. The corrective and preventive actions submitted by the registered provider did not prevent recurrence of this non-compliance. Action submitted by the Registered Provider
Provider's corrective action:
Infection Control:
a. Staff have all been re-trained on importance of hygiene hand washing for children in their care following the nappy changing process. The management team will conduct regular training through observations and skill demonstration on the nappy changing policy and process with all staff weekly and bi-monthly. b. Staff have received refresher training on the steps outlined in our hand washing procedure, the training included children’s hands to be washed under running water with hand soaps. Training and observations will be carried out on the task of handwashing with the staff team. c. The staff team have been provided with further retraining on the handwashing steps and process for their own hand hygiene before and after the task. Additional aids such as posters in different languages have been implemented to support the team actively carry out this process. Skill demonstrations have and will be completed by all staff regularly as part of the ongoing training plan implemented. d. Staff members have been re-trained on importance of cleaning down the changing mat after every use. The management will conduct regular checks on the process of nappy changing and the hygiene requirements to ensure that all staff are clear on what is expected to limit cross infection. e. Retraining on the nappy changing process has been done with all staff, skills demonstrations have been conducted to under pin the importance of this process. Continuous training with staff at training evenings monthly will include all of the above. f. The staff members have received further training on the importance of cleaning and wiping children after each change as occurred. The staff team have been made aware of the element of cross infection if the process is not carried out correctly. As mentioned above training is underway and will continue to be carried out with the staff team and new recruits joining out team. 2. The staff teams within the rooms mentioned have undergone supports and active measures to assist on accurate handwashing steps throughout phases of the child’s day ie: garden time and preparation for meals times. The management will work closely with staff in all rooms to ensure this is being followed and handwashing is being completed correctly. 3. Sterilisation boxes have all been relabelled and staff have been retrained on the sterilisation policy for mouth toys within the baby unit to ensure cross infection is addressed. The management team will carry out spot checks to ensure sterilisation is being done in all rooms and within rooms where mouthed toys are in place. 4. The staff member on the day mixed up the children, to address this matter all beakers and cups have been relabelled with the child’s full name and additional measure the child picture has been added to each beaker. The staff have been made aware of the importance of fluid beakers being accessible to children and following the implementation of the pictures and names alongside the position of beakers in an area for children, this will be monitored and observed by the team for correct practice. Administration of Medication: 5. The staff team along with the management have re-visited the protocol for the attending child. In collaboration with the parents who now supplied us with 2 epi-pens with a pharmacy sticker on them. These have been placed in the child’s bag within a stored container with all details available when required. The safety and storage of the child’s bag is on a hook out of reach of the children and accessible to the adults only. The management team will monitor and carry out checks to ensure there is no loops hole for safety. The management team have implemented a check list that will monitor daily to ensure both epi-pens stay in a safe area, parent collaboration on this matter has been discussed with the family and the staff team. Safe Sleep: 6. The management team have actively reviewed the safe sleep protocols with all staff, they have carried out training and will continuously review the practices on the importance of recording and carrying out sleep checks. Regular checks by management will be carried out to ensure this is being done & ongoing training is being completed during staff training evenings and ongoing training in house on a weekly basis. The staff have undergone intense re-training on the importance of sleep checks, when to complete and documents the timings. Ongoing training with staff to ensure safe sleep is being adhered to