Regulation 16 — Record in relation to pre-school service
1 (i) The following details were not documented on the staff roster. • The surnames of each staff member was not recorded
Provider's corrective action:
The staff roster has been updated to clearly show the full names of all staff members as well as the rooms in which they are working in. Management will ensure all future staff rosters are detailed and clearly show full names of staff
Regulation 19 — Health, welfare and development of child
BASIC NEEDS The privacy and dignity of children was not respected at nappy changing. Three children aged 2-3 years from the Pre-Ecce room were observed having to wait in the nappy changing area sitting on a ledge while another child was having its nappy changed in the sanitary accommodation upstairs
Provider's corrective action:
Management have advised the staff member in charge of this room to seek cover from management or another staff member when nappy changing needs to take place. This will ensure that only one child will be in the sanitary accommodation at any one time and the privacy and dignity of the children will be respected at all times. Management will ensure that all staff have adequate cover when nappy changing is required and the privacy and dignity of children will be respected at all times
Regulation 29 — Premises
(d) 1. Sections of the outdoor play area to the rear of the facility was waterlogged. This was detailed as a non-compliance on the inspection reports dated 9 September 2021, 22 November 2023 and 28 June 2024 and responses given by the registered provider in previous corrective and preventive actions has not prevented this reoccurrence. This posed a risk to the safety of the children. (e) 2. The water pressure and flow of water at the wash hand basin in the nappy changing area upstairs was inadequate to facilitate hygienic hand washing
Provider's corrective action:
1.To resolve the water-logging issue to the rear of the facility would take a substantial financial investment which the business is not in the position to undertake at the moment given the current financial climate. If the weather is particularly bad and it is not safe for the children to access this area, children will get outside time at the front play area or alternatively the staff will bring the children on trips to the local park. The play area at the rear of the facility will only be used when it is safe to do so. 2. The taps in the upstairs nappy changing area were assessed by a plumber and the water pressure is now at an adequate pressure to ensure hygienic hand washing can take place. Management will monitor water pressure regularly in the service
Found compliant: Regulation 9, 11, 23.
Inspection of 24 February 2025 — Inspection Report
Immediate action notice. 10 April 2025 A meeting was held with the person in charge and the service manager who attended the meeting on behalf of the registered provider. The purpose of the meeting was to seek clarification regarding the CAPA 2 (Corrective and Preventive Action) document, which had not been received by the Inspectorate, and to determine how and when the outstanding non-compliances under regulations 9,19, and 29 would be addressed. Through discussion, it became apparent that the CAPA 2 submission had been returned by the person in charge on 21 March 2025; however, it failed to deliver to the Inspectorate because of the size of the email attachments. The CAPA 2 was resent to the Inspectorate on 10 April 2025.
Immediate action notice. 15 April 2025 A Regulatory Compliance Meeting was facilitated by the Inspection and Registration Manager, with persons who the registered provider delegated to attend the meeting on her behalf. The purpose of the meeting was to: • Discuss the outstanding non-compliance regarding
Regulation 9 — Management and recruitment
(4) Six staff working directly with children did not have an appropriate qualification in early childhood care and education or an equivalent such qualification. • In the wobbler room at 11.10 hrs there were fifteen preschool children aged 1-2 years being cared for by two staff who had childcare qualifications. The third adult present in the room did not have a childcare qualification. • In the toddler room at 11.10 hrs there were fourteen preschool children aged 2-3 years being cared for by two staff who had childcare qualifications. The third adult present in the room did not have a childcare qualification. • In ECCE room 3 at 15.00hrs there were twelve preschool children aged 3 years being cared for by one staff who had childcare qualifications. The second adult present in the room did not have a childcare qualification and was documented on the staff roster as working with the school aged children. • Staff breaks throughout the service were covered by staff who did not have childcare qualifications. This is a reoccurring non-compliance as on the previous inspection dated 28 May 2024 where there were three staff working directly with the preschool children who did not have documentary evidence of childcare qualifications or an equivalent qualification. Staff employed without a recognised childcare qualification have the potential to impact on the level of quality care and learning opportunities provided to the children in the care of the service
Provider's corrective action:
14 March 2025: CAPA 1 was returned by the person in charge. This response was not accepted as it was not specific, measurable, and timely. The response in the corrective and preventive action plan and in previous corrective and preventive action plans were not actioned to prevent this non-compliance reoccurring. This was also a non-compliance on the previous inspection dated 28 May 2024 as there were three staff working directly with the preschool children who did not have documentary evidence of a childcare qualification or an equivalent qualification. On the inspection dated 22 November 2023 there were two staff working directly with the preschool children who did not have documentary evidence of a childcare qualification or an equivalent qualification. 10 April 2025: A meeting was held with the person in charge and the service manager who attended the meeting on behalf of the registered provider. The purpose of the meeting was to seek clarification regarding the CAPA 2 (Corrective and Preventive Action) document which had not been received by the Inspectorate, and to determine how and when the outstanding non-compliances under regulations 9,19, and 29 would be addressed. Through discussion, it became apparent that the CAPA 2 document had been returned by the person in charge on 21 March 2025; however, it failed to deliver to the Inspectorate because of the size of the email attachments. The CAPA 2 was resent to the Inspectorate on 10 April 2025. Following the review of the CAPA 2 document sent to the early years Inspectorate on 10 April 2025 the response was not accepted regarding regulation 9 (4). 15 April 2025: A Regulatory Compliance Meeting was facilitated by the Inspection and Registration Manager, with persons who the registered provider delegated to attend the meeting on her behalf. In the meeting, the outstanding non- compliance regarding Regulation 9 (4) following the service’s CAPA 2 response was discussed. During the Regulatory Compliance Meeting, it was confirmed that staff who did not hold the required qualifications continued to work directly with the children daily to cover the break times of qualified staff. A decision was made to refer the service to the National Registration Enforcement Panel in relation to unresolved areas of recurring and outstanding non-compliance within the service. Please refer to the Additional Information section of this inspection report for information regarding a Regulatory Enforcement Meeting that was held with the service, and how the continued registration of the service is now subject to the addition of the condition for a 12 month period
Regulation 10 — Policies, procedures etc. of pre-school service
The following first aid requirements were not detailed on the outings policy in relation to • The attendance of a person trained in first aid for children to accompany the group on each outing when they leave the premises. This posed a potential safety risk to children in the event of an emergency. • A well-stocked first aid box must be taken by staff when they leave the premises to go on an outing. This posed a potential safety risk to children in the event of an emergency
Provider's corrective action:
The outings policy has been revised to include the details that were not included. A staff member up to date in first aid responder will accompany children on outings and all staff are aware that a first aid box must also be brought on outings
Regulation 19 — Health, welfare and development of child
PHYSICAL AND MATERIAL ENVIRONMENT: 1. Opportunities for children to be outdoors as often as possible for fresh air, movement and outdoor play was limited: - As the outplay area to the front of the facility was not available for use as repair works had commenced in the area. - The outdoor play area to the rear of the facility was poorly maintained as it was waterlogged and covered in moss, leaves and debris. This was detailed as a non-compliance on the inspection reports dated 9 September 2021, 22 November 2023 and 28 June 2024 and responses given by the registered provider in previous corrective and preventive actions have not been actioned or prevented this reoccurrence. 2. There was limited age-appropriate play equipment exclusive for outdoor use available in the outdoor play area for the younger children. 3. Distinct area had not been developed in the outdoor play area for the different age groups for e.g. sheltered areas were not available to provide protection for children in warm or in wet weather conditions or areas with different age-appropriate toys and equipment
Provider's corrective action:
14 March 2025: CAPA 1 was returned by the person in charge. This response was not accepted as it was not specific or measurable. Photographic evidence was not submitted in relation to the work completed in the play area at the entrance to the facility. Evidence of when the repair works to the rear outdoor play area will commence and be completed was not submitted. Photographic evidence was not submitted in relation to provision of play equipment in the outdoor play area for the younger age group. 10 April 2025: A meeting was held with the person in charge and the service manager who attended the meeting on behalf of the registered provider. The purpose of the meeting was to seek clarification regarding the CAPA 2 (Corrective and Preventive Action) document which had not been received by the Inspectorate, and to determine how and when the outstanding non-compliances including regulation 19 would be addressed. Through discussion, it became apparent that the CAPA 2 document had been returned by the person in charge on 21 March 2025; however, it failed to deliver to the Inspectorate because of the size of the email attachments. The CAPA 2 was resent to the Inspectorate on 10 April 2025. Following the review of the CAPA 2 document sent to the early years Inspectorate on 10 April 2025, the response was accepted regarding regulation 19
Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: 1. A communal cloth hand towel was observed to be used by the children and the staff following handwashing in the toddler room which increased the risk of cross infection between children and between staff. Outing: 2. Children were taken on an outing to the local park on the day of the inspection. Staff stated that they did not take a first aid box with them when they took children on outings from the service. This posed a safety risk to the children in the event of an emergency. 3. A person trained in first aid for children did not accompany the children on the outing when they left the premises on the day of the inspection. This posed a potential safety risk to children in the event of an emergency. Action submitted by the Registered Provider
Provider's corrective action:
1. Staff have been reminded of the infection control policy and of the importance of hand hygiene in relation to infection control. Communal cloth hand towels have been removed from the toddler room. 2. & 3. Staff have been informed of the revised outings policy which states that a first aid box must be brought on any outing outside of the creche and that a person qualified in first aid must accompany the children on any outing outside of the creche. Staff have been reminded that they must follow the policies
Regulation 29 — Premises
1. A section of the outdoor play area used by the younger children was waterlogged, covered in moss, leaves and dirt. There was no evidence of a cleaning and maintenance schedule for this area. This has been highlighted on previous inspections dated 9 September2021, 22 November 2023 and 28 June 2024 and responses given by the registered provider in previous corrective and preventive actions have not been actioned or prevented this reoccurrence. It is acknowledged that the outdoor play area for the older children is currently being upgraded and is not currently in use
Provider's corrective action:
14 March 2025: CAPA 1 was returned by the person in charge. This response was not accepted as it was not specific, measurable, and timely. Photographic evidence was not submitted that the area has been appropriately cleaned and suitable for use by the children. This has been highlighted on previous inspections dated 9 September 2021, 22 November 2023 and 28 June 2024. 10 April 2025: A meeting was held with the person in charge and the service manager who attended the meeting on behalf of the registered provider. The purpose of the meeting was to seek clarification regarding the CAPA 2 (Corrective and Preventive Action) document which had not been received by the Inspectorate, and to determine how and when the outstanding non-compliances including regulation 29 would be addressed. Through discussion, it became apparent that the CAPA 2 document had been returned by the person in charge on 21 March 2025; however, it failed to deliver to the Inspectorate because of the size of the email attachments. The CAPA 2 was resent to the Inspectorate on 10 April 2025. Following the review of the CAPA 2 document sent to the early years Inspectorate on 10 April 2025, the response was accepted regarding regulation 29