Controlling infection in your early years setting
Rigorous infection control measures
You, your staff and your families should be confident that your service has rigorous infection control measures in place such as:
- good basic hygiene practices such as regular hand-washing (practitioners and children)
- supervise young children to ensure they wash their hands for 20 seconds more often than usual with soap and water
- clean and disinfect regularly touched objects and surfaces more often than usual using your standard cleaning products
- waterproof dressing to cover on any existing wounds or lesions
- personal protective equipment (PPE) such as aprons and gloves are used as necessary
- clear procedures are in place for cleaning equipment and wider environment
- immediate cleaning of spillages of blood and other bodily fluids
- clear procedures on safe disposal of waste
- infection control guidance and management procedures in place which are clearly understood and adhered to by staff
- any items that come into contact with mouths such as cups, bottles and straws should not be shared.
Public Health England advises that children and staff should be encouraged to catch sneezes with a tissue, bin the tissue and wash their hands.
You should also remind children to wash their hands:
- after outside breaks
- before meals and snack times
- after using the toilet
- when they arrive at your setting
- at the end of the day before they go home.
If you do not have access to soap and water to hand at the time, an alcohol-based hand sanitizer can be used instead. Look for products with minimum 60% alcohol. It is important that everyone should try not to touch their eyes, nose and mouth with unwashed hands.
Good ventilation can help reduce the risk of spreading coronavirus, so a focus on improving general air flow, preferably through fresh air or effective mechanical systems, can help to create a safer environment for staff and children.
It is important to ensure your setting is well ventilated and that a comfortable environment is maintained.
You should identify any poorly ventilated spaces as part of your risk assessment and take steps to improve fresh air flow in these areas, giving particular consideration when holding events where visitors such as parents are on site, for example for a show or play.
Where it is safe to do so, opening external windows can improve natural ventilation and, in addition, opening internal doors, can also assist with creating a throughput of air. If necessary, external opening doors may also be used (if they are not fire doors and where safe to do so).
Read the full government guidance here.
The Health and Safety Executive also provides guidance on ventilation and air conditioning during the coronavirus (COVID-19) pandemic.
The use of CO2 monitors
CO2 monitors are being rolled out to education settings to help identify areas of poor ventilation.
The DfE has published a guide to using CO2 monitors. You can download it from here.
On November 29, 2021 government guidance was updated to recommend that "face coverings should be worn when moving around the premises, outside of classrooms, such as in corridors and communal areas" as a "temporary measure". This recommendation applies to "staff and visitors, including children aged 11 or above on 31 August 2021". Face coverings do not need to be worn outdoors.
What should I do if a child starts displaying symptoms of Covid-19?
If anyone in your setting develops a new, continuous cough or a high temperature, or has a loss of, or change in, their normal sense of taste or smell (anosmia), they must be sent home and be advised to follow the guidance for households with possible or confirmed coronavirus (COVID-19) infection.
They should avoid using public transport and, wherever possible, be collected by a member of their family or household.
If a child is awaiting collection, appropriate PPE should be used if close contact is necessary. Further information on this can be found in use of PPE in education, childcare and children’s social care. Any rooms they use should be cleaned after they have left.
Staff members should not come into work if they have any symptoms.
If anyone in your setting develops symptoms of coronavirus (COVID-19), however mild, you should send them home and they should follow public health advice.
The guidance says anyone displaying symptoms must:
• arrange to have a test to see if they have coronavirus (COVID-19)
• self-isolate for at least 10 days if they test positive.
1. In an emergency, call 999 if they are seriously ill or injured or their life is at risk. Do not visit the GP, urgent care centre or a hospital except in an emergency.
2. Call parents/legal guardian to collect child and take them home.
3. While the child is awaiting collection, move them to an isolated room and open a window for ventilation. If it is not possible to isolate them, move them to an area which is at least 2 metres away from other people.
4. Since it’s unlikely that staff caring for a young child while they are awaiting collection will be able to maintain a 2 metre distance, they should wear suitable PPE
— If 2m distance cannot be maintained a face mask should be worn
— If contact is necessary then gloves, an apron and a face mask should be worn
— If there is a risk of fluids entering the eye (e.g. from coughing, spitting or vomiting) then eye protection should also be worn.
More information on PPE use can be found in the Safe working in education, childcare and children’s social care settings, including the use of personal protective equipment (PPE) guidance.
5. If the child needs to go to the bathroom while waiting to be collected, they should use a separate bathroom if possible. The bathroom should be cleaned and disinfected using standard cleaning products before being used by anyone else.
6. Staff/other children who have had contact with the symptomatic child must wash their hands thoroughly for 20 seconds.
7. When parents/legal guardian pick up the child, advise them to get the child tested and notify you of the results.
8. Once the child has left the premises, thoroughly disinfect/clean all surfaces and touchpoints they came into contact with (including the bathroom if used).
What to do if a child or staff member tests positive for coronavirus (COVID-19)
- When an individual has a positive test children, staff and other adults should follow public health advice on when to self-isolate and what to do.
- They should not come into the setting if they have symptoms of coronavirus (COVID-19) or other reasons requiring them to stay at home due to the risk of them passing on COVID-19 (for example, they are required to quarantine).
- The household (including any siblings) should follow PHE’s stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection.
UPDATE on self-isolation (17 Jan 2022)
The government has announced that individuals testing positive for Covid-19 can now end their self-isolation after five days if they receive negative lateral flow test results on days five and the morning of day six of self-isolation and do not have a temperature.
The DfE has now confirmed that this advice also applies to children aged under five who have tested positive for Covid-19.
The first test must be taken no earlier than day five of the self-isolation period and tests must be taken 24 hours apart. If both these test results are negative, and the child does not have a high temperature, they may end their self-isolation after the second negative test result and return to their education setting.
If an individual is positive on day five, then a negative test is required on day six and day seven to release an individual from isolation.
Anyone who is unable or chooses not to take lateral flow tests will need to complete the full 10-day period of self-isolation.
The following people can take a lateral flow test every day for six days instead of isolating, if they have been identified as a close contact of a suspected or confirmed case of any variant of Covid-19 (including Omicron):
- fully vaccinated adults (i.e. those who have had 2 doses of an approved vaccine)
- all children and young people aged between five year old to 18 years and six months, regardless of their vaccination status
- people who are not able to get vaccinated for medical reasons
- people taking part, or have taken part, in an approved clinical trial for a COVID-19 vaccine.
The results of each lateral flow test should be reported through the Online Reporting System. If an individual tests negative, they can continue to attend their education setting.
Anyone over the age of 18 years and six months who is not fully vaccinated (and not exempt from isolating for any of the reasons listed above) is still required to self-isolate in line with government guidelines if they are a close contact of a positive case.
If a close contact tests positive using a lateral flow test, they no longer need to take a PCR test to confirm the result.
Temporary scrapping of confirmatory PCR tests
The government has stated that this is a temporary measure while Covid-19 rates remain high across the UK as "whilst levels of Covid-19 are high, the vast majority of people with positive LFD [lateral flow device] results can be confident that they have Covid-19".
Under this new approach, anyone who receives a positive lateral flow test result should report their result on Gov.uk and must self-isolate immediately but will not need to take a follow-up PCR test. After reporting a positive lateral flow test result, they will be contacted by NHS Test and Trace so that their contacts can be traced and must continue to self-isolate.
The government has confirmed a few exceptions to this revised approach:
- People who are eligible for the £500 Test and Trace Support Payment who will still be asked to take a confirmatory PCR if they receive a positive lateral flow test result to enable them to access financial support.
- People participating in research or surveillance programmes who may still be asked to take a follow-up PCR test, according to the research or surveillance protocol.
- People in England who are at particular risk of becoming seriously ill from Covid-19, have been identified by the NHS as being potentially eligible for new treatments and will be receiving a PCR test kit at home by mid-January to use if they develop symptoms or if they get a positive lateral flow result, as they may be eligible for new treatments if they receive a positive PCR result.
NB: An adult is considered fully-vaccinated from two weeks after having received two doses of an approved vaccine (such as Pfizer/BioNTech, AstraZeneca or Moderna/Spikevax) or one dose of the single-dose Janssen vaccine.
Reporting an incident to Ofsted
Ofsted has created a page for providers who need to report a Covid-19 incident at their setting.
Additional questions and updates
- Do practitioners need to use personal protective equipment (PPE) in childcare settings?
Most staff in education, childcare and children’s social care settings will not require PPE beyond what they would normally need for their work.
PPE is only needed in a very small number of cases if:
an individual child, young person or other learner becomes ill with coronavirus (COVID-19) symptoms
a child, young person or learner already has routine intimate care needs that involve the use of PPE, in which case the same PPE should continue to be used.
You can read more detail on PPE here: Safe working in education, childcare and children’s social care settings, including the use of personal protective equipment (PPE)
- Do practitioners need to wash or change their clothes immediately after leaving the setting?
PHE and the DfE have confirmed that there is no need to clean your clothes immediately after leaving work at a childcare setting – this is only required by healthcare professionals.
Practitioners simply need to follow the guidance here.
- Updated guidance on supervised toothbrushing programmes in early years settings
The wet brushing model is no longer recommended during the COVID-19 recovery phase as it is considered more likely to risk droplet and contact transmission and offers no additional benefit to oral health over dry brushing.
Latest government advice and support
Infection prevention resources
- Alliance members can complete our FREE EduCare course Infection prevention and control in an early years setting and non-members can access for small cost.
- A copy of our publication Good Practice in Early Years Infection Control is available in our online shop.