All schools need to be prepared to deal with pupils who have wet or soiled themselves. Many young children will have an occasional ‘accident’, perhaps because over-excitement has meant that they have left it too late. Others may be late-developers or there may be an underlying physical or psychological cause for the wetting or soiling. Schools may find that these types of issues become more acute because of the extension of early years provision due to both the increase in the number of hours children may attend nursery and the trend towards early admittance to reception
The purpose of this guidance is to:
- help teachers and support staff to understand their role in this area
- suggest ways in which schools can adopt policies and practices which will minimise the likelihood of accidents occurring
- ensure that when they do happen, they are dealt with in an appropriate way.
It is not the role of schools to toilet train children entering nursery. It is reasonable to expect that this process should have begun by the time the child is admitted, even if in most cases the child may not be fully toilet-trained. Under the terms of the Equality Act 2010 schools must not refuse admission to a child who is not toilet-trained because of a disability.
All schools should have a continence policy setting out how wetting or soiling incidents will be dealt with. The policy should also set out how vomiting incidents will be dealt with. When children become ill at school, vomiting and soiling are often the unfortunate end result. The NEU publishes separate guidance – Hygiene Control in Schools – which sets out the procedures which should be followed by schools to minimise the risk of infection.
What should be included in a school continence policy?
The most important issue to cover is that it is not part of a teacher’s professional duties to clean up children. Such a responsibility cannot, therefore, be added to a teacher’s job description. Quite apart from the fact that such a task is not making good use of a teacher’s skills and time, there are practical issues too. Teachers cannot simply abandon their class to attend to a child who needs this kind of assistance.
Although the vast majority of teachers would assist in an emergency, as no child should be left in wet or soiled clothing, it is important that there is no expectation that routine and predictable incidents are dealt with by teachers.
Some members of support staff may have the duty of helping children with personal care written into their employment contract. However if this isn’t the case, it should not be assumed that they will undertake these duties. Where changes are proposed to employment contracts, or job descriptions, negotiation is required. A generalised clause, which appears at the end of nearly all job descriptions requiring a support staff employee, to carry out ‘any other reasonable request’ by management does not give managers carte blanche to simply impose permanent additional changes such as administering personal care.
Others areas to be covered in a continence policy are:
- The importance of building a supportive and sensitive relationship with the parent/carer and including the class teacher, special educational needs (SEN) co-ordinator and school nurse.
- The need for spare clothes to be provided by parents where regular wetting/soiling occurs.
- Where children will be taken to be cleaned up - the area chosen should be private and should be easy to clean.
- The procedure to be followed when incidents occur. Parents should be informed how their child will be dealt with, taking into account the age of the child and the extent of the soiling. Written permission should be sought from parents that they accept the procedure.
- That there is no legal requirement for two adults to be present in such circumstances and that such a requirement might in any case be impractical.
What can schools do to minimise the likelihood of accidents occurring?
Notwithstanding the fact that some children will have underlying problems that need to be addressed with the support of medical professionals, there are steps which schools can take to reduce the likelihood of children wetting and soiling themselves.
For children to stay healthy they need to drink water regularly throughout the day. They also need to empty their bladder and bowels regularly and fully when the need arises.
Having set times for access to the toilet can cause “I’ll go just in case” practices which means the bladder doesn’t get used to holding on until it’s full. Over time, the bladder capacity can reduce, increasing the need to visit the toilet more frequently. At the same time, the amount of fluid a child can drink before needing to go to the toilet is reduced. This results in a vicious circle. A child may consciously or unconsciously ration their fluid intake, or avoid drinking altogether, if they fear not being able to go to the toilet when they need to.
It is of course recognised that allowing children access to toilets at all times can be disruptive. Some children will abuse such a policy. Also, there are good reasons for encouraging all children to go to the toilet before embarking on a school visit. It is worthwhile however, for schools to consider how to maintain order and discipline in this area, while at the same time considering possible long-term health effects for children.
Some children may attempt to lessen their liquid intake to reduce the need to visit the toilet because of concerns about a lack of privacy, unpleasant toilet conditions or not enough time to visit the toilet. These issues are dealt with in more detail below.
Privacy is a major issue for children of all ages. Adequate locks that are easy to operate and that other pupils cannot open from the outside are essential, as are doors/partitions that are high/low enough so that other children cannot look over/under the door.
Smelly toilets are a deterrent to many children who may ‘hold on’ until they get home in order to avoid using unpleasant facilities. Apart from partial or total refurbishments which may be a long-term solution, the best way of eradicating bad smells is the establishment of a programme of regular cleaning – at least twice a day.
Toilets deteriorate over time. The worse state they are in, the less carefully pupils look after them and so they deteriorate further. Toilets need to be well maintained, promptly repaired and cleaned adequately (which in most schools will mean at least twice a day) and then pupils need to be encouraged to take responsibility for, and ownership of, them in order to keep them in a reasonable state. Peer pressure may be more successful than staff pressure as pupils may be more likely to listen to each other than to teachers in this respect.