Immediate action notice. Additional information was requested from the registered provider regarding an outstanding non-compliance in
Regulation 9 — Management and recruitment
One police vetting remains outstanding for a staff member whose file was reviewed on the last inspection in February 2024
There was no evidence to show that one staff member who was observed working directly with the children held at least a major award in Early childhood Care and Education at Level 5 on the National Qualifications Framework or a qualification deemed by the Minister to be equivalent
Provider's corrective action:
In response to the non-compliance the service has stated that the staff member is continuing to follow up on the outstanding police vetting but is finding it difficult to obtain. The staff member is awaiting an appointment with the relevant embassy
In response the service has stated that the staff member has re-registered to complete their level 5 and will be finished in May 2025. Until then they are not currently including them in the staff-child ratios
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. Visibility strips were not present on the glass doors in the Baby room. This increased the potential risk to a child of walking into the doors. 2. An adult chair and a sofa in the Baby room was torn exposing the foam. This did not allow for easy cleaning and posed a choking hazard should a child ingest the foam. Infection Control: 3. Six cot mattresses did not have wipeable covers. Administration of Medication: 4. On review of 14 administration of medication records available the following was observed. • The child’s date of birth was not documented on 14 forms. • The dosage of medication to be administered was not recorded on 2 forms. • More than 1 medication was recorded on 3 forms. • The signature of the staff member that witnessed the medication administration was not recorded on 7 forms. • The signature of the parent following administration of the medication to confirm that they were made aware of the administration was not recorded on 12 forms. 5. Medication that was administered to a child twice daily in the Baby room did not have their name, date of birth and medication dosage documented on the medication to ensure that an accurate amount of medication was administered while they attended the service
Provider's corrective action:
Corrective & Preventive Action General Safety: 1. In response to the non-compliance the service has stated that visibility stickers have been placed on all the windows. They will ensure that extra visibility stickers are always present on the doors and windows. 2. To address the non-compliance the service has responded that the torn corners have been covered with extra strong tape. Maintenance checks will be done on all equipment. Infection Control: 3. Six new waterproof mattress protectors have been purchased and will be placed on the cots. Administration of Medication: 4. New medication forms have been placed in all the rooms. Staff were given instructions that only one medication per form and all forms are to be filled out every day for all medications administered. 5. To address the non-compliance the parent of the child was notified and the correct medication with the child’s correct name has since been brought in and signed for. All staff to double check names and details at all times before administering medication
Regulation 25 — First aid
(1) A staff member with up to date First Aid Responder (FAR) training was not available within the service. It is acknowledged that staff had FAR certificates with an expiry date of 14 January 2025. The service has planned to renew certification on the 8 and 9 February 2025
Provider's corrective action:
(1) In response the service has stated that all staff have since completed a 2-day refresher First Aid Responder course and the manager has also completed a paediatric first aid course. Reminders have been set for all staff to renew the first aid course every 2-3 years
Found compliant: Regulation 11, 19.
Inspection of 22 February 2024 — Inspection Report
(2)(a)(b) The required references were not available on file for the following staff. • One written and verified reference for one staff member. • Evidence that one reference from a past employer was verified. (c) A Garda vetting disclosure was not available for a staff member employed within the service. (d) 1. Police vetting from two countries was not available for a staff member who had lived outside the state for more than 6 months as an adult. 2. Documentation was not available to clearly demonstrate that four staff members had not lived outside the jurisdiction for longer than six months as an adult. (4) There was no evidence to show that one staff member who was observed working directly with the children held at least a major award in Early childhood Care and Education at Level 5 on the National Qualifications Framework or a qualification deemed by the Minister to be equivalent
Provider's corrective action:
(2)(a) and (b) In response to the non-compliances the service has stated that two written references have been obtained and checked and verified for all staff members. All references will be obtained and kept on file for all staff members. (c) The registered provider responded to the immediate action notice issued to the service on the 23 February with the measures implemented within the service. In their corrective and preventive action, they stated that all Garda vetting has been updated and are all on file. All garda vetting will be obtained every 3 years even for students. Manager will ensure staff files will be reviewed on an annual basis. (d) Police vetting was submitted for one of the two countries for one staff member. (4) Administration staff helping on the day of inspection to cover preschool breaks, will not be permitted to cover any breaks going forward as they do not have a level 5 in childcare qualification. Manager will ensure only fully qualified staff members are counted in the ratios even during lunch hours
Regulation 19 — Health, welfare and development of child
Basic Needs: 1. Children in the Baby room did not receive two meals and two snacks at 3 hourly intervals as recommended in the Nutrition Standards for Early Learning and Care services. They were provided with breakfast of cereal and milk at 9am, dinner of mince and rice from 12 to 12:30pm and an afternoon tea of ham sandwiches at 4pm. Young children need to eat small amounts of food and frequently. This did not ensure that the children received a nutritious and adequate diet. 2. Children in the Baby room had their outer clothes, socks and shoes removed at 10:30am to facilitate nappy changing, eating, and sleeping. The children slept from 11am to 12:30pm and were not dressed again in their clothes until 2:30pm. The comfort needs of the children were not considered. Supporting Relationships: 3. An adult chair was not available in the Baby room to enable staff to adequately comfort and assist children during mealtimes. As a result, it was observed that during lunch time two staff members sat on the children’s table with their backs to two seated children while assisting two children in highchairs. This did not support or create a sociable environment at mealtimes
Provider's corrective action:
1. In response to the non-compliance the service has stated that all children in our centre receive between 1-3 meals per day plus 2 snacks (depending on hours of attendance). Staff in Baby room have been reminded of this and re-assured me that this is the norm on a daily basis. Staff were reminded to be mindful of the time frame of when the children last ate. All children are offered a snack or meal every 3 hours. 2. To address this all staff in the Baby room have been advised that leaving the babies outer clothes off them for such a long period of time, is not common or normal practice within our centre. All babies will be dressed as soon as they are up from their sleep and finished their dinner. 3. Staff have taken t his point has been taken on board by all staff and all staff are more mindful of these situations and will not sit in that position whilst a child is at the table. All staff will use adult chairs or couch to sit on whilst feeding the children
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. The service did not ensure that designated fire exits were unobstructed during the operation of the service. This reduced the effective evacuation of staff and children in the event of an emergency. An Immediate Action Notice was issued on the day of inspection to the registered provider for the following reasons. • In the Cot room a child slept in a cot directly in front of the designated fire exit. • In the Wobbler room a child slept on a mattress directly in front of the designated fire exit. 2. Garda vetting was available for four staff members. However, the vetting disclosures were not dated within the previous three years in adherence to with the Early Years Inspectorate Regulatory Notice ‘EYI- RN12.3 Renewal of Garda Vetting. 3. At 10:37am it was observed that while 5 children were present in the Wobbler room, only 4 children were signed in as being present. This reduced the effective evacuation of children in the event of an emergency. 4. Visibility strips were not present on the glass doors in the Baby room, Wobbler room and Toddler rooms. This increased the potential risk to a child of walking into the doors. 5. Adult shaving foam was accessible to the children in an unlocked cupboard in the Toddler room. This increased the potential risk of causing an injury to a child. 6. Amber beads were observed on two children present in the service. This is at variance with best practice guidelines and increased the potential risk of choking to the children. 7. Documentation was not available to demonstrate that parental permission was sought prior to the provision of diluted milk and water in a bottle to a child in the Baby room. 8. A trailing garden hose was accessible to the children in the outdoor area. This increased the potential risk of strangulation of a child. Infection Control: 9. Staff did not carry out the nappy changing as per best practice guidelines, as one staff member did not wear an apron while changing three children’s nappies. 10. Sofas in the Wobbler and Toddler rooms were torn exposing the foam inside. This did not allow for easy cleaning and posed a choking hazard should a child ingest the foam. 11. Individual storage was not available for the storage of sheets used by the children during sleep time in the Toddler rooms. Sheets were stored on the mattresses which were stored on shelves in the care room. This increased the potential risk of cross infection. 12. Soothers were not handled by staff to reduce cross infection, as they were gathered in a pile prior to giving them to each child. Administration of Medication: 13. Prescribed medication was not managed according to best practice guidelines. For example. • Documented pre consent to administer the medication twice daily to a child from the parent was not available. • Staff did not maintain a written record for the twice daily administration of the medication. • The medication was not administrated according to the written guidance available on the prescribed medication. Safe Sleep: 14. During sleep time in the cot room and Wobbler room cots and mattresses were not positioned with the recommended 50 centimetres between each child to enable staff to access children in an emergency and reduce the potential risk of cross infection. 15. Sleep care practices observed during the inspection were not consistent with best practice guidelines and increased the potential risk of causing an injury to a child. For example. • A child aged 1 years of age was provided with a weighted blanket at sleep time. A documented sleep plan and sleep risk assessment that was discussed and agreed with the parents of the child was not available. An Immediate Action Notice was issued on the day of inspection to the registered provider. • A child aged 1 year 5 months was provided with a pillow at sleep time. • Two children were given bottles of milk to drink while lying down in their cots. • One cot mattress did not have a safety label and six mattresses did not have a wipeable cover. • The temperature of the cot room while children slept was not recorded to ensure it was maintained between the recommended 18-220C. 16. An accurate sleep record was not maintained for eight children that slept in the Wobbler room. For example. • Staff did not maintain 10-minute sleep checks to include their colour, breathing and position. • Staff did not record the temperature of the room to ensure that it was maintained between the recommended 18-220C. As a result, the temperature of the care room was recorded as 22.50C at 12:20pm. 17. An accurate sleep record was not maintained for children in the Baby room as one staff member was caring for six children aged from 1-2 years of age. The designated person in charge was available to the staff member, however, ten-minute sleep checks were not recorded from 12:05-12:32pm. Fire Safety: 18. Fire drills were not completed monthly as required. A review of the documentation showed that a fire drill had taken place in February 2024, however, no fire drills took place in December 2023 and January 2024. This reduced the effective evacuation of staff and children in the event of an emergency. Action submitted by the Registered Provider
Provider's corrective action:
In response to the non-compliances observed on inspection the service has stated the following. General Safety: 1. The registered provider responded to the immediate action notice issued to the service on the 22 February with the measures implemented within the service; • The service responded in their corrective action that management have re-arranged the cots in the sleep room, and all are 50cm apart now. Manager has ordered a new smaller space saving cot, which will free up an opening of 84cm which is a larger opening than the actual exit door, which we hope will suffice for now until we are able to reduce our baby-room down to 5 babies instead of 6 at the end of August. • All low beds in the Wobbler room, have been spread out and a max of 10 beds are being used at any one time in order to keep a safe distance and keep exits clear. Wobbler room will be cleared out at nap time every day to allow more space between cats and less obstruction at exit point. 2. Garda Vetting has been updated for all staff. 3. Staff members were reminded about the importance of every child being marked in immediately as they enter the creche. 4. Visibility strips that had worn off the windows have been replaced on all doors. Visibility strips or colourful stickers on glass doors to be replaced as needed. 5. Shaving foam bottle that was used for sensory play has been removed from them room. All staff have been informed that shaving foam not allowed to be used in creche. 6. Amber beads on two of the children were removed and advised parents not to place them on the children as they are a potential choking hazard. Parents have been updated on the review of policies regarding amber bracelets or chains. 7. Manager obtained written consent from parent for her child to be given additional water with milk, however, this has not ceased due to improvement in the child’s condition. 8. The hose in the back garden has since been wrapped up tightly and is no longer a potential hazard. Garden hose retractor pull has been adjusted, so will no longer hang down. Infection Control: 9. Staff have been reminded of our policy on always wearing aprons when changing nappies. 10. All worn and torn Wobbler and Toddler sofas, have been removed from creche and are currently waiting on delivery of new ones. 11. All children’s blankets are stored in individual storage containers to help alleviate this issue. 12. All staff were reminded of our policy and best practice of keeping all soothers separate at all times. We have all soothers stored in separate named and labelled containers. And will be handed out individually going forward. Children individual soothers will be placed in individual containers and placed above babies’ cots after sterilisation. Administration of Medication: 13. The medication consent form has now been re-signed by the parents and daily recording is now being implemented at all times. The parent of this child has also clarified how the medication can be administered. Any change in formula bottle measurements will be documented and signed by parents and kept on record going forward. Outstanding Signed medication form has been signed by both parents and staff attached. Safe Sleep: 14. All cots in baby room have been re-positioned and a smaller cot has been ordered to save more space. Baby room will be reduced down to 5 babies and 5 cots from August /September 2024. Wobbler room will be re-arranged and clear out all moveable furniture, at sleep time every day, in order to allow more space between beds and to keep all exits free from obstruction. 15. In response to the non-compliances the service stated the following. • Weighted blanket that was supplied by a parent, has been removed from the child’s cot. We have advised the parents that upon risk assessment, this was not in accordance with our health and safety policy and best practice guidelines. The parent agreed to remove the blanket from the creche. and the new policy regarding banning of any weighted blankets for children under the age of 3. • As in our current policies and procedures, any child who may have a small cough or a cold, and needs to be slightly elevated, to alleviate symptoms when lying down, may have a small pillow placed under their mattress only. This was corrected on the day of inspection. • The staff were reminded that this is not in our best practice guidelines and policies and procedures, (even when the staff are present in the room at all times) This soothing procedure has been dis-continued with immediate effect. Parents and staff have been reminded and informed that under no circumstances can babies be administered a bottle in their Cot, regardless of staff presence. • All cots have safety labels on them in the cot room and we have ordered wipe-able mattress protectors for all cots mattresses. • All sleep rooms have new thermometers in them, and temperature recording is noted every sleep time in the sleep record sheets. All rooms have been equipped with new thermometers and staff are implementing the recording of full sleep checks and temperature checks in all sleep rooms. 16. The registered provider responded to the immediate action notice issued to the service on the 22 February with the measures implemented within the service In response we have implemented this into our policies and procedures for good practice, going forward. 17. Sleep records will be maintained every 10 minutes in Baby cot room, and written down as we monitor (not to be caught up on at a later stage). Fire Safety: 18. To address this a reminder has been placed on the creche computer as a scheduled fire drill to alleviate any chance of human error/ time lapse. Monthly fire drills are continued in an ongoing with a reminder being set to avoid any time lapses in regularity