Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. The tall shelving unit and lockers in the hallway by the Little Bunnies room were not secured to the wall and were observed to be unstable. This posed a potential injury risk to the children. 2. A trailing flex from the air cooler unit in the Little Bears room was accessible to children in the afternoon and posed a potential injury risk. Infection Control: The following increased the potential risk of infection: 3. The practice for disposing of sanitary waste was not in line with hygienic practice and increased the potential risk of cross contamination. The following was observed: • The lid of the nappy bin was observed to be overflowing as the lid was propped open and was not in use during four nappy changing procedures. This posed a risk of cross infection. • The was no bin liner in use in the bin for used paper towels in the sanitary area between the little Bears and Little Monkeys. 4. The drinking cups used in the Little Bears room were stored directly adjacent to the sink used for the children’s handwashing. This potentially increased the risk of cross contamination. Administration of Medication: 5. See Statutory Notice section in relation to Improvement Notice IN 0344 served. Safe Sleep: The following was not in line with safe sleep guidance and the service policy on safe sleep. 6. A child under the age of two years old was observed to sleep on a sleep mat. Children under the age of two years old require access to a floor bed with a suitable mattress depth of between 6 to 15 cm depth. 7. Although it is acknowledged there were templates available for the daily sleep risk assessment of the sleep environment while children sleep on floor beds, there was evidence that these had not been maintained contemporaneously in a consistent manner. Sleep risk assessments should be completed on a daily basis prior to children sleeping. Fire Safety: 8. The space between the sleeping mats in the Little Bears room and the cots in the Little Bunnies room was not an adequate space to comfortably tend to sleeping children should the need arise. This could impede accessing sleeping children in the case of an emergency. Action submitted by the Registered Provider
Provider's corrective action:
General Safety: 1. The registered provider confirms the shelving unit was removed and replaced with a lower-level unit, the lockers were removed from the hallway and put into the staff room. They will ensure there will be no tall units or lockers in the hallway going forward. 2. Brackets were fitted to secure the wire. Staff were reminded to ensure they inform management to reposition if trailing. Infection Control: 3. The registered provider confirms that all bins have been filled with bin liners for tissues, paper towels and wipes. The lid of the bin in the Bunnies nappy changing area was readjusted. Staff were made aware to use the pedal for the bin to open and close it, to not put the nappy on top but in the bin and pushed down 4. The registered provider confirms that the cups were oved to a different location in the room and staff were reminded to ensure the cups stay at the ‘hydration station’. Safe Sleep: 6. The registered provider confirms there is now a suitable floor bed available and will ensure that children under the age of 2 years will not sleep on sleep mats. 7. The sleep risk assessments were reprinted, and the registered provider reports that staff were reminded to fill the sheets in on a daily basis and will ensure these will be checked by management. Fire Safety: 8. The registered provider confirms the furniture in the Little Bears room was rearranged to ensure in adequate space between each bed and that cots are now spaced evenly in Little Bunnies. They will ensure there will be sufficient space between cots and beds during sleep time
Regulation not named in the report text
(1) The registered provider did not notify the agency of a change in service type. Documentation was available that established that five children had attended the service whilst they were under the age of one year old. The age profile the service is registered for is for children in the 1-to-6-year age range. Acknowledgments The inspectors wish to acknowledge the cooperation of the area manager, person in charge, staff and children who were present on the day of the inspection. Statutory Notices Notice Date Served Detail Improvement Notice IN 0344 13/05/2026 Documentation available and the storage of prescribed emergency medication for four children was insufficient which posed a significant risk of safe administration of medication. Status Action was taken by the person in charge immediately following the issue of the notice and the person in charge submitted a written response which detailed corrective and preventive actions which were accepted by the inspectorate
(4) The was no documentary evidence available to show that one adult who worked directly with children attending the service held at least a major award in Early Childhood Care and Education at Level 5 on the National Qualifications Framework or a qualification deemed eligible
Provider's corrective action:
Corrective action: The service contacted the college where the staff member attended, and the college confirmed the student had completed a relevant course and will receive a provisional statement of results in March. Preventive action: All staff files were checked and updated according to Tusla regulation in regard to childcare qualification
Regulation 19 — Health, welfare and development of child
(1)(b) A child in Little Bunnies did not have their wet clothing changed in a timely manner and was placed in a cot for sleep wearing the wet clothing. This did not meet the child’s basic need for comfort. It is acknowledged the child was changed immediately when the inspector brought it to the attention of the staff member
Provider's corrective action:
Corrective action: Staff were briefed and informed of the issue raised by the inspector of not changing a child’s wet clothing in a timely manner. Preventive action: All staff were informed that children must be checked that they are clean, dry, safe, and comfortable after mealtimes, especially when going to sleep. If a child has wet/food covered clothing it must be changed once noticed, it was recommended to implement delegated jobs to each staff to improve the transition from dinner to sleep time and keep clear communication through the process to avoid children going to bed in wet clothing
Regulation 23 — Safeguarding health, safety and welfare of child
General Safety: 1. There were trailing flexes in Busy Bees and Little Bears which were accessible to children. This posed a potential risk of injury. 2. The water temperature in the wash hand basin used by the children in the Busy Bees room exceeded the recommended temperature of 43oC. A temperature of 44.8oC was recorded by the inspector at 11.01am. This posed a scald risk to the children. Infection Control: The following increased the potential risk of infection: 3. The practice around the cleaning and storage of soothers in Little Bunnies was not sufficient to support appropriate infection control. The following was observed: o A soother which the inspector found in a toy box was given to a child without cleaning. o Soothers were stored uncovered by the sink while hand washing and cleaning of the trays from the highchairs was underway. o A child was observed to take a soother from another and place it in their mouth. o A soother found on the floor was washed under a running tap and staff reported that soothers were steamed every second day. This is not effective cleaning for soothers. Soothers require appropriate storage and effective cleaning procedures must be in place to reduce the potential risk of infection. 4. The practice around the use of nappy creams was not sufficient to support appropriate infection control. Nappy creams were not individually labelled in Busy Bees, Little Bunnies and Little Monkeys. There was a risk staff could use an incorrect cream on a child, thereby increasing the risk of cross contamination. 5. The following impacted on appropriate infection control in the sanitary areas: o The paper towel for hand drying in the sanitary accommodation off Little Monkeys was not hygienically dispensed and required repeated hand touch. o There was no paper towel directly accessible in Busy Bees sanitary accommodation, and the children were observed to use paper towel in the care room which was not hygienically dispensed. This was identified as a non-compliance on the last inspection held on the 7 February 2024 and actions put in place failed to prevent a recurrence. o The toilet roll in Busy Bees was not hygienically dispensed. This increased the potential for cross contamination. Administration of Medication: 6. The emergency medication for a child was out of date. This could reduce the effectiveness of the medication and was not in line with safe practice. Action submitted by the Registered Provider
Provider's corrective action:
General Safety: Corrective actions: 1. The trailing flexes were in both rooms were secured and are now inaccessible. 2. The temperature of the water was adjusted to not exceed 43 degrees Celsius. Preventive actions: 1. In the Busy Bee room, a standing table for the staff has been moved over to the plug sockets where there is a safe, non-accessible area from the children where tablets can be charged and speakers plugged in. Conduit boarding was installed to cover the trailing flexes in the Little Bear room where staff plugged in chargers and a small disco light. A small shelf was installed to keep the tablet/disco light in a safe secure place. 2. The service ensure water temperature will be checked twice a day for the forthcoming week to ensure it has stayed at the correct temperature as in accordance with Tusla regulations. Infection Control: Corrective actions: 3. Staff were informed of the issues raised and briefed on safe practice surrounding infection control; staff were informed if a child’s soother comes into contact with an un-sanitized surface it must be disinfected before being given to the child. 4. Nappy creams were labelled with the children’s full name and put in the child’s corresponding shelf with their nappies and wipes in the changing rooms. 5. Staff were informed to encourage the children and provide support for them to take their own piece of tissue and not rely on the staff to tear a piece off and hand it to them. Paper towel and refills have been placed within both care room and sanitary accommodation. Preventive actions: 3. The service will ensure that all soothers are now placed in appropriate storage; a labelled box with each individual child’s name, stored above the sink in a designated soother box on a shelf. Soothers will be sterilised every day at the end of the day in a ‘soother tree’ that can be placed in the dishwasher. Staff were informed going forward babies should only have soothers during sleep time, teething or if upset, otherwise throughout the day, the babies do not need them. 4. The service will ensure all creams/wipes/nappies will be recorded on a sheet with the date it was handed in and the name of the child of who it belongs to. All staff were informed all creams must be labelled with the child’s full name to prevent cross contamination and improve infection control within the room. 5. The paper towel used for hand drying in the Little Monkeys is stored in a handheld casing by the staff where the children can take off their own piece of paper tissue. A paper towel holder has been installed in the Busy Bees sanitary accommodation at a height accessible to children in both care room and toilet area. The toilet rolls in the Busy Bee sanitary accommodation have been placed on a handle where the children can rip off their tissue without picking up/handling the roll of toilet roll to improve infection control. Administration of Medication: 6. Corrective action: The out-of-date emergency medication was returned to the child’s parents, and a new in-date medication was provided. Preventive action: All care plans were updated in terms of medication both daily and in case of emergencies. More frequent check-ups of twice per month on medication dates have been implemented. All care plans have been updated, and expiry dates of each medication has been added
Found compliant: Regulation 11, 16, 21, 25.
Inspection of 15 February 2024 — Inspection Report
Regulation 16 — Record in relation to pre-school service
(j) Following a review of a sample of 15 records of the administration of medication, the registered provider did not ensure a full record in writing was maintained. For example: o Nine of the 15 records reviewed did not have a record of the signature of the parent acknowledging the child had received the medication. The record keeping system used for these records did not allow for this to be recorded. o In three of the 15 records reviewed, the surname of either the child or the staff was not recorded. o In two of the 15 records reviewed, the date of the administration of the medication was incomplete. Accurate and complete records must be maintained to support the safe administration of medication
Provider's corrective action:
Corrective Action Staff Training has been updated for all staff regarding the use of medication and filling record forms. The service has replaced all old record forms with new updated medication forms which parents complete and sign. Staff have signed off on these new changes. Preventive Action New documents are now in place, regular training, Management to regularly check
Regulation 19 — Health, welfare and development of child
1. The registered provider did not follow their service policy on behaviour management to support children to positively regulate ongoing unwanted behaviours effectively. A review of documentation showed a trend of ongoing challenging behaviour. There was no documented review of a programme of care, there was no documented behaviour support plan developed in line with parents, and no documented risk assessments put in place. This was not in line with the service policy and can negatively impact a child’s successful engagement in the daily experiences of the service. 2. Documented individual care planning for children who had additional care needs was not maintained and reviewed on a consistent basis. o The was no documented care plan available for a child who had additional care needs. Individual care plans detail the child strengths, challenges, and goals. These allow for the monitoring and evaluation of practices which can support the child within the service and assist in identifying additional resources and supports for the child
Provider's corrective action:
(1)(a) Corrective Action 1. The service updated their Behaviour management policy and included a step-by-step plan on how to deal with ongoing challenging behaviour for staff to follow . T hese steps include strategies for working with children and communicating with families. The service has also introduced a risk assessment for ongoing challenging behaviour. 2. The service has held meetings with staff to develop care plans for children who may require them. These detailed the child’s strengths and challenges, and specified goals were identified . They have also introduced a diary for children who may have additional care needs where information on the child’s day is detailed. This is shared between the home and the service to develop communication with families. Preventive Action 1. The service commits to follow their policy and procedures and step by step guidance, including developing a behaviour management plan and risk assessment and to document all meetings and plans. 2. The service commits to monitoring, evaluating and reviewing these goals every two months, with a focus on what works well and what doesn’t for each child. They will also update required equipment for the child’s needs
Regulation 23 — Safeguarding health, safety and welfare of child
Infection Control: The following increased the potential risk of infection: 1. Hand drying facilities throughout the service were not appropriate to support effective hygienic practice. The paper towels used to dry hands were not hygienically dispensed, and the paper roll available required repeated hand touch. This increased the potential for cross contamination. 2. The nappy changing practice was not carried out according to the service nappy changing procedures which were displayed in the room and as a result posed a risk of cross-contamination. The following practices were observed: o The gloves used for nappy changing were not appropriate. They were of a polyethylene material and there was a risk they would leak or tear. o The same apron, which was torn, was retained for the duration of four nappy changes. o The clean nappy was placed under the child prior to the child being cleaned. o The gloves were not removed prior to the child being dressed and were worn to support the child during hand washing. o Repeated hand touch of the lid of the bin was observed during the disposal of the soiled nappies. o The changing mat was not consistently cleaned after each nappy change. Administration of Medication: 3. The administration of medication was not sufficient to support effective safe practice. For example: o It is acknowledged care plans were available on file for children requiring medication, however the procedures for when to administer medication were not clearly outlined in these care plans. Individual care plans with easy-to-read procedures were not displayed in the care rooms. As a result, staff were not aware of the practice around the administration of a medication of a child who required a specific medication. o The details of the consent and dosage for two medications were detailed on the one consent sheet for one child. There was a risk the dosage could be mis-read. The consent and details for how to administer the medication must be clearly detailed for each medication. Safe Sleep: 4. Sleep practices were not in line with current safe sleep guidance. The following practices were observed: o Children under two years old were observed to sleep on sleep-mats which were placed directly on the floor. These are not suitable sleep facilities for children under two years old. o There was no agreed sleep plans available with a risk assessments in place. A sleep plan, incorporating a risk assessment of the sleep environment should be completed before moving a child from a cot to a sleep-mat. It is acknowledged that the registered provider is in the process of updating the service safe sleep policy in line with current best practice and sleep plans for use with under twos were under development and draft copies were available for review but were not in use. It is also acknowledged that the service is awaiting the delivery of new appropriate sleep mats for under two’s which had been ordered on the 8 January 2024. Action submitted by the Registered Provider
Provider's corrective action:
Infection Control: Corrective Action 1. All Blue hand roll dispensers have been serviced, filled, and blue roll properly inserted. 2. All polyethylene gloves have been replaced with appropriate ones. Staff in question were given retraining on the steps of how to change a nappy correctly. Preventive Action 1. Blue hand roll dispensers will be used correctly. 2. Correct equipment has been put in place for nappy changing use Administration of Medication: Corrective Action 3. The service has updated care plans for children requiring specific medication including specific details, when and why the medication needed and where it is stored. Meetings were held with staff on the procedures of administering different types of medication. Each updated care plan is displayed in every room. The medication administration forms have been updated to correctly detail specific medication. Preventive Action 3. The service commits to keeping care plan updated on a regular basis, to check expiry dates on all medication, to keep staff updated on training and to get as much information from parents regarding children requiring medication. Safe Sleep: Corrective Action 4. Appropriate new mats, cocoon beds have been delivered and are in full use for children under 2 years old in the service. Safe Sleep policy was developed for children under two years old with a risk assessment maintained on file. Preventive Action 4. New mats are in use in line with new safe sleep care plan and risk assessment is updated on the policies
Regulation 32 — Complaints
The registered provider did not ensure the following: (2)(b) Although it is acknowledged that there was a record maintained of a complaint that was made. Following discussion with staff and a review of documentation the inspector found that a complaint was not dealt with in accordance with the service complaints policy. o There was no evidence of an acknowledgement that a complaint was received with an agreed timeline of a response given. o There was no evidence of an investigation to see if service policy had been breached. o There was no record maintained of meetings and agreed decisions. (3)(a) Although it is acknowledged that all records were made available to the inspectors, a complete record in writing was not maintained of the way the complaint was dealt with. The record reviewed did not demonstrate that complaint made had been closed out. There was no final review with the outcome recorded and recommendations including any required changes to policy in line with the service policy
Provider's corrective action:
Corrective Action (2)(b) The service has reviewed and updated their Complaints policy. They have developed a step-by-step guidance on how they deal with complaints. (3)(a) The service developed a review on how they dealt with complaints. Preventive Action (2)(b) The service complaints policy has been updated. Following any complaints; the service commits to follow this and other relevant policies. All complaints made will be documented, with a time frame of 10 working days response. All parents are to receive a copy of the new complaints policy. (3)(a) The service complaints policy has been updated. Following any complaints; the service commits to follow this and other relevant policies. All complaints made will be documented, with a time frame of 10 working days response. All parents are to receive a copy of the new complaints policy