Coronavirus (COVID-19): early learning and childcare services

Minimising the spread of COVID-19

It is important that local authorities and providers take account of their own circustances and assessment of risk when implementating this guidance and take every appropriate step to ensure the safety and wellbeing of children and staff.

Contents of this page

• vaccines
• testing
• Highest Risk List
• hand hygiene
• respiratory and cough hygiene
• cleaning practices
• face coverings
• personal protective equipment (PPE)
• physical distancing
• ventilation
• risk assessments
• pick up/drop off, visits and trips

Vaccines

Vaccines are the most effective method of reducing the public health impact of COVID-19 and they are highly effective against serious illness.

All settings should encourage and enable staff who have not been fully vaccinated to seek vaccination as soon as possible.

Accessing a vaccine

• advice and guidance on how to access COVID-19 vaccinations can be found online
• COVID-19 vaccines are recommended in pregnancy

Encouraging staff to be vaccinated

Like some other vaccines, levels of protection may begin to reduce over time. The COVID-19 vaccine booster dose will help extend the protection you gained from previous doses and will give you longer-term protection.

Testing

Highest Risk List

People who were on the Highest Risk List

The Highest Risk List ended on 31 May 2022. The success of the vaccination programme and the availability of new medicines to treat COVID-19 means that the majority of people that were on the list were at no greater risk from COVID-19 than the rest of the population in Scotland.

The Chief Medical Officer has for some time advised people who were on the Highest Risk List, including children, to follow the same guidance as the rest of the population unless they are advised otherwise by their GP or clinician. This applies equally to household members of people who were on the list and includes going into schools and early learning and childcare settings. He has also advised people whose immune system is suppressed to take extra care and follow the advice of their GP or clinician, as they would have done before the pandemic.

Staff who were on the Highest Risk List

It continues to be the employer’s responsibility to regularly carry out workplace risk assessments and put in place measures to make the workplace as safe as is reasonably practicable to try and minimise risks to staff. Employees also have a responsibility to comply with safe working practices.

Specific COVID-19 workplace risk assessments are no longer necessary. COVID-19 risks should be considered as part of wider workplace risk assessments.

The Distance Aware scheme includes a toolkit to help those worried about mixing with others as we adapt to living with COVID-19. More information is available online at Coronavirus (COVID-19): distance aware scheme.

Hand hygiene

Hand hygiene is important in reducing the transmission of infections. Everyone within a setting should carry out effective hand hygiene, at the right time to prevent the spread of COVID-19 and other common infections such as colds, flu and gastrointestinal illnesses.

Hand hygiene for staff

Hand washing must be performed after exposure to any blood and or body fluids e.g toileting (including nappy changing), after providing care to a child with a diarrhoeal or vomiting illness, after exposure to respiratory secretions and when hands are visibly soiled/dirty. 

In all other circumstances, hand hygiene can be performed using an alcohol based hand rub (ABHR) provided this is stored securely out of the reach of children. Read best practice on the use of ABHR online as part of the National Infection Prevention and Control advice. It is not recommended that children under the age of 5 use ABHR.

Hand hygiene for children

It is important that children understand why it is necessary to wash their hands and are supported to do so. They should be taught how to wash, rinse and dry their hands correctly from an early age.

There are a range of resources available from the NHS such as the Children’s Pack to encourage children with handwashing. NHS Education for Scotland (NES) has produced a video to demonstrate the correct way to wash hands with liquid soap and warm water.

Support children with handwashing at the following times:

• on arrival to the setting
• before and after eating or handling food
• after toileting
• after having contact or touching animals
• when returning from play outside
• after blowing your nose, coughing or sneezing
• after contact with contaminated surfaces
• at regular intervals throughout the day

Best practice for hand washing can be found online as part of the National Infection Prevention and Control Manual.

The following are good practice points pertaining to hand washing:

• use warm water, wash hands for 20 seconds and never share water in a communal bowl
• use liquid soap (there is no need to use soaps advertised as antibacterial or antiseptic) and rub hands in the order described in the link above
• dry hands thoroughly using disposable paper towels (childminders may use kitchen roll or a designated hand towel, which should be washed every day or more often if visibly dirty). A designated, lined bin that the children can operate easily should be provided for the disposal of hand towels
• all visible cuts and abrasions should be covered with a waterproof dressing
• when away from the childcare facility, and if there is no running water available, hand wipes may be used (children and staff should wash their hands at the first available opportunity)
• encourage children not to touch their face

Hand washing when outdoors

When learning is undertaken outdoors, considerations should be made on how to continue to provide suitable hand hygiene facilities for both staff and children.

We recommend liquid soap and warm water for children under the age of 5 and where hands are visibly soiled.

Respiratory and cough hygiene

Respiratory and cough hygiene is designed to minimise the risk of the transmission of respiratory illness such as COVID-19. We appreciate that it is difficult to follow respiratory and cough hygiene practices, especially when working with very young children. Where possible, we recommend that staff and children should always try to:

• cover their nose and mouth with a disposable tissue when sneezing, coughing, wiping and blowing their nose. If a disposable tissue is not available, use their elbow to cover their nose and mouth when coughing or sneezing

• dispose of used and/or contaminated tissues and face masks immediately into a waste bin after use
• wash hands with liquid soap and warm water after coughing, sneezing, using tissues, or after contact with spit or mucus
• when away from the childcare facility, and if there is no running water available, hand wipes may be used by staff and children and ABHR then applied (over the age of 5). Hands should then be washed at the first available opportunity
• keep contaminated hands away from the eyes nose, mouth and other people
• do not touch your face with unwashed hands if you can avoid it
• encourage children not to touch their face

Routine cleaning practices

It is important to maintain high levels of cleaning within childcare settings to reduce the risk of transmitting COVID-19 and other infections. 

Settings should produce local cleaning schedules which stipulate how frequently cleaning should take place and who is responsible for carrying it out.

A full routine clean should take place at least daily, which includes touch surfaces such as door handles, telephones and keyboards.

General purpose detergent is sufficient for general areas and staff undertaking cleaning should wear apron and gloves. Disinfectants should be used to clean toilet areas and food preparation areas. Surfaces in dining or snack areas should be wiped down and disinfected between use by each group of children. A disinfectant should also be used in any general area of the childcare setting if there is visible contamination with blood or body fluids. Cleaning staff areas should be an integral part of the routine and enhanced cleaning strategy.

Refillable spray containers are not recommended for use for cleaning products as there is a risk of contamination and other associated risks, which will prevent effective cleaning standards. Cleaning products which come in non-refillable spray containers may be used as long as they conform to EN standards. 

Enhanced cleaning should also be carried out in the event of an outbreak (see the next chapter for information on this).

Equipment cleanliness

All toys and equipment must be safe for use and well maintained to reduce the spread of COVID-19. Advice on general equipment management can be found at: Infection Prevention and Control in Childcare Settings.

We recommend:

• toys and equipment that children access should, as far as possible, be cleaned daily, if visibly contaminated or if groups of children change during the day, on a sessional basis
• sand does not need to be changed daily and standard cleaning and changing protocols should suffice if good hand hygiene is carried out prior to and following the use of the sand
• if soft furnishings (such as throws and bedding) have been used by a child who shows symptoms of COVID-19, they should be removed and laundered as quickly as possible at the highest recommended temperature in accordance with the manufacturer’s instructions
• children are allowed to bring toys from home to the setting, but if visibly contaminated in the setting or shared among other children then the toy should be cleaned appropriately

In the event of a COVID-19 outbreak (two or more confirmed positive cases within a 14-day period), regular cleaning regimes should be temporarily enhanced. See the next chapter for more information on cleaning during COVID-19 outbreaks.

Face coverings

Advice on face coverings is available on the Coronavirus (COVID-19) in Scotland page. 

Any individual who wishes to continue to wear a face covering in a workplace, health and social care or school setting (including childcare) should be supported to do so.

However, careful attention should be given to the needs of individuals with additional support needs when implementing this measure.

Face coverings and children's wellbeing

The use of face coverings may have an impact on babies and young children, especially those with additional support needs. The ability to see a person’s face clearly contributes to babies and young children’s communication and understanding. This is particularly the case for children with hearing loss, children who are learning English or another language and those who rely on visual cues to enable them to be included in learning.

Some children may need additional support and reassurance around the reasons for adults wearing face coverings, and the wellbeing and needs of children should remain a priority.

Clear instructions should be provided to staff on how to put on, remove, store and dispose of face coverings in all the circumstances above to avoid inadvertently increasing the risks of transmission. Advice on face coverings is available on the Coronavirus (COVID-19) in Scotland page.

Personal protective equipment 

Personal protective equipment (PPE) includes single-use disposable gloves, disposable plastic aprons, and fluid resistant surgical masks (FRSMs). PPE should be readily available, and staff should be trained on its use.

The use of PPE by staff within childcare facilities should continue to be based on a clear assessment of risk and need for an individual child or young person, such as personal care where staff encounter blood and body fluids.

Specific advice on PPE in education, childcare and children's social care settings can be found online as part of Infection Prevention and Control in Childcare Settings advice. 

Physical distancing

It is important for children to feel secure and well cared for, including through physical contact that is appropriate to their needs, especially when they are receiving personal care, need comfort or reassurance. 

Staff and visitors should follow general guidance for safety in the workplace in indoor communal areas, when not working directly with children and when moving around the building.

Ventilation

Advice published on 3 August 2021 emphasised the need for a renewed focus on the importance of good ventilation to help reduce the risk of transmission of COVID-19. The primary effective method of increasing natural ventilation remains the opening of external doors, windows and vents. All settings should work to increase natural ventilation where practicable, whilst maintaining appropriate internal temperatures. Guidance on heating, ventilation, lighting, noise and sustainability in ELC settings is available online as part of early learning, childcare and out of school care services design guidance, and we have also published general workplace guidance.

Ways to improve ventilation

• partially open doors and windows to provide ventilation while reducing draughts. Fire doors must never be propped open
• open high-level windows in preference to low level windows to reduce draughts when weather conditions allow, and it is safe to do so. You may wish to open windows at different sides of the building to get a cross flow of ventilation
• refreshing the air in spaces by opening windows, vents and external doors at times which avoid user discomfort (e.g. between sessions or when children are outdoors). This may be particularly appropriate during winter periods to balance ventilation and thermal comfort
• flexible uniform/staff dress policies to help ensure that children, young people and staff can stay warm if/when windows or doors require to be opened
• maintaining appropriate heating strategies

Settings should consider safety risks when opening windows and doors, and ventilation must be considered as part of local risk assessments.

The suitability of ventilation solutions will depend on a range of local factors including building type, occupancy patterns and weather conditions. All settings must ensure as a minimum, that adequate levels of ventilation are provided in line with existing guidance, the Care Inspectorate’s Space to Grow design guidance and the Workplace (Health, Safety and Welfare) Regulations 1992.

Guidance on ventilation is available as well on the webpages of the Health and Safety Executive.

Additional advice on ventilation, heating, temperature control and air cleaners which will also be applicable to childcare settings is available online in the Coronavirus (COVID-19) guidance on reducing the risks in schools.

CO2 monitors

CO2 monitors can be used to support good air quality and they can be particularly beneficial in enclosed spaces. Local authorities should ensure that all local authority schools and relevant ELC settings have access to CO2 monitoring, whether via mobile or fixed devices. This is to support the goal of all settings being assessed regularly for issues with a view to remedial action being taken when that is required.

Non local authority settings are encouraged to use CO2 monitors and should contact their local authority for advice. CO2 monitors have not been required in childminding settings, and therefore this guidance does not apply to most childminding settings (other than larger settings). 

It is important that local authority advice is sought on the use of CO2 monitors to ensure their proper specification, installation, location, calibration and effective use. Further guidance is avilable online from the Health and Safety Executive on ventilation in the workplace.

Outdoor learning and play

Outdoor play-based learning is an integral, every day, part of early learning and childcare in Scotland. It has many benefits for children’s physical and cognitive development, physical health, and mental wellbeing. It improves their social competence and connection with their communities, and helps them develop a connectedness with nature. It is our vision that children in Scotland will spend at least as much time outdoors as they do indoors as part of their ELC experience. The Playwork principles specifically support school age childcare development.

Being outdoors also helps to limit the transmission of viruses and illnesses, including COVID-19. Staff should consider how they can safely maximise the use of outdoor space, as well as the opportunities of day visits and excursions.

Risk assessments

Infection prevention and control in childcare settings involves carrying out risk assessments and putting mitigations in place to manage any risks identified.

Risk assessments are a legal requirement, and risks and mitigations should be reviewed and updated regularly, including taking reasonable steps to protect staff, children and others from infections such as COVID-19.

Managers must ensure that risk assessments take place on a setting and individual basis, where required, and that these include input from staff and assistants, and trade unions. Student placements should also be part of risk assessments.

Specific COVID-19 workplace risk assessments are no longer necessary and COVID-19 risks should be considered as part of wider workplace risk assessments.

Setting-level risk assessments are expected to consider all risks identified in respect of infections, including COVID-19. These must take account of relevant guidance from Public Health Scotland and the Health and Safety Executive. All risk assessments should be reviewed regularly and as circumstances change.

To help with setting-level risk assessments, the Health and Safety Executive has provided advice at managing risk and risk assessments at work, and a risk assessment template.

Children with additional support needs

Every child will have different levels of required support and risk assessments play a key part in considering the individual needs of a child. Risk assessments, which may be integrated into a Child’s Plan, should already exist for children with complex additional support needs.

These risk assessments should be reviewed and updated as appropriate, reflecting current circumstances. Where they are not in place or they have not been updated they must be undertaken or reviewed swiftly. Where there is a need to work in proximity with adults and children, the safety measures to protect adults and children alike should be followed.

Staff should wear a face covering or PPE where a risk assessment has deemed it appropriate (e.g. when carrying out Aerosol Generating Procedures), and regularly wash their hands before and after contact.

The Supporting Children and Young People with Health Care Needs in Schools Guidance provides advice for those with additional clinical needs. Advice for employees with additional healthcare needs, including pregnant workers can be found on the Health and Safety Executives Vulnerable Workers page.

Pick-ups/drop-offs, visits and trips

There are no ongoing COVID-19 related or other public health restrictions or recommendations on any movements in or out of ELC settings. This includes no requirement or recommendation for staggered pick-ups or drop-offs, break or lunch times, restricting visitors (including parents and carers) or restricting visits out of settings.