Nappy changing practice in Limerick childcare facility put kids at risk of ‘infection’

Fintan Walsh, Health Correspondent

Reporter:

Fintan Walsh, Health Correspondent

Email:

fintan.walsh@limerickleader.ie

Inspectors discovered faults at 31 childcare facilities since January 2017

Inspectors discovered faults at 31 childcare facilities since January 2017

CHILDREN were exposed to “cross infection” at a Limerick childcare facility after staff were observed wearing used protective gloves “to collect the next child for nappy changing”, according to a Tusla inspection report.

This service provider was one of 31 facilities across the city and county that were found to be non-compliant in certain practices, in a review of around 200 inspection reports published since January 2017. 

Inspectors also found that at another facility, “it had been three weeks since these children were outdoors” and that there was no designated outdoor space for children, aged six to 18 months.

A city facility, which was inspected in June last, was found to be at risk of having “unauthorised persons accessing the service”.

The inspector, in this case, had been informed that “many parents” had knowledge of the access code to the building and that it was “not secure”. 

Revealed: Inspectors discover faults in 31 childcare facilities

More than 30 crèches, childminders and Montessoris across the city and county were found to be engaging in non-compliant practices since 2017, according to Tusla inspection reports. 

In a review of around 200 inspection reports, the Limerick Leader found 31 facilities to be non-compliant  in relation to infection control, garda vetting, security and suitability of play areas and other areas. 

The majority of childcare facilities in Limerick received unanimously positive reviews by inspectors.

The majority of reports of centres where faults were identified were largely positive. 

According to an inspection report of a city facility in April last, some adults did not wash their hands before handling food “before and after nappy changing” and after outdoor play with children.

The inspector also noted that, even though staff were wearing protective gloves during nappy changing they “were not changing them between children”.

“The staff member re-entered the playroom still wearing the used gloves to collect the next child for nappy changing which exposed the children to risk of cross infection,” the report stated.

The report added that there was no nappy changing policy displayed to guide staff at the facility.

In response to this, the centre said that an in-house training day “cross-infection will be a core area for all staff to cover”, a review of nappy changing policy will take place and staff will meet to discuss “proper procedure” for nappy changing and cross infection.

Toddlers were also exposed to cross infection due to torn safety mattresses in three cots, the inspector found. The service provider responded that all mattresses will be replaced.

The report added that the wheel of a cot in the toddlers’ sleep room was broken and “it was supported by a piece of block”.

One County Limerick facility did not have information on procedures to protect children and staff from the transmission of infection in its infection control policy, two inspectors reported in September 2017.

The facility said that it has included this information in its infection control policy.

Tusla found that parents were “not aware who their child’s key worker was in many of the playrooms” and that the opportunity for siblings to be together “was not adequate”.

The report also stated that “children were mixing for minutes only and not long periods throughout the day”.

Inspectors also found that “it had been three weeks since these children were outdoors” and that there was no designated outdoor space for children, aged six to 18 months.

The range and choice, including sand and water play activities, were “inadequate” in some areas of this facility. In a Montessori room, children appeared “visibly tired and it was difficult to reduce the sensory stimulation of the fluorescent lighting”.

In response, the service provider stated that parents were informed of their child’s key worker, and that this information is on notice boards in each room.

The facility said that siblings are now encouraged to mix for longer periods of time, and that staff in a specific room have “included in the daily routine plan the opportunity for outdoor play on a daily basis”.

In relation to the lights, the service provider said: “On a room to room basis as the finances allows, the service are replacing the fluorescent lighting with a more natural light bulb.”

A city facility, which was inspected in June last, was found to be at risk of having “unauthorised persons accessing the service”.

The report stated that the inspector was “informed by staff that the access code to enter the building was not secure as many parents had knowledge of the code which could lead to unauthorised access by an adult to the building and/or egress of child from the building”.

In response, the manager has documented that a keypad on the main door has been disabled, with the entry and exit controlled by the office solely.

Additionally, the manager said that a qualified professional “will remain at the front reception at all times”.

A new security camera was installed at the front door of the facility, and that swipe cards will be used for staff access only.

In an inspection in July 2018, it was found that a facility in County Limerick had not maintained its fire fighting equipment since September 2012. The centre replaced two fire extinguishers following the inspection.

Another County Limerick centre, inspected in April last, had a slide in the outdoor area that was broken and “not properly secured to the ground”. The service said that all outdoor equipment is checked on a regular basis “to ensure broken materials are removed or repaired when required”.

One city service had six pre-school children attending the facility at the time of an unannounced inspection in June last. This, according to inspectors, exceeded the maximum number of children permitted to attend the service, which was five.

In response, the service provider said that one extra child was “only there on that one occasion as a parent had asked her to take the child due to an unforeseen circumstance”.

Another facility in County Limerick exceeded the maximum number by two children, all of whom were aged 10 months to five years.

The service said that two children were due to leave on the day of the inspection in July 2018, and two children had started in the service that week.

One service did not have garda vetting for five staff members who lived outside the jurisdiction for longer than six months.

The city service, which was inspected in March last, responded that police vetting was secured for four staff, and that the fifth staff member no longer works at the facility, the report stated. 

A “significant” safety risk was identified at a city facility during an inspection in December 2017, in relation to an outdoor play area “where the steps leading to the climbing frame were slippery and wet and there was an accumulation of wet leaves on the all weather surface covering the area”.

In response, the service provider said the outdoor area has been “cleaned and power-hosed”. 

A County Limerick facility, inspected in December 2017, did not have two written and validated references for three adults working in the service at the time of inspection. 

The centre also did not have garda vetting available for two staff members.

In response, the references and garda vetting documents were emailed to the inspectorate office.