Infection control for nurseries regarding coronavirus / COVID-19

This page includes information on:

  • Symptoms
  • Infection rate
  • Safe working
  • Testing for early years staff and children
  • Quarantine and entering the UK
  • COVID-19 apps
  • NHS Test and Trace - England
  • Test, Trace, Protect - Wales
  • Test and Protect - Scotland
  • PPE for nurseries
  • Social distancing at nursery
  • What are the rules for self-isolating?
  • What to do if you have a confirmed case in your setting
  • What to do if you have a suspected case in your setting
  • What to do if a child is otherwise ill or has had immunisations causing illness
  • What to do to clean the nursery afterwards
  • How to prevent the spread of the virus
  • Do you need to close your nursery if a child/staff are confirmed as contracting COVID-19?
  • Working with special needs children who spit and protecting yourself.

Symptoms

High temperature/fever and/or a new persistent cough/Anosmia (the loss of or a change in your normal sense of smell/taste). Find out more about symptoms on the government website here.

Scientific evidence indicates that a child with high temperatures does not necessarily mean that they have COVID-19 symptoms. See the Implementing Protective Measures guidance here.

Infection rate

Because the disease is new there isn’t the wealth of research evidence that exists for other diseases but some studies have suggested a lower infection and transmission rate in young children. However, this risk is not and will never be zero. A further explanation has been published of the scientific evidence for the Government’s decisions. This document covers infection and transmission, the risk to different groups, testing, PPE and international comparisons as well.

The Welsh Government Technical Advisory Group has published information regarding the transmission of coronavirus in children.

Safe working

England
See what childcare services, early years settings, childminders and local authorities in England need to provide during the coronavirus (COVID-19) outbreak in 'Actions for early years and childcare providers during the coronavirus (COVID-19) outbreak' here.

Scotland
See non-statutory guidance for early learning and childcare (ELC) providers in the local authority, private and third sectors to support a safe reopening of these settings during Phase 3 in 
'Coronavirus (COVID-19): guidance on reopening early learning and childcare services' here.


Wales
See how to get your Wales-based childcare service ready to allow more children to attend and protect them and your staff from coronavirus in 'Protective measures in childcare settings: keep childcare safe' guidance here.
 
They include advice on:
  • Minimising contact
  • Changes of work practices
  • Hand and respiratory hygiene
  • Increased cleaning of the environment
  • Limiting movement
  • When you might need to use personal protective equipment (PPE)
  • Testing – all early years staff who develop symptoms should book a test.

Testing for early years staff and children

Staff in England
The Government guidance 'Coronavirus (COVID-19): getting tested' states that essential workers - which includes anyone working in education and childcare - have priority access to testing.

Join our campaign - #TestAllEarlyYearsWorkers! The ask is simple – all early years professionals irrespective of whether they work in the maintained or PVI sector - should have equal access to COVID-19 tests wherever they work. Children and Families Minister Vicky Ford confirmed that maintained nurseries and nurseries in schools have been given testing kits but not PVI nurseries. The lack of testing capacity affects parents too – as this could mean children having to spend more time out of settings. You can also contact your MP directly and ask them to raise testing issues you have faced with Ministers on your behalf - or Tweet them about it using #TestAllEarlyYearsWorkers. We feel that this is grossly unfair and yet again the PVI sector are treated as second class citizens. We want to show just how unfair this decision is – we want your voice to be heard.

Public Health England has introduced a new dedicated advice service for nurseries, schools and colleges. The service is for those needing support on the action they should take when they have been informed of a confirmed coronavirus case in their setting whether a child or staff member. It can be reached by calling the Department for Education coronavirus (COVID-19) helpline on 0800 046 8687 and selecting option 1. The line is available Monday to Friday from 8am to 6pm and Saturday and Sunday from 10am to 4pm.

Children in England:
All children over the age of five are eligible for testing if they display symptoms of possible coronavirus: high temperature, a dry cough and now loss of taste or smell. In the Implementing protective measures in education and childcare settings guidance the DfE say that children under five can be tested but there is a different approach to booking this:
 
“[A]ll those children and young people eligible to attend, and members of their households, will have access to testing if they display symptoms of coronavirus…. To access testing parents will be able to use the 111 online coronavirus service if their child is 5 or over. Parents will be able to call 111 if their child is aged under 5.”

Staff in Scotland
The Scottish Government has announced that all teachers and early years staff will be able to request a coronavirus test if they are concerned they may have been at risk from infection, even if they show no symptoms. Testing for staff who may be concerned about exposure but who are asymptomatic will use the Employer referral route. Individuals will need to request to be referred for a test through their employer; employers will have to be registered with the employer portal.

Children in Scotland
In Scotland parents and carers can apply for a test through the Test and Protect Program for children under five when they show symptoms of COVID-19. The test will be undertaken by the child’s parent/carer. If a child tests positive then the Test and Protect procedure for isolation will come in play.

Staff in Wales
In Wales, the testing capacity has been increased to support contact tracing and home tests and tests at the drive-through centres for both critical workers and the public can be booked onlineYou can apply for a test for yourself or someone in your household with symptoms. This includes adults and children, including under 5s. You are also able to apply for a test by calling the free number 119 between the hours of 7am to 11pm. People with hearing or speech difficulties can call 18001 119.

There are two routes for accessing the UK Testing Programme for staff:

  • The employer referral portal – education, childcare and children’s social care settings, as employers, can obtain a log in to a secure online employer referral portal, through which they can upload a full list of names of self-isolating essential workers that need a test
  • The employee portal – this allows individual key workers to book a test directly themselves.

Quarantine and entering the UK

All the government information about countries that are in travel corridors - meaning people arriving from those places don’t need to self-isolate - is here. This also covers the need to self-isolate if the country is not on this list as well as all the latest updates. The guidance all travellers should follow on self-isolating is here.

Under the section on testing it says “If you are tested and receive a negative result for coronavirus, you must continue to self-isolate until you have been in the UK for 14 days, even if your symptoms have gone.

The only exception a parent could claim is if the child didn’t travel. There is an infographic in the guidance which shows that if a parent/carer is self-isolating but has no symptoms, the household doesn’t need to self-isolate. So a child who didn’t travel can still attend a setting as long as no parent/carer who has travelled leaves the house with them.

COVID-19 apps

England and Wales
The app will be used, alongside traditional contact tracing, to notify users if they come into contact with someone who later tests positive for coronavirus. The app also allows users to report symptoms, order a coronavirus test, check into venues by scanning a QR code and it helps the NHS trace individuals that may have coronavirus. An explainer video is available about the app and you can find a full range of resources and FAQs here. This includes information about using and downloading the app and what the app does. Settings don’t need to download and display a QR code unless you are expecting a lot of visitors from members of the general public rather than parents or families with whom you have regular contact. Ensure staff pause the app if phones are kept in communal places at work while turned on to avoid false self-isolation instructions.

Scotland
The Protect Scotland app from NHS Scotland’s Test and Protect is a free, mobile phone app designed to help us protect each other and reduce the spread of coronavirus. The app will alert you if you have been in close contact with another app user who tests positive for coronavirus. And if you test positive, it can help in determining contacts that you may have otherwise missed while keeping your information private and anonymous. To avoid any unnecessary notifications to your staff through the Protect Scotland app,  if your teams have downloaded the app you may want to ask them to pause it or turn their phone off while at work.

NHS Test and Trace - England

See guidance on the NHS Test and Trace service for employers, businesses and workers. For your staff teams, Public Health England has published guidance explaining what they should do if the NHS Test and Trace service notifies them that they have been in contact with a person who has tested positive for coronavirus. 

Test, Trace, Protect - Wales

See information about Test, Trace, Protect here including specific information for employers, critical workers and the general public. It includes a downloadable toolkit available for employers to raise awareness in the workforce. Anyone who has a positive coronavirus test result will be contacted by a team of contact tracers and asked for details of everyone they have had close contact with while they have had symptoms. See information about the contact tracing process. See Welsh Government guidance explaining how employers in Wales can play their part in helping to deliver Wales’ Test, Trace, Protect strategy.

Test and Protect - Scotland

See information about Test and Protect here. It will prevent the spread of coronavirus in the community by identifying cases of coronavirus through testing, tracing the people who may have become infected by spending time in close contact with them and supporting those close contacts to self-isolate, so that if they have the disease they are less likely transmit it to others. The Scottish Government Test and Protect Strategy not only asks those close contacts of people who test positive to self-isolate but also to take a test themselves. This will allow the Test and Protect Team to identify further contacts, and in turn, further containing wider outbreaks. You can find full details of how and when to access a test here.

PPE for nurseries

We know that many of you might have staff with personal safety concerns and we continue to raise this issue with the Department for Education and devolved governments – especially with schools being offered support in sourcing equipment and cleaning supplies. We believe nurseries should have the same support too. We are hearing that some members are struggling to access supplies of gloves, aprons and other protective equipment. We know of some councils who are providing these kits to nurseries as well so you could check with your local authority for help with supplies.

England
See PPE government guidance for England nurseries hereSee the Department for Education's Safe working in education an childcare guidance here. See What parents and carers need to know about educational settings during the coronavirus outbreak guidance. See advice for safe public travel here. See government guidance on how to make a face covering here.

Wales
See PPE government guidance for nurseries in Wales here which includes general guidance on PPE and additional guidance on PPE where there is a suspected case of coronavirus. There is also further workplace guidance for nurseries in Wales available here. The Keep Wales Safe at Work guidance states that employers should support their workers in using face coverings safely if they choose to wear one, it also provides information to support employers in doing this. 

Scotland
See Scottish Government's physical distancing and PPE guidance for education and childcare settings.

The Scottish Government has set up a framework agreement with third-party supplier Lyreco to offer a route to buying PPE for private, voluntary and independent early learning and childcare services. Lyreco offers a range of products to purchase, including face masks, aprons, gloves, visors, hand sanitiser, goggles and safety glasses. All products are subject to availability and prices are updated regularly on the Lyreco website. If you wish to open an account with Lyreco, please first read the privacy notice, then complete the form, which must include your Care Inspectorate CS number and email it to PPEDirectorate@gov.scot. Once your CS number is confirmed as being a registered care service your account will be set up. This may take a few days depending on the volume of forms returned. Lyreco will then give you access to their online ordering site, where you will be able to see the full range of products available and current prices. Opening an account does not place you under any obligation to place an order. If you already have an existing Lyreco account then you must set up a new account to go through this procurement process.

Social distancing at nursery

England
See social distancing guidance for England nurseries here. 

Scotland
See Scotland's guidance on social distancing for businesses here and the Scottish Government's advice on physical distancing in early learning and childcare settings from the COVID-19 Advisory Sub-Group on Education and Children’s Issues. 

Wales
See specific social distancing guidance to help employers in Wales here. It is important that all childcare providers in Wales follow the Protective Measures Guidance. Safety and physical distancing signs in a number of languages are also available to support employers.

What are the rules for self-isolating?

  • If you have symptoms of COVID-19 however mild, self-isolate for at least 10 days from when your symptoms started
  • If you are not experiencing symptoms but have tested positive for COVID-19, self-isolate for at least 10 days, starting from the day the test was taken. If you develop symptoms during this isolation period, restart your 10-day isolation from the day you developed symptoms
  • After 10 days, if you still have a temperature you should continue to self-isolate and seek medical advice. You do not need to self-isolate after 10 days if you only have a cough or loss of sense of smell or taste, as these symptoms can last for several weeks after the infection has gone. See the ending isolation section below for more information
  • If you live with others, all other household members need to stay at home and not leave the house for 14 days. The 14-day period starts from the day when the first person in the household became ill or if they do not have symptoms, from the day their test was taken.

What does this mean for nursery staff and children?

  • If a child or staff member is symptomatic they must self-isolate for 10 days. Children and staff can request a test if they are symptomatic.
  • If a child or staff member gets a positive test they need to self-isolate for 10 days instead of seven
  • Anyone who has been in contact with someone who has had a positive test result must self-isolate for the 14 day period
  • If a person believes they have symptoms they will have to isolate until they get a test result, but if that comes back negative and they no longer have symptoms they will be able to come out of isolation.

A person still won’t be able to get a test unless they are showing symptoms so situations where they have to self-isolate for 14 days due to quarantine post-return to the UK or as a result of test and trace contacts, they will still have to isolate for 14 days. They can only get a test within that 14 day period if they start to show symptoms. Anyone not complying with an official instruction to self-isolate could be fined £1,000 which rises to £10,000 for serial offenders or serious breaches.

What to do if you have a confirmed case in your setting

England
The Department for Education (DfE) update on 17 September states that if you have a positive case in your setting you need to ring the DfE’s helpline on 0800 046 8687. You should then choose option 1 to get advice on how to proceed. A triage system will be in place and should you require it, your local Health Protection Team will get in touch. The helpline is manned Monday to Friday from 8am to 6pm and 10am to 4pm on Saturdays and Sundays. This option should only be selected if there is a confirmed case of coronavirus (COVID-19) within your nursery. Callers will be put through to a team of advisors who will advise on what action is needed based on the latest public health advice, and work through a risk assessment to identify close contacts.

While the first priority should be to work with public health officials, Ofsted’s latest update says: "Any confirmed cases of coronavirus in the setting, or if the setting has been advised to close as a result, should be reported to Ofsted as soon as reasonably practical, and in any case within 14 days."

Wales
The Welsh Government has issued guidance noting: "If you have more than one confirmed case of COVID-19 within 14 days, in your workplace, you must report it to your regional Test Trace and Protect team." You can find the contact details for the Regional Test Trace and Protect teams here and you may want to have these included in any plan for a response to cases so they are easily accessible if they are ever needed.

What to do if you have a suspected case at your setting

If the child or staff member is displaying the symptoms, they should be sent home to self-isolate for 10 days and their whole household should isolate for 14 days. If they have a positive result, your local public health protection team will contact your setting and advise on what precautions you should take.

A child should be moved away from other children and cared for separately with appropriate adult supervision. If it is not possible to isolate the child, move them to an area which is at least 2 metres away from other children. Ideally, a window should be opened for ventilation. Disposable gloves, apron and a fluid-resistant surgical mask should be worn if the child requires personal care or close contact. If a risk assessment determines that there is a risk of splashing to the eyes, for example from coughing, spitting, or vomiting, then eye protection should also be worn. If a child needs to go to the toilet while waiting to be collected, they should use a separate toilet if possible.

Wales
Wales-based nurseries - as per the CIW FAQs - need to ensure that you are notifying CIW of confirmed and suspected cases of COVID-19 of people using the service, and members of staff (and in the case of childminders, other family members living at the premises). 

What do I do while I wait for a child to be collected?

In England, as outlined within the Protective Measures guidance'Settings will need to have a clear, written procedure in place for the protection of staff and children if a child develops symptoms while at the setting. Their parent/carer should be called immediately and the child collected and taken home. Young sick children will need to be cared for until they are collected.'

Should there be a delay in a parent collecting a symptomatic child, you should contact the local environmental health officer via your local council’s website.

What to do if a child is otherwise ill or has had immunisations causing illness

If the child is unwell but does not have any COVID-19 symptoms, we advise you to follow your usual nursery policy as agreed with parents on giving medicines. Public Health England has also issued advice regarding children who have been given routine immunisations as many experience a fever for a couple of days.

What to do to clean the nursery afterwards

The areas where a person suspected of having COVID-19 has been, including toilets, must be cleaned and disinfected. Gloves and aprons should be used when cleaning the areas where a person suspected of having COVID-19 has been. In England, cleaning of the setting must take place as set out in Infection Prevention and Control Guidance for Childcare Settings. Additional cleaning and disinfecting must be undertaken of areas that a symptomatic individual has come into contact with. 

If a member of staff has helped someone who was taken unwell, they do not need to go home unless they develop symptoms (new continuous cough, high temperature, loss of smell or taste) themselves. They should wash their hands thoroughly for 20 seconds after any contact with someone who is unwell and where possible should change into clean clothing.

How to prevent the spread of the virus

Good hygiene and handwashing is essential and very important in nurseries anyway. See our tips on encouraging children to wash their hands thoroughly.

There is an excellent BBC video that shows you how you should be washing your hands each time. You can also ring the Department for Education Helpline for general hygiene advice. 

Do you need to close your nursery if a child/staff are confirmed as contracting COVID-19?

There has not been any advice given as to when or in what circumstances any business would have to shut as a result of COVID-19. In England you do NOT need to notify Ofsted if someone is self-isolating but if a child or staff member has a positive test, you must notify Ofsted. 

In Wales you are required to notify CIW and Public Health Wales of both confirmed and suspected cases. 

Working with special needs children who spit and protecting yourself

In England the DfE guidance states:

'If non-symptomatic children present behaviours which may increase the risk of droplet transmission (such as biting, licking, kissing or spitting) or require care that cannot be provided without close hands-on contact, they should continue to receive care in the same way, including any existing routine use of PPE.

'In these circumstances, to reduce the risk of coronavirus (COVID-19) transmission, no additional PPE is necessary as these are non-symptomatic children in a non-healthcare setting and so the risk of viral transmission is very low. However, additional space and frequent cleaning of surfaces, objects and toys will be required. Cleaning arrangements should be increased in all settings, with a specific focus on surfaces which are touched a lot.'


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