What adjustments should nursery be making?

[gdaysport]

DD is 3.5 and has been at nursery since she was one. She is on the ASD pathway for speech delay and is mostly non verbal at nursery. She has sensory issues with sound such as crying.

She initially loved the preschool room but they moved her keyworker who she loved to another room and since then we’ve had a few incidents that have resulted in me asking for a meeting with the nursery manager tomorrow, such as DD being able to scratch and cut her arm in distress which was not noticed by staff. Today they also didn’t notice that she didn’t come in from the garden and eventually found her outside in a playhouse - I don’t know the length of time it took for them to notice she was gone as they want to discuss in person.

I know they can’t change the ratio but it just feels like she’s not being watched enough. They always seem to appoint the room leader as her keyworker - would a room leader have enough time to also look after a SEN child?

I don’t want to be fobbed off - what reasonable adjustments should they be making? They used to have some smaller group or even one on one sessions with her for speech but that’s gone since she’s moved to the bigger room.

That sounds really tough, OP - I have no advice but giving you a hopeful bump in the hope of more knowledge mumsnetters coming along soon.

I’d be interested to know how you know she scratched and cut her own arm in distress if no staff noticed her doing it.
If she were in a school nursery, we would be looking at what additional provision she would need, apply for Early years funding to enable them to appoint an extra a staff member, and ensure a referral had been made to relevant agencies.

Even if she didn't have SEN they sound quite negligent -- especially the playhouse incident.

I’ve put two and two together sure, we already know she can sometimes scratch her inner arms when upset and I noticed her arms were scratched raw when I took her coat off as soon as got home so she had absolutely done it at nursery. They never normally mention if she’s been upset by sound but that day they did mention that it had been paticulary noisy and they had needed to use her ear defenders for a lot of the day.

i didn’t know nursery could ask for more funding - why would they not seek to do that, surely it benefits them?

I'm pretty sure they can't get any extra funding until you have a definite diagnosis.

Yes they can. No diagnosis needed. https://www.bolton.gov.uk/downloads/file/2212/early-years-sen-inclusion-fund-five-minute-facts#:~:text=The%20Early%20Years%20SEN%20Inclusion,learning%20through%20direct%20adult%20interventions.

OP, look at your LA website for their Local SEND Offer. It will have details of the EY Inclusion funding but may be called something different in your LA.

Apologies - I didn’t mean to imply she didn’t do it at nursery. I meant she could have done it absently. My DGD scratches herself particularly in her inner elbows and behind her knees as she has super sensitive skin. When she’s hot and bothered she does it more. She’s not necessarily in distress though. She even does it in her sleep so can wake up from her nap scratched.

Honestly, I would take her out. They are clearly not able to meet her needs and she sounds very distressed. If that isn’t an option, would you/they consider moving her to a younger room with more staff/better ratio?

It's needs based, not diagnosis based. Early years funding was really simple for us. Within 6 weeks of attending, I was approached to ask if DD1 could be observed by an inclusion coordinator. She came out the following week. DD1 had a less than 30 seconds attention span, so they immediately funded 1:1 support. I still paid the preschool fee, but the LA paid for her additional support costs.

Also, @gdaysport you can ask for a referral to Portage, and they can advise the nursery on how to manage your DD.

That’s ok! Yes DD loves to stick her fingers inside my elbows for comfort - she could have done it absent mindedly - it’s more they didn’t notice the scratches - they look so sore!

The problem is, the younger room is more of a sensory trigger for her as the younger children tend to cry more.
mice considered a childminder but what happens if the other children there are a huge noise trigger for her and the CM doesn’t have the resource to take her into another room like nursery can. It’s such a hard balance to find….

Do you want to keep her at the nursery? My son is non verbal, we were having difficulties with his nursery being able to meet his needs. It was the health visitor who told us to apply to the council special needs provision. Which we did, and got accepted for. We were nervous about changing nursery but it was the best thing and wish we'd done it sooner. I'd speak to your health visitor and ask what options there are in your area for an establishment that can specifically meet the needs of your child.

My DD is 3 (non-verbal, most likely ASD) and she started in the pre-school room a couple of months ago and straight away was under an enhanced ratio of 1:4 as opposed to the usual ratio of 1:8.

They’re also applying for early years funding, she has a support plan in place plus a risk assessment and a de-escalation plan in place to help her when dysregulated. Looking to apply for an EHCP as soon as possible too.

Her portage sessions stopped when she started nursery but nursery should have an inclusion support contact who they can ask for advice.

She needs a diagnosis. Be careful not to go in guns-a-blazing: the nursery can refuse to have her if they don't have adequate staffing to cover what you want/ need. Clearly they don't and both these incidents show they are under staffed for her requirements. This will also be impacting other children. I know this because I work in a preschool. We have undiagnosed child who is taking up 1:1 on staff (we rotate him between us). This means the other 25 children are understaffed even though we are 'within ratio' . If she had a 1:1 and these incidents happened then you would certainly be able to complain. You should be pursuing a diagnosis through nursery/ GP, although it's going to take a while.

It's very difficult at the moment, kids are over excited. Staff are off sick. Nursery I'm sure will apologise but it's going to be challenging to actually change anything without 1:1.

The garden incident is pretty bad though - and not specific to her needs. We check the garden when the children are all in (particularly play houses) and we also count them soon after they come in. The scratching... I can easily see that happening if she's sorting quietly somewhere doing it.

Also they will be giving her to the room leader as this is likely the most experienced person in the room. You could just ask for her to have whoever she has the closest bond with.

My DD has no diagnosis, but nursery are already giving her a 1:4 ratio (usually they need the extra funding before they can do this). But they have just sent off forms to request this.

In terms of a diagnosis, next month NHS speech and language will request for her to be put on the ASD assessment list- if accepted, it will be an 18-24 month wait to be seen.

I guess it depends on each setting too, eg my DD’s nursery would probably not be able to meet her needs if an EHCP says she needs 1:1 for the whole time she was there and then I’d have to move her to a special nursery.

I agree with this, the incidents mentioned would really bother me, regardless of ratios or SEN.

I would ask for a meeting with the senco and nursery manager. Explain concerns and ask what they can put in place going forward to safeguard, they can apply for funding from the local authority for 1:1 if it's deemed necessary. Ask them to risk assess this.

I would also ask them to do a Sen plan. Which will look at what areas they can support your dc and how they can do targeted work with her.

You can enquire about Applying for a ehcp with them although they may feel it's better to wait until at school so the plan is specific to needs in that environment.

If they are reluctant to start putting things in place to support your child I'd be concerned

Ignore anyone saying to be careful not to cause issue with nursery!! Nursery should be fully compliant with ensuring your child thrives in their environment.

I had a productive meeting with the nursery manager and SENCO this morning. They were pretty appalled that the scratching has gone unnoticed, and now all staff in the room know to not only watch for triggers or stressors for DD, but to watch her and redirect if she starts pulling at her sleeves.
They assured me and confirmed with CCTV that DD was alone in the garden for less than a minute before they realised and went and got her from the playhouse. This is the first incident we have had in 2.5 years so I am confident this will not happen again.
They have agreed to have the inclusion officer come in January to review and make suggestions (thank you PP for letting me know this was a thing!), as well as start the process for an EHCP. We also reviewed the current IEP in place.
As for noise sensitivity, they are going to split the current group into two rooms, with the newer preschool children going into a smaller room which will take her room total down to 16. It was great to get some positive feedback that she has formed some good relationships with children in the room. We also discussed the level of detail in her assessments to ensure it includes things like when DD stims.
I have followed up in writing so we have a record. I am still going to call the LA tomorrow to see what other support they can offer.

Thank you so much for your help!

I'm pleased to hear you had a such productive meeting @gdaysport. My advice is to make some notes of it, while it's still fresh in your mind - who was there, what was said, the outcomes etc. It's useful if you ever have to hold anyone to account; I had a pretty hefty file by the time my son left school!