Exclusion Policy (Sickness and Infection)

Bijou Nursery operate a strict exclusion policy in relation to all staff, volunteers and children who have encountered an infectious disease. Both staff and children must stay away from nursery for the minimum periods set out in the table below for each infectious disease.

The reason for these is exclusion is to help to isolate the infection and prevent others from contracting it and risking an outbreak throughout the nursery, it is also appropriate that people who have been sick take adequate amounts of time to recuperate and regain their strength and bring their immune system back to a strong level.
If children are unwell and have visited a doctor who has prescribed medication for an illness, sickness or infection, children should stay off nursery for a minimum of 24 hours after beginning the medication. However, children may need to stay off for longer, depending on the specific condition. The table below sets out these minimum periods.
Bijou Nursery aims to promote a healthy environment for the children in our care and we need your co-operation to support this.
If parents/carers notice their child becoming ill or infectious they must inform the setting and they must have regard to the exclusion list below.
If a child becomes ill or infectious at the setting, every effort will be made to contact the parents/carers. It is essential therefore that the setting has up to date information in order to be able to contact the parents/carers during settings hours. If the parent/carer cannot be contacted, setting staff will endeavour to contact the other named contacts on the child’s record
If the setting is unable to contact a parent/carer or other named contact, Bijou Nursery reserves the right to take the child to a general practitioner or hospital in an emergency. Parents/carers will be required to give signed consent for this procedure on registering their child at the setting.
If we have an outbreak of infections or diseases such as chicken pox, scabies, ringworm, hand foot and mouth or impetigo within the setting all parents attending will be notified of these and provided information about the infection and how to identify or minimise the risks. Head lice will also be notified to parents/carers as a way of minimising the risk of spreading around the setting.

All areas will be deep cleaned as a risk control to avoid spreading. Any children with a medical issue their rights to confidentiality will be maintain and a notice will be passed to others as precaution.
Staff/parents will also be informed due to complications during any pregnancies or health issues which may be affected e.g., chickenpox and pregnancy.

Notification of exposure to infectious diseases, illness /infectious diseases:

Period of exclusion:

Chicken pox - 5 days after the onset of the rash AND until all blisters have crusted over.

Conjunctivitis- 24 hours.

Diarrhoea and /or vomiting- Children and staff should be excluded from the setting until their symptoms have settled and until 48 hours after the last episode of diarrhoea or vomiting.

Diphtheria – must not attend setting. Always consult the Health Protection Team.

Flu (Influenza) – Remain absent for 5 days after onset of symptoms. Can return when no longer symptomatic. Cases who are unwell and have a high temperature should stay at home and avoid contact with others where they can. Can return to setting when they no longer have a high temperature for 48 hours and they are well enough to attend.

Glandular fever- There is no benefit in keeping children or staff off once they feel well enough to attend.

Hand, foot, and mouth (Coxsackie Viral Infection) – A child who has been diagnosed with hand, food and mouth will need to remain absent for 24 hours or until they are well enough to attend following their exclusion period.

Head lice-None. Treatment is recommended only in cases where live lice have been seen. Please visit your local Pharmacist for advice and treatment.

Hepatitis A - Until the child feels well or until 7 days after the onset of jaundice, whichever is the later.

Hepatitis B- Children who develop symptoms will be too ill to be at the setting.

Hepatitis C- Usually no symptoms but care must be taken with bodily fluids if person is known to have Hep C. HIV /Aids, should not be restricted or excluded.

High Temperature/fever – 48 hours after temperature/fever has gone

Impetigo - Remain absent until affected areas are crusted and healed, or 48 hours after commencing antibiotic of treatment. If there is an outbreak, stop using sand, water, playdough and cooking activities and wash all dressing up clothes. (An outbreak is 2 or more cases.)

Measles – yes, until 4 days after the onset of the rash, 1st day of rash is classed as day 0.

Mumps- the child should be excluded for 5 days after the onset of neck/jaw swelling.

German Measles (Rubella)- for 4 days after onset of the rash and whilst unwell.

Meningitis Viral - Children will be too ill to attend and there is no need to exclude siblings or other close contacts.

Meningococcal Meningitis/Septicaemia – remain absent until they have received the appropriate antibiotic treatment. Always consult the Health Protection Team.

Haemophilus Influenza Type B (Hib) Meningitis/Septicaemia – remain absent until received the appropriate antibiotic treatment. Always consult the Health Protection Team.

Molluscum Contagiosum - Should seek advice of Pharmacist or GP.

Pharyngitis /tonsillitis- If the disease is known to be caused by streptococcal (bacterial) infection the child or member of staff should be kept away from the setting until 24 hours after the start of treatment. Otherwise, they should stay at home while they feel unwell.

Ringworm- Children need to remain absent until treatment has been commenced. Spread could be prevented by good personal hygiene, regular hand washing and use of separate towels and toilet articles.

Rashes- A child who is unwell and has a rash should visit their GP to establish the reason for it.

Scabies – remain absent until 24 hours after first treatment.

Scarlet fever - Once a patient has been on antibiotic treatment for 24 hours they can return, provided they feel well enough. If not treated with antibiotics the individual should not return until symptoms have resolved.

Shingles – Only to be kept away from setting if rash is weeping and cannot be covered.

Streptococcal A (also k ow as strep throat) – remain absent until full 24 hours of appropriate antibiotics.

Slapped cheek syndrome- An affected child need not be excluded because they are no longer infectious by the time the rash occurs.

Typhoid, paratyphoid (enteric fever)- Yes and infected child is likely to be very ill and whilst infectious unable to attend the setting.

Tuberculosis (TB)- Always consult the Health Protection Team. “Open” cases –until 2 weeks after treatment started. “Open” cases of drug resistant TB when the hospital physician advises. (“Open” is determined by sputum samples).

Warts and Verrucae- No exclusion

Whooping cough (pertussis) - Remain absent for 48 hours following commencement of antibiotics, or for 14 days following the onset of coughing if they are not being treated.

Threadworm - Treatment required for affected and family members. Exclude for 24 hours after first treatment is given.

Tonsillitis – none usually. If tonsillitis is cause by Group A Streptococcus, individual can return 24 hours after commencing appropriate antibiotic treatment.

If a child contracts any of the above infectious diseases, other parents will be informed via the famly app.

If we have reason to believe that any child is suffering from a notifiable disease identified as such in the Public Health (Infection Diseases) Regulations 1988, we will inform the Health Protection Agency and CIW.

We will act on any advice given by the Health Protection Agency and inform CIW of any action taken.

If staff are unavailable to complete their shift due to absence or illness, they are to contact the setting at the earliest convenience to allow time to arrange cover and cover ratios as compliance.

These exclusion guidelines have been adapted from Public Health Wales – Exclusion Period for Common infections (July 2024) Including A-Z of Common Infections and Next Steps.

https://phw.nhs.wales/services-and-teams/aware-health-protection-team/guidance-for-childcare-preschool-and-educational-settings/

Any staff or parents who do not abide by the exclusion rules stated above or comply with exclusion requests from the management team, may be subject to disciplinary action or risk losing their place at the nursery.