Inspection of 23 April 2024 — Inspection Report
Immediate action notice. An immediate action notice was issued to the registered provider on the 23rd of April 2024 following the 2nd day of inspection in respect of Regulation 9(2)(c), Garda Vetting. An adult present on the 1st day of inspection was working directly with the children in the service and a Garda Vetting disclosure had not been obtained for the adult. A response was received from the service on the 23rd April 2024 which sufficiently mitigated the risk identified. On the 31st July 2024 a regulatory compliance meeting was convened with the registered provider to discuss corrective and preventive actions submitted in response to non-compliant findings identified on inspection and outline outstanding non compliances which did not meet the requirements of regulation. The registered provider was afforded a further opportunity to provide a response to the outstanding non-compliant findings the details of which are outlined in the inspection report.
Regulation 9 — Management and recruitment
- (a) (b) (c) (d) The registered provider did not ensure that each employee, unpaid worker and contractor is suitable and competent taking into consideration the nature of the needs of children as follows: - There were no references available for one of the adults. - There was no 2nd validated reference available for 3 of the adults. - Two of the references available for one adult has not been translated by a verified translation service, therefore could not be verified by the registered provider. - International police vetting was not available for 4 adults who required it. - A Garda Vetting disclosure was not available and had not been obtained for one adult. An immediate action notice was issued to the registered provider on the 23rd April 2024 in respect of Regulation 9(2)(c), Garda Vetting. (3) A review of documentation evidenced the registered provider had not taken the required steps as outlined in Regulation 9(2)(a)(b)(c)(d) to ensure that new recruits were suitable and competent before allowing them access to children, as detailed above. (4) There was no evidence available to show that 2 of the adults who were working directly with the children held a relevant major award in Early Childhood Care and Education on the National Framework of Qualifications. The corrective and preventive actions submitted by the registered provider following the previous inspection of the service on the 11 th January 2023 did not prevent the re -occurrence of the non -compliance identified under Regulation 9(2)(a)(b)(3) and (4)
Provider's corrective action:
- The registered provider submitted the following response: Corrective and Preventive Action
- (b) (b) (c) (d) - Garda vetting applied for immediately and the adult in question was only permitted return upon receipt of vetting. - A 2nd reference for three adults now available and validated. The adult with no references has now left the service. - Two references in Spanish have been translated by an official translator. - Two of the staff members requiring international vetting are no longer working in the service. The international vetting for the two other adults has been obtained. (3) Staff relevant documentation list to be used to ensure all relevant paperwork on file. New staff will not be permitted to commence employment prior to reference validation. Staff recruitment policy re-issued to relevant Managers. Check list to be completed/checked before start date given to new staff. (4) One of the adults is still awaiting their full award qualification. The other adult could not get their qualification recognized by the department and therefore will no longer be working directly with the children in the service. To ensure that the service eliminate all non-compliances in relation to new staff required paperwork, the following has been implemented. - updated the recruitment policy which outlines all requirements prior to a staff commencing employment - created an in-depth checklist highlighting all paperwork to be in place prior to commencement - added a note/reminder to the internal google calendar 2 weeks before start date to double check everything in place. - at interview stage new staff will be notified that until all full paperwork in place as per checklist they are not in a position to commence employment
Regulation 19 — Health, welfare and development of child
- Some practices were observed which may negatively impact children’s learning and development, and did not promote the positive health and wellbeing of the children in attendance as follows; 1. The individual sleep needs of a child aged 1 year attending the Caterpillar room were not met on the first day of inspection. A child was observed at 14:25pm asleep in the care room on a staff members shoulder. Staff stated the child had not been offered a sleep that day despite the routine displayed in the care room stating they sleep at 14:00pm. Staff stated during discussions with the inspector that there was no cot available for the child at 14:00, and a cot was still not available. The child remained asleep until 14:50pm in the staff members arms. This is at variance with the safe sleep policy in place in the service. 2. Drinking water was not made available to the children at all times in the 4 care rooms on either day of inspection. Water and cups were taken into care rooms and offered to the children after mealtimes. This non-compliance was identified on the last inspection of the service. The corrective and preventive actions submitted by the registered provider did not prevent the re-occurrence of the non-compliance. 3. Privacy was not afforded to a number of children whilst using the toilet and having their nappy changed as follows; There was no door available on one of the toilet cubicles and the nappy changing unit was not self- contained. Groups of children were taken to the sanitary area at the same time during the inspection. Children having their nappies changed and children who did not require toileting assistance were in view of other children and staff who were washing hands or waiting their turn. 4. Some practices were observed in the Montessori room at mealtimes which were inappropriate and at variance with the healthy eating and behaviour management policies in place in the service as follows; - For a 40-minute period, staff told children who repeatedly expressed they disliked the dinner to remain seated and try it. No alternative food was offered to the children as required. - Fruit and yogurt were offered to some children after dinner. Children who did not eat the food after expressing they disliked it were not offered this. Staff members informed children if they did not eat the dinner they could not have the fruit or yoghurt. - A child expressed they did not want to participate in a numbers lesson prior to snack time. A staff member was observed taking the child’s snack plate from them as they would not participate, resulting in the child becoming upset and distressed prior to an inspector intervening. 5. A child was denied access to the toilet when they informed staff members they required it posing a risk of a toileting accident which could negatively impact the well-being of the child. At 12:18pm in the Montessori room, a child asked staff members if they could use the toilet. During this time the child was observed showing signs of discomfort. The child was informed they had to wait until after circle time, which finished 42minutes later at 1pm. 6. Children in the caterpillar room were provided with small bibs during snack and dinner time. One child’s clothing became heavily soiled with milk and food residue. The child was not changed during the inspection and was placed to sleep in the soiled clothing. 7. There was no opportunity for self-feeding for a child aged 1 year in the Caterpillar room. A staff member was observed holding the bowl and spoon away from the child spoon feeding during dinner. 8. In the small Caterpillar room, two of the chairs’ children sat on to eat were too big and not at an appropriate height for the table. This resulted in children’s knees being at table height and children finding it difficult to eat, having to lean down uncomfortably to the table to eat. 9. The water in the children’s bathroom was not warm to provide comfort to children and allow for effective handwashing. The water was recorded to be 12.7°Celsius during the inspection. The corrective and preventive actions submitted by the registered provider following the last inspection of the service 11th January 2023 did not prevent the re-occurrence of the non-compliances identified under point 2
Provider's corrective action:
- The registered provider submitted the following response: Corrective and Preventive Action 1. The service accept that a cot should have been made available by us. To this end, staff in caterpillar room have been asked to be more conscious of scheduling sleep times and ensuring all children can nap when required. Copy of safe sleep policy to be issued to all staff. Staff to be more conscious of scheduling naps and ensure child is put down prior to falling asleep in a staff member’s arms. 2. Labelled personal re-fillable water bottles have been requested and received for the two older groups. Cups are now available beside the sink for the butterfly and caterpillar rooms. The service will ensure each morning that clean cups are available and remind children that water is there should they need a drink outside of mealtimes. 3. One child to have their nappy changed at a time with one staff member when bathroom empty and no Montessori children using toilet. Montessori children may use bathroom two at a time when no nappies are being changed. When a staff member is changing a baby, they will place a “Busy” cone outside the bathroom door visible to the Montessori children. There will be two toilet flags placed in the Montessori room and each child may place their flag in relevant pocket when they need to use bathroom. This ensures only two children may go to bathroom at any one time. The service are allowing two children per visit which leaves the small “training toilet” free should a child training or who has had an accident need the bathroom. Montessori circle time has focused on how the new rules will apply and the importance of toilet hygiene. - children loved the idea of the “busy cone”. 4. Staff have been asked to limit the time children have their meal in front of them and the service have increased our weekly grocery shop to ensure that additional fruit/yogurt may be offered to those who do not like their meal. It was noted that a child’s snack was taken away from them, which was seen as a punishment. Staff have been spoken to in relation to this incident and re-issued with the service behavior policy. The healthy eating policy has been re-issued to all staff. 5. Staff spoken to in relation to a child’s request to use the bathroom and it was explained that irrelevant to the time of day, all children should be given permission to use the bathroom. 6. Staff in caterpillar room were spoken to in relation to mealtimes and ensuring all children have a suitable bib. However, if a child is soiled/wet after mealtime or throughout the day their clothes should be changed, placed in bag for parents and replenishment requested. 7. It was also discussed that children should be encouraged to eat by themselves. 8. At the time of inspection, the wrong chairs for the children to have at mealtime were in the front baby room. This has been amended and suitable height chairs are now stored in babyroom. 9. Thermostat in bathroom has been raised to ensure warm water available for handwashing. The service will purchase larger bibs to ensure less chance of children’s clothes getting soiled. The service will keep lower chairs out in baby room, stored safely at all times
Regulation 23 — Safeguarding health, safety and welfare of child
- General Safety: 1. The entrance gate to the service was left unlocked and accessible on both days of the inspection for a period of 5 minutes when a staff member left on their lunch. The gate led from outside the service directly into an internal courtyard where doors into the main building and the Treehouse room were unlocked and accessible posing the risk of unauthorised access to the service. The inspectors informed the person in charge at the time of the incidents. 2. The service did not adhere to the re-vetting timeframes as outlined in the Early Years Inspectorate Regulatory Notice, requiring services to renew Garda vetting every three years. 3 staff members working in the service did not have a Garda Vetting disclosure which was dated within the last 3 years. Infection Control: Some practices observed were ineffective for infection control purposes, and posed the risk of cross contamination as outlined below; 3. The handwashing practices observed during the inspection were inconsistent and at variance with the handwashing and nappy changing policies in place as follows; - Some children’s hands were not routinely washed after toileting, after nappy changing, after outdoor play, and before meals. - Some staff members did not wash their hands prior to assisting with food preparation, after nappy changing, and after assisting children with toileting. One staff member was observed changing 5 children’s nappies with no handwashing in between. - Staff members were observed in the Caterpillar and the Butterfly room using a communal towel to dry all children’s hands after handwashing. The towels were not changed throughout the inspection day. 4. The nappy changing practices observed were inconsistent and at variance with the policy in place as follows; - Children were re-dressed by staff members using the soiled gloves which were worn during the nappy change. - Staff members did not routinely clean the nappy changing mat between uses. 5. Plates or bowls were not provided to children for fruit snack. Sliced fruit was placed directly onto the table during mealtimes for children to eat. 6. The bins in place in the service for disposal of waste were inappropriate; - Some lidded bins were in place in the service which were not pedal operated. - Some of the pedal operated bins in place were broken. - Unlidded bins were in use in some care rooms for the disposal of waste and nasal tissues. - Despite a pedal operated bin being in place for nappy changing, staff were observed repeatedly handling the bins lid to dispose of nappies. 7. Four of the shared cot mattresses in place did not have a waterproof covering or a waterproof sheet to prevent cross contamination. 8. The children’s bathroom in the treehouse room had a play kitchen and toys being stored in it, adjacent to the children’s toilet. 9. The children’s play kitchen in the Montessori room was heavily chipped and worn in parts and could not be effectively cleaned. 10. Two soft play cushions in the Caterpillar room and a mat in the Treehouse room were torn with internal foam exposed and could not be effectively cleaned. 11. The straps on three of the children’s feeding chairs were heavily stained, soiled and discoloured and required a deep clean. 12. Groups of children were taken to the communal bathroom/nappy area for toileting and nappy changing which created a number of infection control concerns as follows; - Staff members were observed placing younger children on the floor of the bathroom to wait for their turn for nappy changing. - During this time children aged one year were observed walking in and out of toilet cubicles touching toilet seats and lids and playing with the lid of the nappy bin. Administration of Medication: 13. There was no documented care plan in place for a child attending the service who required an auto adrenaline injector for a severe allergy. A review of documentation also evidenced that no pre-consent or written instruction for administration had been obtained by the service to administer the emergency medication to the child if required. This posed a risk of the child not receiving emergency medication in a timely manner or the incorrect administration of the medication to the child. 14. The record available for the administration of a prescribed medication to a child in the service was incomplete and did not contain the required details to ensure safe administration to the child as follows; - There was no documented consent recorded for the administration of the medication to the child posing a potential risk of the incorrect dosage being administered to the child. - The record contained only the name of the medication given to the child. Details of the child, the required and the administered dose, and the required frequency of the medication was not recorded. Safe Sleep: 15. A standard cot mattress was not in use in one of the cots where a child sleep during the inspection. The mattress in use had no covering around the layered foam material and did not have a recognised safety which may pose a risk of harm to a child. Fire Safety: 16. Fire drills had not been completed monthly in the service as required. Staff members stated an evacuation drill had not been completed since January 2024. This may impede the safe evacuation of children and staff in the event of a fire. The corrective and preventive actions submitted by the registered provider following the last inspection of the service 11th January 2023 did not prevent the re-occurrence of the non-compliances identified under points 2, 3, 5, 9, and 15. Action submitted by the Registered Provider The following response was received from the registered provider:
Provider's corrective action:
- General Safety: 1. Front gate has been replaced with higher and more secure option. A new fence/gate has been erected with “Please close gate” signs in place. Gate is spring loaded with automatic closing and therefore should be no issues with being left open 2. Updated vetting has been submitted. No preventive action submitted. Infection Control: 3. Discussed at staff meeting, along with training and re-issue of hand washing policy which is also on display in bathroom. Managers to supervise/random check staff’s adherence to policies. 4. New policy placed on bathroom wall above nappy changing unit, and as a preventative method an additional staff member will be employed from September 1st to assist with cover for nappy changing but also allow time for managers to supervise/random check staff’s adherence to policies. 5. When children have finished their snack, instead of collecting their empty plates, staff will use this plate to put their fruit on if suitable, otherwise fresh plates/bowls will be given. Additional children’s plates have been purchased and signs placed in each eating area as a reminder for staff in addition to above, manager will now be in a position ratio wise with additional staff to carry out spot checks at mealtimes, which will be logged on google calendar 6. Bins used in each classroom/bathroom have all been replaced with pedal operated bins. The service have placed a “no hands” sign on the top of each lid as a reminder to staff/children. Regular monitoring will take place. 7. Waterproof mattress now purchased for all 5 cots. 8. Treehouse has been cleared out of all toys stored there. 9. Toy kitchen has been removed. 10. Ripped sponges have been disposed on in caterpillar room. 11. Highchair straps have been removed and deep cleaned with a disinfectant. 12. See corrective actions outlined under regulation 19(3). Administration of Medication: 13. Meeting was held with relevant parent and care plan now in place for child who may require epi-pen. Copy of plan now on display in each room. 14. Administration of medicine - discussed at staff meeting and all staff issued with copy of procedures. Safe Sleep: 15. The mattress has been replaced. Fire Safety: 16. It was felt that aside from Manager we should delegate a fire drill officer. This monthly task has been delegated to a full-time member of staff. To ensure the fire drills are carried out monthly, the fire drill officer will have access to google calendar with monthly reminders in place. Manager will oversee completion of task- reminders set in google calendar which will be checked daily by manager
Regulation 26 — Fire safety measures
- The procedures to be followed during a fire drill and in the event of a fire were not displayed in a conspicuous location within the service. Procedures were not displayed throughout the service which could impede the safe evacuation of children and adults
Provider's corrective action:
- A copy of fire evacuation procedures are now in place in each room/area. Fire Drill officer will check to ensure the fire evacuation procedures are still available in each room prior to carrying out monthly fire drill
Regulation 29 — Premises
- (c) 1. There was a malodour present in the children’s bathroom which was also the nappy changing room throughout both days of inspection indicating the ventilation in place was inadequate. (d) 2. The linoleum flooring in the Caterpillars, Treehouse, and Montessori room was heavily stained in parts with areas of black discolouration, indicative of a potential presence of mould. 3. There was no toilet seat on one of the children’s toilets in use. A second toilet seat was loose and moving while children were trying to use the toilet. The corrective and preventive actions submitted following the previous inspection of the 11th January 2023 did not prevent the reoccurrence of the non-compliance under point 2 above
Provider's corrective action:
- The registered provider submitted the following response: Corrective and Preventive Action 1. Instructions have now been placed on nappy changing sheet to remind staff each morning to ensure bathroom window open. 2. The linoleum floor in the caterpillar room will be completely replaced. The dark areas of discoloration on the linoleum in the treehouse will be removed and replaced. The dark areas of discoloration on the linoleum in the Montessori classroom will be removed and replaced. Fitting to be completed within the next week. A dehumidifier will be rotated periodically among the relevant rooms to ensure no damp within the building. 3. New toilet seat purchased and loose one fixed by maintenance
Found compliant: Regulation 11, 16, 25.