Supervision of Children Eating – Compliance and Quality Indicators

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Supervision of Children Eating – What this Should Look Like in Practice in Home-based ECE and in Centres.

Licensing Criterion HS19 (Home-Based) and HS22 (all centres but not including Hospital-based)
– Children are supervised and seated while eating.
– Where food is provided by the service, foods that pose a high choking risk are not to be served unless prepared in accordance with best practice as set out in Ministry of Health: Reducing food-related choking for babies and young children.
– Where food is provided by parents, the service promotes best practices as set out in Ministry of Health: Reducing food-related choking for babies and young children and must provide to all parents at the time of enrolment a copy of Ministry of Health: Reducing food-related choking for babies and young children.

Legal requirements and issues

The Ministry of Education intentions in setting the above criterion are “to minimise the risk of [children] choking on food and to ensure in an event of an adverse reaction appropriate action is taken”.

Meeting the licensing criterion is a legal requirement. But, the guidance that the ministry attaches to it is guidance only – which leaves interpretation of the legal requirement wide open.

The Education Review Office (ERO) told us that “it is not ERO’s role to interpret or comment on licensing criteria”. Yet, ERO may as part of reviewing a service find it to be non-compliant and report it to the Ministry of Education (MoE). Without an agreed on set of indicators of what supervision of children when eating must look like in practice, ERO and MoE staff can differ in what they each judge to be compliance or non-compliance. This can lead to disagreements and also uncertainties for services when there is a review or a licensing check.

So, we prepared a set of indicators to assist services to put quality and safe practices in place – thereby ensuring a service will be fully compliant and neither the Ministry nor ERO should have reason to doubt this.

We asked the Ministry of Education for their feedback on the indicators (see the next section for the indicators):

“Following a review of your draft compliance indicators we believe all of these actions would be ‘indicators’ of compliance with licensing criteria. However, it is also important to note that not all of your indictors are requirements.  Specifically, the following indicators are not requirements:

  • There is no regulatory requirement that the person supervising children while eating holds a recognised first aid qualification. 
  • Ratios are applied across the service, there is no ratio requirement applied to the number of children eating and the number of adults supervising those children.”

We believe that while it is not a legal requirement for the person(s) supervising children to hold a first aid qualification, a service must be able to explain how it ensures that in the “event of an adverse reaction appropriate action is taken”. Should a child suffer an adverse reaction, WorkSafe are likely to consider whether the person/s supervising the eating are first aid trained.

The same goes for ratios. The ratio requirements are set on the basis of the minimum considered acceptable for safety when children are in the service. It therefore follows that for supervision of children when eating (a high risk situation) these would also be the ratios that a service should at least have if it is to be considered to be taking all reasonable precautions to prevent injury.

Indictors of compliance and quality supervision of children eating

Definition of ‘supervisor of children eating’

For this licensing criterion, the supervisor for children eating is defined as an adult who holds a current recognised First Aid qualification (or higher medical qualification) that included a course component on the appropriate response to a choking infant, toddler, and older or larger-sized child.  

Quality supervision of children eating to ensure compliance and child safety

The following are requirements for quality supervision of children who are eating (these do not apply to children who have finished eating but may still be seated).

  • For up to every 10 over-twos children eating there is at least one adult who supervises.  For up to every 5 under-twos there is at least one supervisor for eating. In mixed-aged settings over-twos may be counted in the under-twos ratios where there is spare capacity.
  • The supervisor for eating is physically present in the same space as children (i.e., not supervising children by remote means, watching from another room, or keeping an eye on children through a window).
  • The supervisor for eating may be seated with the children, or in another position such as standing. However, at no time is the supervisor in a position that they cannot still see the front of children (i.e., they will not have their back to the children and no child will be seated such that their back is to the supervisor).
  • The supervisor for eating provides a calming, settling environment for children’s eating.
  • The supervisor for eating ensures children are seated when eating, encourages children to chew their food, and to talk only when they do not have food in their mouth.
  • In addition to watching and assisting the children who are eating, the supervisor/s may engage in activities and attend to tasks that do not see them turning their back or leaving the children (even temporarily).  Activities and tasks the supervisor may engage in include:
    • Eating lunch or snacks along with the children.
    • Spoon-feeding and bottle-feeding infants and young children unable to do this on their own.
    • Giving a child a cuddle or holding an upset child in their arms.
    • Helping a child with unwrapping a food item and getting a lid of a packaged item.
    • Guiding children in cutting/grating/mashing food they may have brought from home, or doing this for them (depending, of course on safety factors and children’s own capabilities).
    • Telling a story (with or without a book or finger-puppets/ hand-puppets), saying some rhymes or poems – but this should be managed carefully so the focus is on children listening and not engaging in actions.
    • Engaging in professional conversation with other supervisors of children’s eating when necessary for optimal co-ordination. 
    • Talking to another adult when assistance is needed. For example, to bring a cup of water or to check on a child who hasn’t returned from the toilet. (See the next section below for more explanation)

Assistance and peparations

Preparations in advance of meal/snack times to support active supervision may be necessary, particularly if the service is operating on minimum adult:child ratios at the time and there is no adult or parent spare to be a ‘runner’. Anything that may be needed – such as cleaning materials and a bucket to clean up any spills or wipe surfaces – should be on-hand before children are seated for eating.

Another adult, a ‘runner’ may be needed to ensure that the person/s supervising the children do not need to leave them while they are eating. For example, the ‘runner’ may go to help a child with taking off their outdoor jacket and hand-washing before sitting at the table, the ‘runner’ may go after another child who has moved away while eating, or may be needed to collect more food or plates from the kitchen.

Seating

Children may be seated on any surface that is assessed as safe – this may be on a chair at a table, in a high-chair, or sitting on a floor mat, the deck, or grass under a tree.  It may also be on the lap of an adult providing the adult who is supervising (who may or may not be providing the lap) has a clear vision of the front of the child.

Highchairs present an issue only if not stable (which could put a child at risk of choking if the highchair is knocked) and if there is not a quick release mechanism on the highchair.   

Managing spontaneous eating and ‘grazing’

Should the ECE service have fruit trees and/or an edible garden – it may support children to pick fruit, vegetable and herbs and prepare these for eating according to health guidelines. (Note that involving children in food preparation is an appropriate early childhood education learning activity.)

The above indicators of compliance for supervision also apply when a child is eating outside of usual meal or snack times at the service. Namely that an adult with first-aid/medical training is in the same space as the child who is eating, has a clear view of the front of the child, and is fully available to guide or intervene if needed to ensure safe eating.

… ENDS.

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