Nappy Changing and Potty Training

Policy statement

No child will be excluded from participating in our setting who may, for any reason, not yet be toilet trained and who may still be wearing nappies or equivalent.  We work with parents towards toilet training unless there are medical or other developmental reasons why this may not be appropriate at the time.

We provide nappy changing facilities and exercise good hygiene practices in order to accommodate children who are not yet toilet trained.

We see toilet training as a self-care skill that children have the opportunity to learn with the full support and non-judgemental concern of adults.

Members of staff have attended potty and toilet training run by the charity ERIC and we have lots of advice and tips to try and support parents/carers and children when looking at toilet training or if difficulties arise

Intimate care is provided by suitable, vetted staff, with concerns arising during nappy changing reported immediately following the safeguarding procedure.

Procedures

• Children will be checked by their keyperson periodically throughout each session; during choosing time 9:30 am and 11am.Then again between 1:30pm and 2:30pm and 2:30pm and 3:30pm. – if their usual keyperson isn’t present the practitioner assuming keyperson responsibilities will do the checks or the child’s named buddy.  Soiled or wet nappies will be changed, and this will be recorded on a daily sheet in the bathroom area.
• The Manager or Deputy will review and sign sheets at the end of each day to confirm that procedures have been followed.
• Changing areas are clean and safe areas for children to be changed.  Children are encouraged to stand up to have their nappy changed however a mat and a changing unit is available if needed, the mat is cleaned before and after each use. 
• Disposable aprons and gloves can be used. If it comes to the attention of any key person that a child requires changing at a time between checks, the child will be changed.
• Children’s privacy is considered and balanced with safeguarding procedures; therefore, we have small divider screens that are in the disabled toilet. This gives a level of privacy for the child having their nappy changed and or using the potty, but the adults can be always seen by others. This ensures they remain visible and are appropriately supervised to maintain safeguarding.
• All staff members are familiar with the hygiene procedures and carry these out when changing nappies. 
• All staff members are gentle when changing; they avoid pulling faces and making negative comments about ‘nappy contents.  Staff members are familiar with specific cleansing procedures relating to boys and girls.
• All staff members have ‘duty of care’ towards children’s intimate personal needs.  If children are left in wet or soiled nappies/pull ups in the setting this may constitute neglect and will be a disciplinary matter.  The responsibility of the care routines lies with the child’s designated key person.
• Children are encouraged to take an interest in the toilet/potty, they may just want to sit on it and talk to a friend who is also using the toilet.

To support children’s health, wellbeing and development by promoting effective potty training at an appropriate time, in partnership with parents/carers.

Objectives for potty/toilet training:

·Child’s individual needs are identified and met.

·Family’s cultural preferences are considered.

·Potty training is a positive experience; family and child feel supported throughout.

·All families are provided with information and signposts to sources of further information about bladder and bowel health and potty training such as ERIC website–www.eric.org.ukandERIC’sHelpline (0845 370 8008).

·Communication between the setting and family is promoted before, during and after potty training.

Actions:

Preparation:

• Potty training can be a very daunting process for families. Ladybirds staff will support families if needed by discussing expectations of potty training and providing information such as ERIC’s Guide to Potty Training.

• We are committed to working in partnership with parents to support this important stage of development and will advise and support a consistent approach between the setting and home.
• Families will be supported to decide the best time to potty train their child. Provider will explain why it is helpful for the same approach to be taken at home and in the early years setting, including using the same words for wee/poo/potty/toilet etc.

Assessment of Readiness:

The first stage of potty training is to recognise when the child is ready. It is essential that the child is:

• Pooing at least one soft poo a day
• Staying dry for at least an hour and a half between wees

Other signs to look out for are:

• Showing interest in the toilet
• They can follow simple instructions
• Able to sit themselves on the potty and get up again
• Starting to show signs of awareness of when they have done a wee or a poo
• Showing awareness that other family members and peers don’t wear nappies, and that they use the toilet
• Children with additional needs may not show reliable signs of awareness. Potty training should not be delayed; it is much harder to achieve when the child is older. Readiness can be assessed by monitoring the child’s wees and poos.

Delivery:

Ladybirds Staff will ensure that the following recommendations are supported:

• Suitable facility is offered –either a range of potties, or toilet with suitable foot support and toilet seat insert. In the early stages children cannot differentiate between the need for a wee and the need for a poo. If they ‘wee’ standing up they may hold onto the poo and can easily become constipated with them stood up if they prefer this to laying down on the changing mat.
• We also change children’s nappies
• The correct mechanism of weeing is triggered by relaxation –it is much easier to relax when seated.
• They may empty their bladder better sitting down.

• It is more hygienic as they are less likely to wee on the floor/over the toilet seat.
• Children have access to water throughout the day and are offered milk during snack and lunch times. Children are encouraged to have plenty to drink and taught the importance of drinking plenty of water.
• Ladybirds staff will discuss clothing with family; family will ensure that the child is dressed in clothes that are easy to pull up and down, and will supply several spare pants, trousers, socks etc.
• Ladybirds staff will work with family to ensure a consistent transition from nappies to pants in one step to avoid confusing the child with a mixture of nappies/pull-ups/pants.
• Ladybirds staff will maintain calm, supportive approach at all times; children should not be rushed or forced to use the potty against their will. ‘Accidents’ are to be expected, children learn to recognise the sensation of needing a wee/poo by wetting/soiling.
• All Ladybirds staff and family to ensure child is regularly encouraged and praised. N.B. aim to recognise achievable goals such as sitting on the potty when asked to do so. Keeping pants dry maybe an unachievable goal initially.
• Staff will encourage children to participate in their own care where developmentally appropriate, for example pulling up trouser, wiping hands or flushing toilet to promote independence.

Communication:

• Ladybirds staff will ensure all staff are aware of each child’s current stage of potty training to confirm consistent approach.
• Ladybirds staff will ensure a record is kept of successful potty/toilet visits as well as wetting/soiling incidents in order to monitor child’s progress. Either via tapestry care diary or a log kept in the bathroom
• Regular updates to be shared with parents with the expectation that they will share information about progress at home. Potty training is a joint effort!
• Staff will explain to children what they are doing, seek cooperation appropriate to the child’s age and understanding, and carry our care respectfully (Eg: photo/visual, verbally, Makaton, now & next, object of reference).

PPE will be available for staff to use (gloves and aprons). Staff will use effective handwashing and encourage effective handwashing for children/ Staff will clean and disinfect the changing area after each use and it will also be cleaned during lunch time. Safe desposal of nappies and contaminated waste.

The current UK health protection guidance states that staff must wear disposable gloves when changing nappies or when there is contact with urine, faeces, blood, vomit or other bodily fluids. Disposable plastic aprons are also recommended when there is a risk of clothing becoming contaminated.

Privacy:

The setting recognises that some children may use potties or toilets within the same toileting area. Practitioners will ensure each child’s privacy and dignity are respected by;

• Positioning of these area’s
• Using privacy screens and practitioners’ bodies when supporting intimate care
• Encourage standing for nappy changing
• Encouraging children to wait or use the opposite toilet (with a door- more privacy. Especially children that are confident at toileting and need less support)
• Ensure children are not unnecessarily exposed to others.

Trouble shooting: Ladybirds staff are here to support parents/carers with any difficulties and will be able to sign post you to useful websites and can offer some support themselves.

We have Jade Parker and Kirsty Nutburn on site who have been trained by ERIC to help support successful toilet training