Nappy changing for early learning and childcare settings

Overview

This document offers a practical guide on aspects of nappy changing while balancing the need to reduce the risk of infection for children, staff and anyone accessing the setting.

All early learning and childcare (ELC) building-based settings (excluding childminders) that care for children who use nappies must have appropriate changing facilities.  This includes a safe, clean environment with appropriate equipment. Children's privacy, dignity and, where appropriate independence, must be respected and always promoted.

Nappy changing must also be supported by staff who understand and implement current infection prevention and control good practice. This can be demonstrated by staff understanding the importance of good hand hygiene, effective cleaning of equipment and the environment to reduce the risks of transmitting any infection to children, staff and anyone accessing the setting.

All providers are expected to follow the Health protection in children and young people settings, including education (March 2024).

There must be a minimum of one nappy changing facility for every 10 children using nappies. This is consistent with the minimum number of toilets required for older children.

For new registrations and variations to settings that need nappy changing facilities, the expectations in this guidance are the minimum standards that must be met. This is to support and protect the health and wellbeing of every child and staff member.

When we register, inspect, undertake a complaint investigation, or consider a variation to your setting, we will review the facilities and outcomes for children.  We may identify areas for improvement or make requirements where improvements are needed to ensure positive outcomes for children.

Introduction

The 2013 Nappy Changing Guidance was introduced to the ELC sector following a serious outbreak of E. coli.

We acknowledge the diverse needs of early learning and childcare (ELC) providers. We remain committed to working in partnership with the sector to develop practical and proportionate solutions. These solutions will continue to prioritise children’s health, safety, and wellbeing.

In every aspect of ELC, it is vital that staff build strong relationships with children. Children benefit from warm, responsive and sensitive interactions, and nappy changes provide a great opportunity to spend valuable one-to-one time with children. Connection supports a sense of wellbeing and belonging, and children should feel safe, nurtured, included and respected when being changed.

It is important that everyone who plans, provides, commissions or uses ELC settings is aware of the required nappy changing facilities. All providers and staff working with children in ELC settings must have a clear understanding of their responsibilities to keep children and staff safe, and to prevent the spread of infection. They should have knowledge of and understand infection, prevention and control guidance, policies and procedures.

Providers have a responsibility to consider any new guidance or research as it becomes available.

Background

Infections are caused by microorganisms (bugs) including bacteria, fungi and viruses. There are many types of microorganisms, they are found everywhere, and most are harmless.

Gastrointestinal infections such as Norovirus, Salmonella, and E. Coli, are highly contagious and may be spread within the nappy changing area if standard infection prevention and control procedures (SICPs) are not properly followed.

The outcome of such infections can be serious for those affected, with children aged under five years most susceptible. It is important to be aware that some people can be infected but do not show any symptoms (carriers).