Exclusive: Concern over lack of data on nursery deaths and injuries

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No official records are kept on the number of deaths, serious injuries and accidents that occur while children are in nursery or other childcare settings, a Nursery World investigation reveals.

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A Freedom of Information request that Nursery World has seen shows that Ofsted does not collate records of the deaths, serious injuries and accidents that occur in early years settings, and it appears that no Government department or agency is collating these records.

All registered early years providers are required to report to Ofsted any serious incidents that require children to attend a hospital.

However, the FOI response shows that Ofsted does not collect this data centrally, which means that it does not appear to keep track of the number of serious incidents related to safety in early years settings.

In its reply Ofsted said that while it could confirm that 'Ofsted holds the childcare factsheets and details of the notifications that it receives from childcare providers when there has been a notifiable incident, however we do not hold data collated from these notifications.'

The FOI request was made amid concerns by nursery owners and experts in the sector that the number of serious incidents in nurseries has risen in recent years.

Nursery owners are also concerned that as the Government looks set to increase the number of children that nurseries and childminders can care for, children's safety could be put at risk.

Last week, education and childcare minister Elizabeth Truss reiterated her view that the staff to child ratio in early years settings should be increased, and it appears likely which this will be a key change proposed by the Government's Childcare Commission, which is expected to report any day now.

The FOI request sought to establish the number of accidents and serious incidents that had taken place in nurseries and childminding settings which had led to a child attending an A&E between 2007 and 2011.

Certainly, anecdotal evidence appears to suggest that serious incidents in nurseries are on the rise. Last autumn, three tragedies occurred in nurseries in the same number of months, and three children died.

On 23 August a 22-month-old girl died after choking on a jelly cube during a messy play session at Dicky Birds Nursery in Wimbledon. Following an investigation by Ofsted and the Health and Safety Executive, the nursery re-opened.

On 17 September three-year-old Lydia Bishop died in hospital from suffering serious injuries after becoming entangled on a rope on a slide in the outdoor area of York College nursery. The nursery has subsequently closed.

A third child died at a nursery in the grounds of a private school.

Some experts have told Nursery World that some serious incidents could be preventable with better early years qualifications and training and that there should be a strengthening of the requirements around first aid qualifications in nurseries.

The Child Accident Prevention Trust said it was concerned that Ofsted did not keep data on accidents in nurseries.

Katrina Phillips, chief executive of the Child Accident Prevention Trust, said, 'It's concerning that Ofsted doesn't collate data on serious accidents in early years settings and a real missed opportunity. By collating, analysing and feeding back data, Ofsted could alert settings to common problems and emerging issues. And this would provide a sound basis for local work designed to keep children safe from serious harm.'

An Ofsted spokesperson said, 'It is in the interest of everyone to ensure that all children are kept safe. Local authorities collate information about serious incidents involving children in their area and Ofsted takes this information into account when inspecting local authority children's services. Early years providers are legally obliged to notify Ofsted of serious incidents that happen in their setting. The purpose of these notifications is to enable Ofsted to assess that the provider is meeting the necessary requirements and to check that the individual provider has taken appropriate action in relation to any reported incidents.'

Nursery owners have expressed surprise that Ofsted does not keep statistics on the number of serious incidents.

Jennie Johnson, owner of Kids Allowed, a group of four nurseries, said, 'It would surely be useful to assess if child safety in childcare is getting better or worse generally.

'It would also be good to have some data before any changes in ratios occur to have a "before and after" picture as logic would say that fewer adults per child will inevitably lead to more accidents.'

She added, 'On the subject of accidents, I also feel that Ofsted needs to review the first aid requirement in childcare settings. At the moment, regardless of the size of the setting, only one person needs to be trained. I feel it should be a ratio (for example, one in every five colleagues on duty must be qualified) meaning there is always someone in the immediate vicinity ready and knowledgeable to act if needed. At Kids Allowed almost all colleagues are first aid trained.'

Julie Lightley, owner of Trafford-based The Village Nursery, said, 'As a registered setting, we're required to notify Ofsted of any serious injuries, accidents or deaths. It's made very clear in the Statutory Framework that failure to comply with this requirement is "committing an offence" and can lead to registration being removed.

'I'm surprised, given the weight and severity of the consequences should we fail to report such an incident, that nothing is published or even collated, which allows providers to review and, more importantly, learn from these incidents.

She added that, 'One particularly worrying aspect is that, without doubt, doubling the number of children that one adult can care for - as reportedly proposed by Elizabeth Truss - will have an impact on the safety of children in settings. This is one policy change that would quickly see accidents and serious injuries spike in any published data from Ofsted and, unfortunately, early years practitioners would be able to do very little about it.

'As a regulatory body, Ofsted has a key responsibility to monitor, track and publish this information. In doing so, patterns will emerge and lessons will be learned, and this is what providers need to help us fulfil our duty to keep children safe.'

In response to concerns that changing ratios could compromise the safety of children in early years settings, a Department for Education spokesperson, said, 'We are looking at other countries because they use similar levels of government spending but appear to be closer towards achieving affordability and high quality.

'Only nurseries which show a commitment to quality and workforce qualifications should be able to have greater staffing flexibility. These go hand in hand. In her report Cathy Nutbrown points out that too many do not have even the basics such as a C in GCSE English and Maths as well as quality specialist training.'

TIMELINE

November 2007

Rhyia Malin was found by staff at Eton Manor Day Nursery (then owned by Casterbridge Care and Education) in Chigwell, Essex trapped between the wall and a roof of a wooden playhouse. The nursery had received a good Ofsted report in January 2006. However, previously there had been complaints from parents about supervision and ratios, and Ofsted had issued actions for improvement and one compliance notice.

March 2009

Just Learning was ordered to pay more than £140,000 in fines and costs when a local authority investigation into the nursery's policies and procedures found health and safety failings. The investigation was launched after ten-month-old Georgia Hollick died from asphyxiation after choking on a piece of apple at the Cambourne nursery in April 2006. An inquest ruled Georgia's death as accidental.

August 2012

A 22-month-old girl died after choking on a raw jelly cube during a messy play session at Dicky Birds Nursery in Wimbledon in South London. The nursery's registration was suspended pending an investigation by the Health and Safety Executive into the incident and the nursery's operational procedures. The nursery's suspension was lifted and it re-opened on 10 September.

September 2012

A three-year-old girl died in hospital after becoming entangled in play equipment in the outdoor area at York College Nursery. The nursery has since closed.

October 2012

A nine-month-old baby died at the nursery in the grounds of the Ramillies Hall private school in Greater Manchester after choking. An inquest was opened and adjourned until April.

CORONERS' RULE 43 REPORTS

Deaths in early years settings have also been cited in Rule 43 reports. Under this rule coroners have a wider remit to make reports to prevent future deaths. Following an inquest coroners may send a report of the circumstances of a death to an organisation, if they feel that there is evidence to suggest that circumstances creating a risk of future deaths exists. The organisation must then respond within 56 days setting out details of action they are taking, or an explanation of why none is proposed.

These reports and responses are published by the Ministry of Justice twice a year.

Two early years settings feature in reports between 1 October 2010 and 31 March 2011.

This includes a response from Casterbridge Nurseries 'to consider its purchasing policy for toys and playground equipment and its policy of staff using mobile phones while on duty'.

Following a separate incident, Ofsted responded that it would consider a review of first aid training provided to nursery nurses and information provided to nurseries on food preparation.

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