Child injured in nursery...

[loopymoomoo]

I am aware this isn't really an aibu but there seems to be an awful lot more traffic on this page...

My DD (2yrs) loves her nursery, she goes mon-weds full days for me to work and she has always loved it and still does.

The problem we have is that on the 1st October she had an accident there, we had a accident form given to DH when he collected her saying she had had a fall and cut her lip but was fine... this is no surprise as DD is very active and does fall/run into things/jump off steps etc.... apparently the accident was at 5pm and DH collected at 5.30.

He walks through the door with a very serious look on his face and says 'now don't panic but'.... her front top tooth is hanging out and she has a huge purple egg on her head, but she's absolutely in herself fine telling me she fell over in nursery and goes running off looking for her doll. I get doll and put DD in the car and head off to A&E.

DH phones the nursery and speaks to the manager that doesn't know anything about the accident but finds out for us, so we are told she's fallen off the bouncy castle and the girls were surprised as although her gum was bleeding she wasn't upset at all (she's a tough cookie!)

Eventually get seen by a triage nurse and she can't believe this has happened and is interrogating me about the severity of the injuries, luckily I grabbed the accident form on the way out of the door and showed her that, she was lovely to me just taken aback with the injuries.

So after about 1.1/2 hours with the nurse and a lovely Dr who has totally got DD's trust he manually pushes the tooth back into the gum, queue lots of screaming and DD attaching herself to me. They were quite happy it might be saved but to go to the dentist the next morning and keep her topped up with pain relief as she will be in pain.

Arrive at the dentist the next morning first thing and although DD has been a few times with me and been checked herself she goes ballistic, dentist says its probably because she thinks he will do what the Dr did the night before. I have an appointment for an xray on the 6th Nov to see if its settled as we couldn't really do much else. If it is damaged or will damage the teeth behind then he wants it taken out. The dentist again tells me that this is 'one hell of a whack she's had'.

I went to the nursery after the dentist to tell them what had happened and they showed me - she fell off a bouncy castle (albeit a small one) that was inside on a hard floor with no mats around it, so she fell off it face first onto a hard floor (think a canteen floor). Since the accident DD has come home and told me that the bouncy castle has a hole in it so its in the box in the cupboard...

The tooth is a little wobbly but hasn't turned black, the gums have healed but over the last two days DD has been telling me her tooth hurts and has been showing it to me by lifting her lips up, so I've given calpol here and there when she complains but have tried not to mention it to her.

I have had lots of advice from family/friends as to what they would do in my position, some I have ignored and other bits I have thought about more closely. Do not get me wrong I totally understand that accidents happen, especially to a very active 2 year old but it still is not sitting well with me that any adult would think a bouncy castle is ok without mats around it or that no-one mentioned the egg on her head or the tooth that was hanging out...

The nursery has a very good reputation and I must say I haven't had any reason to complain before but I really don't know what to do. My husband says we should write a letter of complaint but I have no idea what to say, I also worry that if we took it further it might change the level of care that DD is currently receiving?

Any advice?

Sorry this is so long!

Someone who knows more about the legal / nursery / ofsted side of things will probably be along soon...

...about her tooth. Aged 2 it would have been a baby tooth. You need a referral urgently to a paediatric dentist. When I trained I was taught never to put back a knocked out or partly knocked out baby tooth due to risk of damage to the adult tooth developing underneath. We were taught always to extract, with general anaesthetic if appropriate. Disclaimer: I finished training 13 years ago. Things might have changed. I'd still get to the specialist though...

I think that accidents happen but that the nursery is on this occasion negligent. She should have had the head injury checked out. Indoor bouncing without proper safeguards should not have happened.

DD didn't run into a door, or fall while running outside, she hurt herself during a structured, supervised play because measures were not taken to make the play safe.

• assurance that the nursery have addressed any staff training issues
• review of procedures for medical help as they really should have done more than phone DH.
• confirmation that they see the problem and have taken steps to avoid a reoccurance

the minimum I would expect

In your shoes, I would set up a meeting with nursery manager and ask to see their risk assessment or policy for the bouncy castle. If the procedures that were on the risk assessment were not followed, such as where the bouncy castle should be and on which surface, you can write a formal complain to the nursery. You can ask that the reply be in writing. If their answer is not satisfactory you can formally complain to Ofsted.

It sounds to me as if the nursery either didn't follow their risk assessment (I think it's pretty obvious that a bouncy castle shouldn't be on a hard floor without some kind of carpet/rug) or didn't do a proper assessment to start with, which they need to do. Your child's injuries were quite severe, but imagine if she would have hit the back of her head instead...

Agree with Queen

Accidents happen but this could easily have been avoided. Why not have matting down?!

they should have phoned you especially as it was a head/facial injury. my kids fell over at nursery, she faceplanted on the playground, nose first.

they phoned me immediately, i had to sign the accident form.

Personally at this point, i would ask for a meeting with the nursery manager to discuss this, you should have been phoned about it, even if it was right at the end of the day.

i dont like how they downplayed her injuries. i'd be looking for the nursery manager to be doing a proper investigation into how/why this happened.

Yes, falls happen, but not off a bouncy castle onto an unprotected hard floor!

Thanks for the reply!

Yes the dentist was not happy about the Drs work at all, I have to admit all I could think of was to save the tooth - The 'adult' teeth didn't even come into my thinking!

The dentist said that because the way the tooth has moved it shouldn't have damaged the developing tooth below as the root of the baby tooth was pushed forwards not backward (if that makes any sense).

He wanted the xray but there was no way DD would have stayed still for one on the morning so that's why he booked one in on the 6th, he did say that if I'm worried about anything to just turn up at the surgery and he will see us next; I'm thinking I might take her back tomorrow if she complains about the pain again tonight.

It will just break my heart if she loses the tooth. x

Accidents happen, but who on earth would let young kids use a bouncy castle on a hard floor without mats?

Also why didn't the nursery tell you?

If I were you I'd be kicking up a major fuss, that is rather neglectful of the nursery.

I hired a bouncy castle for an event once and remember there were a long list of safety conditions stuck on the side. I was a quivering wreck for the whole time it was out, in case anyone had an accident. I followed every recommendation and made sure it was watched like a hawk.
Also having worked at many nurseries over the years, they need to consider the accident risks of everything. Children have enough accidents without making it worse.
You totally should talk to the nursery and also consider getting the local council as well, before someone else has an accident. If there is a change in how your daughter is being cared for then it really really isn't a safe place for her to be!

sorry cross posted...

DH wasn't phoned about the incident, it just happened that the accident was at 5pm and she was collected at 5.30.

I have had risk assessments mentioned quite a few times.

When I went to the nursery after the dentist the manager was at best 'sheepish' with me.

thanks for your replies, I'm just nervous about making DD's time there less enjoyable - if that makes any sense?

I'm not sure on this one. Same thing happened to DS at nursery except that there was padding everywhere and he still managed to kill his tooth. It's still in place though, and not black just dead. The dentist advised us soft food for two weeks. He has since knocked it again so it's very wobbly but still in place two years later.

Tbh I wouldn't take any further action but maybe that's because we are two years out from our equivalent incident and the horror has receded !

Don't worry if she looses the baby tooth. It's not ideal, will look horrible and may mean she needs braces when her adult teeth come through. It is however far far better than her getting an infection which actually damages the permenant tooth. I'd be pushing for extraction under general for my (nearly) 2 year old.

Obviously please get photos of the injuries. Both your dentist and the A&E will have made notes which you might need to refer to later, depending on how far you take this.

You need to ask the nursery to show you their risk assessment for the bouncy castle, ask when you are in there not over the phone so they have no time to develop one!

Ask why there was no matting down.

They have been extremely negligent and unless I was having grovelling apologies for their fuck up I sure as hell wouldn't be sending my child back. Good reputation or not they dropped the ball on this one

Accidents do happen but to not have any mats down when 2 yr olds are on a bouncy castle is plain irresponsible, could be wrong but i would think a no win no fee solicitor would have there insurance company for a decent payout for you, just depends if doing that sits well with you or not but if they had injured my child through neglect by not putting mats down i would be hanging them out to dry

And the advice about photos of the injury is good if you do decide to take things further

Please don't worry, they will NOT take it out on dd or treat her differently, really. This is such a common and natural fear for parents but the massive majority of early years staff adore the kids they care for and would do anything for them, they'd never blame a child, would behorrified that anyone could, and most nurseries deal with some really challenging parents - not a very reasonable one like you wanting to discuss a serious accident.

Yes absolutely follow up. Ask for the risk assessment, ask for a meeting with the manager, you need urgent reassurance that dd is safe in their care. Poor little girl, hope she's recovering well.

I would deffo take dd back to dentist for review if she has pain and ask about a referral to the community paediatric dentist.

From the nursery point of view I would want reassurance that lessons have been learnt and they have reviewed their risk assessments. Often these things are one offs, whilst we want things to be 100% safe mistakes and accidents do happen.

Hope the tooth is ok

Thank you for replying everyone!

DH is picking DD up as we speak, he asked them this morning to keep an eye as she has been saying the tooth hurts. I will be taking her tomorrow to the dentist for my piece of mind- will keep you posted.

Think we need to sit down tonight and get a plan of action sorted. We will definitely ask about the risk assessment and any changes since the accident.

I totally agree accidents happen and the girls there are generally speaking fantastic, she adores them and goes running in to see her friends but when you keep getting told that 'you should do something' you start wondering well what should I do and how! X

Wow not to have proper matting down is awful and would be completely against any insurance policy of theirs.

There is a massive list of must-dos when using a bouncy castle in anything other than your own front room.

Appropriate safety matting is always essential.

as a dentist I would not have pushed baby tooth back I would either have left it or extracted it I trained 24 years ago but last trauma to teeth course i was on still said the same about not trying to re-position baby teeth in mouth however with a permanent tooth the advice is the opposite and you would try to re-position immediately and you would re-implant it if knocked out completely

on the other hand 1 in 8 toddlers damage a tooth this includes everything from chips to knocking tooth out completely with toddlers girls and boys are equally affected with adult teeth more boys than girls damage them accidents do happen so although the nursery could and should have had mats I would disagree that it is extremely negligent personally I would not sue but try to ensure changes happen,

it is from your history likely that tooth will discolour ( grey) and even if it survives right now it may require extraction before it is due to fall out age (5.5-7.5)

Thanks everyone, I have showed DH this thread tonight and he says it was a great idea to gauge what to do next. I'm going to send DH in tomorrow to see the manager as I'm a bit rubbish in these situations.

So she banged it at 5 and they didn't have time to call you in the 1/2 hour, so I assume that when you picked up you did had the attention of the staff rather than having been treated and was now playing.

The manger didn't know - in my experience staff who help children with injuries are pretty good at passing on information. In all honestly I can't believe a staff member wouldn't notice a child tooth hanging out and not pass this information on to a superior.

I would suggested that the staff didn't even know the child's tooth had been damaged because they didn't bother to look.

I think you need to work out what you want from the nursery?

I think the poor judgment of the nursery would be a deal-breaker for me. who on earth sets up an indoor bouncy castle with no matting.

Ofsted only require medical attention in the event of an accident this can be a first aider having a quick look. They don't require medical attention appropriate to the injury so they are under no obligation to call for an ambulance if there is a serious injury.

When it comes to risk assessments and safety checks these only have to be done annually. Ofsted would encourage more frequent inspections but will give the setting a couple of weeks to produce evidence of checks having been carried out.

The department of your local council that issues the nursery's licence may be interested in the accident but won't necessarily take any action.

I would ask the nursery how the accident happened and how they plan to reduce the chances of it happening again. If you're not happy with the responses find an alternative nursery.

Oh that's tricky. Basic question - do you feel comfortable sending her back there?

Do you think she's safe there? Unfortuneate one off or symptomatic of a general lack of safety protocols?

Your poor dd - I bet that really hurt!

I'd be questioning the judgement of staff who decided to get the bouncy castle out on a hard floor with no matting and/or member of staff sat on the front to catch any falling children and ensure safe play. It would make me wonder what other safety precautions they were ignoring (high chairs, nappy changing, general supervision).

Having said that, they are most unlikely to take it out on your dd if you make a complaint. Most people who work with children simply aren't made that way.

The EYFS changed in September 2014, and I think the nursery are longer required to have written risk assessments (although it would still be good practice to have them). They still need to be able to demonstrate how they manage risk.

If a child has a serious accident requiring emergency medical treatment, this has to be reported to ofsted (by the nursery). Have they done this?

If a child is injured in their care then they have a duty of care to seek the appropriate medical treatment (and this would certainly include calling an ambulance if necessary! ) In your case, I think it was okay to expect your dh to do the a&e trip, but I'd be a bit worried that they hadn't noticed your dd's tooth hanging out.

If you make a written complaint about the lack of safety precautions (and I think you should) then the nursery are required to investigate this and get back to you within 28 days. They are also required to notify ofsted about any written complaints they get.

Think I would make the complaint, give it a couple of weeks, then call ofsted to check the nursery are dealing with this properly.