Guest Posted December 31, 2008 Share Posted December 31, 2008 Hi all, I work in an LEA Nursery and we recently had a shower installed for 2 Primary aged children in the school who had a medical complaint and therefore had frequent 'accidents' and were able to clean themsleves up. Now we have to write a policy about the use of the shower and the matter of changing children has also been mentioned as we do not have a policy for this either. We currently have 1 child who sometimes poos in his pullups and currently we call his mother to come and change him. We also have some other children, all 3 years old, who wear pull ups and wet themselves while at nursery. Our sessions are 2 1/2 hours long so we don't currently change these children. Obviously we do have the facilities to enable us to change children but I really don't want to have to change them and if I refuse to do it I don't see how I can ask any of my staff to either. I have been told that we should change children otherwise we are risking falling foul of the disabilities and inclusion act but none of these children have a physical problem. Please can anyone advise me whether I have to change these children or not. Link to comment Share on other sites More sharing options...
Cait Posted December 31, 2008 Share Posted December 31, 2008 Why wouldn't you change them? Don't you have parental permission? We regularly change ours, have about a dozen children in nappies or pull-ups and we change them as a matter of routine, especially if they are soiled. Parents are at work so we couldn't call them in anyway - and it would be unfeasible to do so. Link to comment Share on other sites More sharing options...
HappyMaz Posted December 31, 2008 Share Posted December 31, 2008 I have been told that we should change children otherwise we are risking falling foul of the disabilities and inclusion act but none of these children have a physical problem. Please can anyone advise me whether I have to change these children or not. I agree that if you are not prepared to change children's nappies/pull ups or deal with toileting accidents to children who have not quite mastered using the toilet yet then you can't expect your staff to either. However as I understand it your setting is indeed at risk of being accused of discrimination by refusing to change children. As I see it the terms of the disability legislation is fairly broad and gives all settings a statutory responsibility to meet children's individual and additional needs and not just learning or physical disabilities. We were given this directive very firmly by our LEA some years ago and so we changed our policy which was similar to yours in that we would always call a parent to deal with a dirty nappy. I would have assumed that your LEA would advise the same thing - although perhaps given your current policy! All this said, I don't have a nappy changing policy as such although its on my 'to do' list... Someone will be able to help though! Maz Link to comment Share on other sites More sharing options...
narnia Posted January 1, 2009 Share Posted January 1, 2009 I'm sorry,I don't understand why you wouldn't change the children's nappies.Whyever not??it's part and parcel of the job, and to be honest I think it would be awful to knowingly leave a child in a wet or soiled nappy, for any length of time.And no member of staff should be excluded form the job of changing children, unless they do not yet have crb clearance.........and I'm afraid that includes you Susie! As to calling a parent to come and change a nappy.......................my parents would vote with their feet if we tried that, and I think they'd be right.It doesn't matter whether the children have a disability or not, they are simply at the stage they are at and need to be dealt with appropriately, in other words, you have to meet their needs. Link to comment Share on other sites More sharing options...
Guest Posted January 1, 2009 Share Posted January 1, 2009 I agree with Narnia; why would you leave a child in a soiled or wet nappy? And why would you call a parent to change it? It is, or should be, part and parcel of our job!! Link to comment Share on other sites More sharing options...
tess Posted January 1, 2009 Share Posted January 1, 2009 Hi sorry i totally agree that children should be changed - I've just brought the new PLA policy book as I wanted to ensure mine are all in line with EYFS. There recommended nappy changing policy has the statement "if young children are left in a wet or soiled nappies/ pull ups on the setting this may constitute neglect and will be a displinary matter. Settings have a duty of care towards childrens personal needs. I would recommend you lead by example and get involved with changing your key children- it's a fab time to talk, sing and enjoy rhymes' with the children. Link to comment Share on other sites More sharing options...
Phoebe123 Posted January 1, 2009 Share Posted January 1, 2009 Hi Everyone and Happy New Year to you all, I totally agree, nappy changing, toiletting etc. all come within our remit and I agree, it is best to lead by example. I found a really good sheet on here the other day with nappy changing and toiletting in continous provision under the four themes of the EYFS. It will give you some inspiration I am sure! I'll come back to you with the link if you can't find it. Good luck! Lesley Link to comment Share on other sites More sharing options...
Cait Posted January 1, 2009 Share Posted January 1, 2009 Here it is Nappy_changing_from_FSF.doc Link to comment Share on other sites More sharing options...
Phoebe123 Posted January 1, 2009 Share Posted January 1, 2009 Here it is Hi, thanks Cait - still looking around in a daze! Link to comment Share on other sites More sharing options...
julie 12 Posted January 1, 2009 Share Posted January 1, 2009 I think the differences between maintained and private nurseries are hightlighted here, it has always been part of the nursery staffs role to change nappies in daycare settings, but not in my local maintained nurseries where in the past children have not been admitted until they were fully toilet trained. Now that they are taking in younger children and in line with EYFS I presume that they are now willing to do this. Reception classes still change wet accidents but send for the parent for soiling. many of my colleagues in maintained nurseries have issues around admitting children in nappies as they have a 1to 13 ratio and changing children takes them away from the classroom. Julie Link to comment Share on other sites More sharing options...
Guest Posted January 1, 2009 Share Posted January 1, 2009 Doesn't really matter what the ratio is; any nappy changing takes the adult away from the children doesn't it? Legality aside surely our caring nature wouldn't allow us to leave children in wet or soiled nappies? How would you feel if your child was left or you were called from work to change them? Link to comment Share on other sites More sharing options...
HappyMaz Posted January 1, 2009 Share Posted January 1, 2009 Doesn't really matter what the ratio is; any nappy changing takes the adult away from the children doesn't it? I was just thinking about what happens in a setting such as Julie described when there is an accident that necessitates first aid being given? Presumably this would reduce the ratios too but there wouldn't be a suggestion that a parent would be called in to deal with it. Ultimately settings must organise their staffing so that all safe and appropriate ratios are maintained which allow for toileting accidents and other incidents to be handled. There is always potential for difficulty here - even in a setting like ours that works with at worst a 1:6 ratio this can be compromised if we have a child needing to be changed at the same time as a child needs first aid attention. Throw in a visiting parent to the mix and you get the picture! This is one of those issues that needs to be clarified and probably the only way we'll get a definitive answer is by establishing case law. So basically we need a parent to take legal action against a setting that either refuses to enrol a child because they are still in nappies or pull ups, or refuses to change their nappy when necessary. Finally I also wonder what sort of message it sends to the child when their parent is called in to change a nappy or deal with a soiling accident? I can only begin to imagine what a child would be thinking whilst sitting waiting for their parent to arrive to change them, especially if they know that mum/dad or whoever has been called out of work to do so. What pressure to put a child under. Maz Link to comment Share on other sites More sharing options...
Cait Posted January 1, 2009 Share Posted January 1, 2009 That's a good point, HappyMaz. I was looking at it from the adult's perspective - Dad being called out of a board meeting and trying to explain to his boss where he was going and why ......... Link to comment Share on other sites More sharing options...
julie 12 Posted January 1, 2009 Share Posted January 1, 2009 In our maintained nursery classes its usually the school secretary who deals with the first aid if it needs more than a clean up!!!I am aware that many local nursery teachers do not see changing children as part of their role this is because when they were first appointed they only took children who were rising 4 just for 3 terms before they started school. When I opened my pre-school 18 years ago I was the only one in our area that admitted children in nappies!! My middle child only got in his pre-school on the last minute as I didnt put him under pressure to be toilet trained by 2years 9months.... I was made to feel quite uncomfortable at the time so I was definately not going to put any other parents and children in that position. I agree with Maz its unacceptable to put a child under this kind of pressure , as younger children are being admitted into maintained nurseries ( some as young as 2) there will need to be a rethink about the policy regarding nappy changing in some settings. Julie Link to comment Share on other sites More sharing options...
HappyMaz Posted January 1, 2009 Share Posted January 1, 2009 When I opened my pre-school 18 years ago I was the only one in our area that admitted children in nappies!! I can well imagine Julie - you were clearly ahead of your time! Link to comment Share on other sites More sharing options...
Phoebe123 Posted January 1, 2009 Share Posted January 1, 2009 Hello again, This is all very interesting! We have lots of three year olds who are not fully out of nappies, or if they are, they often have 'accidents' necessitating 1-1 care from the team of staff. This often means a more highly qualified member has to do it, as we have quite a few trainees, who not only can't do nappies, but can't be left unattended either. Which reminds me, if you have to go and change nappies or clothes, you also need to ensure that you are not on your own with a child. Lots to consider! I have to add that my colleagues and I have noticed an increasing amount of our pre-schoolers are unable to 'sort themselves out' after toileting and we have a lot of 'accidents'. Has anyone else noticed this? You could write a thesis on all this! PS: What do you do about admininstering medicines? That's another thorny issue! Link to comment Share on other sites More sharing options...
HappyMaz Posted January 1, 2009 Share Posted January 1, 2009 Which reminds me, if you have to go and change nappies or clothes, you also need to ensure that you are not on your own with a child. Lots to consider! At the risk of opening another can of worms, do you mean that you can't be alone with the child you're changing? I am deeply uncomfortable with the idea that people have to be supervised or have 'witnesses' when they change children - it turns what should be a natural part of our relationship with children into something else entirely. Sorry if I have misunderstood! Maz Link to comment Share on other sites More sharing options...
Guest Posted January 1, 2009 Share Posted January 1, 2009 Which reminds me, if you have to go and change nappies or clothes, you also need to ensure that you are not on your own with a child. Lots to consider! Surely this is not necessary unless the person is NOT CRB'd?? Otherwise what is the point of having these checks???? Link to comment Share on other sites More sharing options...
Cait Posted January 1, 2009 Share Posted January 1, 2009 Big O make it quite clear that ONE CRB cleared person changes a nappy, or cleans a soiled child. This is to respect privacy for the child. We have a changing book and the person who changed fills in the information (soiled, wet etc and if any of our clothes are borrowed, or nappies used) and it's countersigned by another member of staff. Parents sign this too to acknowledge clothing borrowed. For babies who have regular changes and provide their own nappies etc, we have a different book which just logs the change in case mum asks, 'when was she changed last?' and we can just tell them Link to comment Share on other sites More sharing options...
Guest Posted January 1, 2009 Share Posted January 1, 2009 Thanks everyone for your replies. I think that you're right, there has always been a difference between maintained and private nurseries, principally because we only accept children from 3 years old and they are normally toilet trained by then and also we only have 2 1/2 hour sessions, not all day sessions. I agree that it does seem to be becoming more common that 3 year olds have not been toilet trained. With regard to calling parents to change soiled nappies, we have only had to call one parent, but this parent has been called fairly regularly. She has never minded coming and I would say that a willing parent changing a child respects his privacy. (BTW 95% of our parents are unemployed so it has never arisen that we have called a parent to come from work). I can cope with wet nappies no problem but I am just really squeamish about dirty ones. With regard to the matter of changing children alone, we have been told it is preferable to have another adult observing but it is not always practicable. This does concern me as we have some very 'aware' children, one child has already accused a staff member of hitting him (this didn't happen but the child was going though a pretty traumatic time and has since been placed in care) and we have had children in the past simulating sex acts. I feel that we would be placing ourselves at risk if we don't have a second adult observing but it just isn't possible as it means that the rest of the class would be unsupervised. I guess really I will just have to be guided by the parents wishes, if they are happy to be called to change a dirty nappy - great, but otherwise I'll just have to face it, as you say it's part of the job! Thanks everyone and Happy New Year - Have a great 2009. Link to comment Share on other sites More sharing options...
Phoebe123 Posted January 1, 2009 Share Posted January 1, 2009 At the risk of opening another can of worms, do you mean that you can't be alone with the child you're changing? I am deeply uncomfortable with the idea that people have to be supervised or have 'witnesses' when they change children - it turns what should be a natural part of our relationship with children into something else entirely. Sorry if I have misunderstood! Maz Hi Maz, I totally agree with you, but we were told that we should not put ourselves in an awkward position and we are never completely on our own with a child. So we always leave a door open, and tell someone that we are going to change a child, so that others are aware. We do not actually supervise one another, but being aware means we can support if need be. We were informed that it was to safeguard ourselves as much as the children. Thanks for asking! Lesley Link to comment Share on other sites More sharing options...
lynned55 Posted January 3, 2009 Share Posted January 3, 2009 We were told by OFSTED (some years ago now) that the only circumstances it would be acceptable to call a parent back to change a child would be if that child refused to let us do it (and then only if we had exhausted every bit of persuasion we had} This is even if the parent was happy/willing/offerred to come back and do it. They said that it ws wrong of us to assume that parents were by the side of a phone available or willing to come back!! We're a sessional group open for 3 hours a day. Link to comment Share on other sites More sharing options...
Chill Posted January 3, 2009 Share Posted January 3, 2009 I have to say I am quite shocked to see this discussion taking place. It was many many years ago that our area SENCO and LEA advisors clearly instructed that all children regardless of stages of toilet training should be equally admitted and fully cared for. I find it so hard to believe that parents are being called in to change the nappy of a three year old. The role of early years workers includes all aspects of care and if a school operates a nursery with QTS then the care of children has to be to the same high standards as the private sector. Sorry! Link to comment Share on other sites More sharing options...
Guest Posted January 3, 2009 Share Posted January 3, 2009 Hi all, I work in an LEA Nursery and we recently had a shower installed for 2 Primary aged children in the school who had a medical complaint and therefore had frequent 'accidents' and were able to clean themsleves up. Now we have to write a policy about the use of the shower and the matter of changing children has also been mentioned as we do not have a policy for this either. We currently have 1 child who sometimes poos in his pullups and currently we call his mother to come and change him. We also have some other children, all 3 years old, who wear pull ups and wet themselves while at nursery. Our sessions are 2 1/2 hours long so we don't currently change these children. Obviously we do have the facilities to enable us to change children but I really don't want to have to change them and if I refuse to do it I don't see how I can ask any of my staff to either. I have been told that we should change children otherwise we are risking falling foul of the disabilities and inclusion act but none of these children have a physical problem. Please can anyone advise me whether I have to change these children or not. To return to the original question I would say, Yes, you do have a duty to change children's nappies. The DDA makes it clear that asking parents to return to change their child's nappy is also in contravention to the act. There's another thread running under 'child initiated learning' which has a link to the PLA newsletter which sets out quite clearly what your policy should be on this matter that may be helpful to look at. Link to comment Share on other sites More sharing options...
Rea Posted January 3, 2009 Share Posted January 3, 2009 I always view these kinds of things in the context of my own children. Would I want my children to sit in a dirty nappy while the setting got the contact list out, phoned me, possibly having to track me down in the building I worked at, and then wait for me to travel? The answer is no. I'd be furious if my child was treated that way. Would we do that to an adult? In all the settings I've worked in nappy changing is top priority. Above planned activites, above lunch and snack that might be on the table, above anything else. Othe members of staff are summonded if the ratios are poor. Link to comment Share on other sites More sharing options...
tess Posted January 3, 2009 Share Posted January 3, 2009 Totally agree Rea - the whole reason I am working in early years is my eldest son's pre-school would only let him join if I stayed in-site so I was ready to change him - he was nearly 3 1/2 when fully toilet trained. He just wasn't ready and had no idea what went on down there ! So (stupid) but caring mum me stayed for 6 months in a nearby room - with my other young child twice a week - looking back I was totally mad. Why did I do this and knowing what I know now - why didn't I just take my son somewhere more caring. What good did it do me? ( never got that much needed break as a new Mum I needed and I was not able to spend time with my youngest son) and as for my eldest - he quickly worked out I was there and never settled. On the fab side - i was so appalled at the practice and worked out it was wrong, I got involved and changed it. But why should I have had to do this, we are a caring profession. Toileting is a basic need for young children and I would say (and I know I will upset some) that if staff are unwilling to change nappies - they are in the wrong job. How can we say we care for young children, but not the nappy end - we can't say we will cover CLL but not physical development. So how can we pick and choose which part of the care we do! It's only a nappy! Please think of the parents and the children - sorry I know this will upset some people and you may have different views. But I know how wrong the practice i encountered was for my family. Ouch I am being harsh - but have firm beliefs on this. Link to comment Share on other sites More sharing options...
Cait Posted January 3, 2009 Share Posted January 3, 2009 Does it actually suggest that the practice in PVI is of a higher standard than maintained sector? I'm sure that this isn't the case, but reading through the threads it seems that PVI have been changing nappies for longer than the maintained sector? Plus there are issues with ratios somewhere, for the maintained sector, if they have ratios of 1:13 then it would make it more difficult for one adult to be absent, whereas in PVI our ratios are lower so it's easier. I do see how it's harder in Nursery but it should still be possible, and maybe ratios need to be re-looked at by Department of Carpets and Soft Furnishings. Of course this would mean changes to funding to allow for funding of additional staff ........... Link to comment Share on other sites More sharing options...
HappyMaz Posted January 3, 2009 Share Posted January 3, 2009 Does it actually suggest that the practice in PVI is of a higher standard than maintained sector? Oh dear now I have to be less diplomatic than usual Cait. I don't think we can make that kind of assertion (or even raise the question) based on a conversation between a variety of practitioners from a variety of settings. We each face our own pressures caused not only by the circumstances we operate under but also the historical factors which underpin our practice. I don't think one kind of setting can lay claim to being the sole arbiter of what consitutes good practice: its all around us and everywhere. As indeed is practice which is sadly in need of improvement. Sometimes even in the same setting! Maz Link to comment Share on other sites More sharing options...
Cait Posted January 3, 2009 Share Posted January 3, 2009 Well of course! I was only playing devil's advocate after reading through the threads. No offence meant of course - and hopefully none taken! Link to comment Share on other sites More sharing options...
HappyMaz Posted January 3, 2009 Share Posted January 3, 2009 I was only playing devil's advocate after reading through the threads. Tsk! You know that's my job! Link to comment Share on other sites More sharing options...
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