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Toilet Training And New To Nursery


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I am moving into the nursery in September so expect me to be on here for lots of advice. I have had my new children in for a visit with their parents and 3 are still in nappies. I have encouraged their parents to train them over the Summer but doubt that in at least two cases this will happen, so my question is: how do you deal with this? If they need changing and training what happens where their are only 2 staff present and both have to be together under CP precedurs when a child is changed?

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As long as staff are police checked you DO NOT have to have two members of staff present when changing a child-it is one of those myths that you do. Just think about child minders-they are police checked and have had OFSTED inspections and they are on their own. Who ensures that they are not abusing children-NOBODY!!!!

It is impossible to have two members of staff present when a child needs to be changed and ensure the safety of all the other children in the setting. As long as you are up front and open about your procedures and have policies in place then you will be OK.

I attended a CP course for designated persons and we were told that we only need to have one person changing a child.

Linda

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Hi,

For a policy consider the following; (off the top of my head and not necessarily in order of importance) It can be added to a toileting policy for all children nappys or not.

 

Aim: to enable children to develop independent toileting skills with regard to hygeinic practice.

 

Working in partnership with parents wishes to promote toileting skills.

Privacy and respect for child

Parents provide own nappys

Permission to administer nappy cream ( parent supply)

Staff supporting children in toilet area CRB checked

Record of nappy/ clothes change kept-date, childs name, time, whether wet/soiled, staff signature.

Health & Hygiene - disposable gloves/apron worn when changing.

Hand washing - anti bac soap, air dyer? paper towel? towels? laundy procedures?

Procedure for storage/disposal of used nappies.

access for children ie: foot stools to enable independence.

Toilet cleaning routine- check list

Procedure for clearing "accidents" within the play areas ( what cloths to use, gloves, disinfectant etc)

No blame attitude toward children who have accidents.

Praise for achievements etc.

 

I hope this helps and I have most probably forgotten something.

Good luck in September.

 

Peggy

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It is our policy that children can only start nursery with us if they are toilet trained. It sounds a little harsh but I don't have the staff ratio to cope with changing nappies.

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Oli

I have been told that to state that I can only accept children who are toilet trained, is discriminating. Up to about three years ago, I used to state the same as you, but I changed it as we now accept children from 2 years old. I ask parents if their child is out of nappies and can use the toilet. If the answer is no, then we work with the parents to promote toilet training both at home and at pre-school. We don't have children in nappies, they are generally in pull ups. We have only had one child who has done a poo in his pull ups a couple of times. (Lucky there!!)

On the occasions when a child needs to be cleaned and changed, up until we broke up for the summer, I have always said that two members of staff should go out. With the discussions here on the forum regarding this topic, and totally agreeing with what was stated (All staff at Pre-school are CRB checked), I told my staff at a meeting last week, that from September just one member of staff should go - unless, of course, it is a real big problem!!!!! ... leaving adequate staff coverage for the rest of the children.

 

Sue J

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to those of you who have seen this, sorry to state this again (put it in another thread) but taken Olis comment felt it was needed.

 

to not change nappies and state that a child must be toilet trained means you are in breach of several national standards..........

3.. care learning and play

7..health

9.. equal opportunities

10.. special needs including special educational needs and disabilities

12.. working with parents

 

A parents complaint to ofsted would cause you lots of problems... you should probably rethink this soon. In fact you are probably very lucky to have got away with it for so long....

 

(we too only have one changing unless in exceptional circumstances.)

 

 

Inge

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On the subject of toilet training - I received through the post, a leaflet entitled "Potty Parties" !!!!

 

It says - "Holding a Potty Party is easy! Just invite parents/carers and their toddlers for a get together to play a few potty games, sing some songs and have some fun" .......(a bit like Tupperware, I think, with a difference!!!

 

I have actually sent off to register with them (Huggies - Pull Ups) I will receive a free kit comprising:

 

Comprehensive guide to running a successful Potty Party in my setting;

Suggested timings, room set up, song words and activity suggestions/sheets:

Party invitation template:

Colourful wall poster to promote my party:

Potty Training Family Strategy Sheets to assist individual parents and practioners in planning and undertaking consistent potty training:

Reward stickers:

Activity sheets:

A set of Guide to Successful Potty Training booklets for each "party goer":

A lively and informative Guide to Successful Potty Training DVD.........

 

The info might be of some help to the parents, I know that it can be a stressful time for some of them. I'll wait and see what the pack contains - I won't hold a "Potty Party" but I will give the sheets out to anyone interested. Perhaps, if one of the parents would like to hold a party then I could give the kit to them to arrange one.

 

For further information call the helpline 0870 240 1640

I love freebies (don't even have to stick a stamp on the postcard, it's postage paid!)

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Oli

 

What do you do if a child has a toilet-based accident and needs a change of clothes at nursery?

 

I'm no expert on the disability discrimination act, but if a parent took you to court on the basis that you were excluding their child because of their individual needs (ie the need to have pull ups or nappies changed during the session), I'm not sure that not having enough staff or facilities would be an acceptable defence.

 

Having said that, if you genuinely feel that in order to overcome these barriers you would need to make more than a 'reasonable adjustment' to your provision, and feel confident in arguing your case, then you should stick by your guns.

 

As Inge says, I would advise that you look at your policy again and see if it is meeting the needs of the children in your group, or if it is leaving your setting open to a discrimination claim.

 

And have you checked with your local Early Years and Childcare Partnership? They may well have a view on this - we have been told in no uncertain terms that we are not allowed to exclude children in this way.

 

I'd be interested to know what you decide to do. Please don't be offended by what I've said - I'm not picking on you: I'm genuinely interested in how different settings approach this vexed topic!

 

Maz

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As Maz said... I also do not want you to be offended but having been in the situation where we had to change policy about 3 years ago now am concerned that you may have problems unless you can really argue the case.

 

we operate as many do in a church hall and have had to find a way to deal with the acommodation we are in. we have a large bag hung in a toilet with all necessary equipment in it for any changing needed... and yes we have to use the toilet floor... only place available!!

As we mostly work to the same adult child ratio (unless very lucky) this in itself was no reason not to change children. It is often easier to change a nappy than a whole set of clothes..

 

Inge

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Hi All

 

I thought you may be interested in this site:

 

http://www.surestart.gov.uk/_doc/P0001663.DOC

 

It discusses the issue of nappies etc and has some interesting facts. Some of particular interest from this document:

 

A3 PROMOTING PERSONAL DEVELOPMENT IN FOUNDATION AND KEY STAGE 1 – CONTINENCE

 

The Disability Discrimination Act (DDA) requires all education providers to re-examine all policies, consider the implications of the Act for practice and revise their current arrangements. In the light of historical practices that no longer comply with new legislation, changes will particularly be required wherever blanket rules about continence have been a feature of a setting/school’s admissions policy. Schools and settings will also need to set in motion action that ensures they provide an accessible toileting facility if this has not previously been available. The Department of Health has issued clear guidance about the facilities that should be available in each school. (Good Practice in Continence Services, 2000).

 

Achieving continence is one of hundreds of developmental milestones usually reached within the context of learning in the home before the child transfers to learning in a nursery/school setting. In some cases this one developmental area has assumed significance beyond all others. Parents are sometimes made to feel guilty that this aspect of learning has not been achieved, whereas other delayed learning is not so stigmatising.

 

Facilities

 

Playgroups and schools are now admitting younger children, some of whom who, by virtue of their immaturity, are likely to have occasional accidents, especially in the first few months after admission. Current DfES recommendations for purpose built foundation stage units include an area for changing and showering children in order to meet the personal development needs of young children. There is also evidence that there is a trend for the parents of children with more complex needs to request a place for their child in a mainstream school. A suitable place for changing children therefore, should have a high priority in any setting’s/school’s Access Plan. The Department of Health recommends that one extended cubicle with a wash basin should be provided in each school for children with disabilities. If it is not possible to provide a purpose built changing area, then it is possible to purchase a changing mat, and change the child on the floor or on another suitable surface. A ‘Do not enter’ sign (visually illustrated) can be placed on the toilet door to ensure that privacy and dignity are maintained during the time taken to change the child. Clean, fresh water drinking facilities should be available at all times.

 

 

Schools and settings should consider the following issues:

 

Health and Safety

 

Schools and all other settings registered to provide education will already have Hygiene or Infection Control policies as part of their Health and Safety policy. This is a necessary statement of the procedures the setting/school will follow in case a child accidentally wets or soils him/herself, or is sick while on the premises. The same precautions will apply for nappy changing.

 

This is likely to include:

· Staff to wear disposable gloves and aprons while dealing with the incident

· Soiled nappies to be double wrapped, or placed in a hygienic disposal unit if the number produced each week exceeds that allowed by Health and Safety Executive’s limit.

· Changing area to be cleaned after use

· Hot water and liquid soap available to wash hands as soon as the task is completed

· Hot air dryer or paper towels available for drying hands.

 

 

Asking parents of a child to come and change a child is likely to be a direct contravention of the DDA, and leaving a child in a soiled nappy for any length of time pending the return of the parent is a form of abuse.

 

 

Child Protection

 

The normal process of changing a nappy should not raise child protection concerns, and there are no regulations that indicate that a second member of staff must be available to supervise the nappy changing process to ensure that abuse does not take place. Few setting/schools will have the staffing resources to provide two members of staff for nappy changing and CRB checks are carried out to ensure the safety of children with staff employed in childcare and education settings. If there is known risk of false allegation by a child then a single practitioner should not undertake nappy changing. A student on placement should not change a nappy unsupervised.

 

Setting/school managers are encouraged to remain highly vigilant for any signs or symptom of improper practice, as they do for all activities carried out on site.

 

 

Agreeing a procedure for personal care in your setting/school

 

Settings/schools should have clear written guidelines for staff to follow when changing a child, to ensure that staff follow correct procedures and are not worried about false accusations of abuse. Parents should be aware of the procedures the school will follow should their child need changing during school time.

Your written guidelines will specify:

· Who will change the nappy

· Where nappy changing will take place

· What resources will be used (Cleansing agents used or cream to be applied?)

· How the nappy will be disposed of

· What infection control measures are in place

· What the staff member will do if the child is unduly distressed by the experience or if the staff member notices marks or injuries

 

Schools may also need to consider the possibility of special circumstances arising, should a child with complex continence needs be admitted. In such circumstances the appropriate health care professional will need to be closely involved in forward planning.

 

Resources

 

Depending on the accessibility and convenience of a setting/school’s facilities,

it could take ten minutes or more to change an individual child. This is not dissimilar to the amount of time that might be allocated to work with a child on an individual learning target, and of course, the time spent changing the child can be a positive, learning time.

 

However, if several children wearing nappies enter foundation stage provision of a setting/school there could be clear resource implications. Within a school, the foundation stage teacher or co-ordinator should speak to the SENCO to ensure that additional resources from the school’s delegated SEN budget are allocated to the foundation stage group to ensure that the children’s individual needs are met. With the enhanced staffing levels of provision within the private, voluntary or independent sector, allocating staff to change the children should not be such an issue, although there may be circumstances within an individual setting that merit an application for additional funding being made through the Early Years Support Link Teacher.

 

Job Descriptions

 

It is likely that most of the personal care will be undertaken by one of the teaching assistants on staff. There are some schools where teachers also take a turn with this task, but we recognise that this does not often happen. Occasionally a setting/school will say that offering personal care is not in the job descriptions of their teaching assistants. It is hard to believe how this could be the case for any assistant working with young children, and we would recommend that this be included at the next review. Certainly any new posts should have offering personal care to promote independent toileting and other self-care skills as one of the tasks.

 

Keys to Success

 

It is not helpful to assume that the child has failed to achieve full continence because the parent hasn’t bothered to try. There are very few parents for whom this would be true. In the unlikely event this is the only reason why the child has not become continent then continence achievement should be uncomplicated if a positive and structured approach is used.

 

Remember that delayed continence may be linked with delays in other aspects of the child’s development, and will benefit from a planned programme worked out in partnership with the child’s parents.

 

There are other professionals who can help with advice and support. The School Nurse or Family Health Visitors have expertise in this area and can support parents to implement toilet training programmes in the home. Health care professionals can also carry out a full health assessment in order to rule out any medical cause of continence problems. The Specialist Community Child Health Services has produced a helpful publication ‘Toileting Issues for Schools and Nurseries’ which you may send for (See Further Information and Guidance) to get additional information on continence issues.

 

Parents are more likely to be open about their concerns about their child’s learning and development and seek help, if they are confident that they and their child are not going to be judged for the child’s delayed learning.

 

 

Partnership Working

 

In some circumstances it may be appropriate for the setting/school to set up a home-setting/school agreement that defines the responsibilities that each partner has, and the expectations each has for the other. This might include:

The parent:

· Agreeing to ensure that the child is changed at the latest possible time before being brought to the setting/school

· Providing the setting/school with spare nappies and a change of clothing

· Understanding and agreeing the procedures that will be followed when their child is changed at school –including the use of any cleanser or the application of any cream

· Agreeing to inform the setting/school should the child have any marks/rash

· Agreeing to a ‘minimum change’ policy i.e. the setting/school would not undertake to change the child more frequently than if s/he were at home.

· Agreeing to review arrangements should this be necessary

 

The school:

· Agreeing to change the child during a single session should the child soil themselves or become uncomfortably wet

· Agreeing how often the child would be changed should the child be staying for the full day

· Agreeing to monitor the number of times the child is changed in order to identify progress made

· Agreeing to report should the child be distressed, or if marks/rashes are seen

· Agreeing to review arrangements should this be necessary.

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Thanks for that Geraldine,

It certainly covers the issue in a professional, common sense way and as I believe with the correct attitude - the child's rights.

 

Peggy

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