Planning child care when in the medical profession can be challenging, due to unpredicatable and antisocial working hours.  Personal circumstances will dictate which option is best for you and your children. Whatever you choose it is essential to have a ‘plan B’ in place – even the best arrangements sometimes fail!  You need to consider your working hours, the age of your child, your expectations, priorities and budget. Looking at what is available locally is a good place to start.  www.direct.gov.uk/childcare

Child Minder

Usually self employed so working hours can be flexible,childminders care for childen in their own homes and offer a family enviroment, with a single carer and a limited number of other children. Childminders are Registered with the Local Authority and inspected by OFSTED (Office for Standards in Education), they undergo basic training including first aid. A childminder is usually cheaper than a Nursery. They care for children of differing ages and can accommodate school collection so siblings can be cared for together. Your child must be taken and collected and alternative arrangements will be needed for illness (either child or minder) and holidays. A written contract is not required but is a good idea. national child minding association

Nanny (home based child carer)

Can offer the most flexibility and care for your child in your own home (may even live in). Some Nannys may agree to additional duties such as cooking, laundry, tidying-up. Many will have qualifications such as nursery nurse training, but they are not required to- anyone can be a Nanny. They are not usually OFSTED inspected, but can be members of the Care Approval Scheme.(this scheme is likely to be replaced with volutary registration with OFSTED).  A Nanny is the most expensive option- you have to pay their National Insurance, holiday and sick pay, employers indemnity insurance and sometimes car insurance and mobile phone use. Be prepared to legally and financially become an employer.  Finding a Nanny wil take time- assume 12 weeks. An agency will charge you a fee (one month salary), but will check references and qualifications. Advertise through magazines such as Nursery World and The Lady or in local papers and notice boards.  Ensure you job description is accurate and agree terms clearly before signing a contract. Take references but speak in person to previous employers. Strongly recommend a company such as Nanny Tax, who will undertake the accountancy, provide payslips and give legal advice.  Again-have back up- what will you do if the Nanny is unwell?

Au Pair

Only suitable for the care of older children, an aupair is usually a European student wishing to come to the UK to live with a family and learn English.They are allowed to work for a maximum of 5 hours, 5 days per week and stay for a maximum of 2 years. They are provided with meals and accommodation in addition to a weekly allowance. They are neither trained nor registered and so can be very variable. There may not be an opportunity to meet before they come to live with you. Make your expectations very clear from the outset re smoking, boyfriends and especially what they are required to do. You role will almost be parental and language barriers may be challenging. Despite this, an Au Pair may be a relatively low cost option and a chance for your family to experiece a different culture. An ‘Au Pair plus’ may take on additional duties-see the web site below for more details.

Day Nurseries

Care is offered from six weeks of age (some only from 2 years) to school age. Nurseries are run by the state,voluntary organisation or privately owned. Some offer after school and holiday clubs for older children. Opening hours are usually 8am to 6pm, Monday to Friday, virtually year round. As care is not single person dependant, they are not affected by staff sickness or holidays. Nurseries are registered and OFSTED inspected. Children gain a broad experience with access to different activities, equipment, toys and plenty of opportunities to make friends. Your child will need to be dropped of and collected-alternative arrangements are required when they are unwell. Many NHS Hospitals have day Nurseries, often with long waiting lists, doctors do not have a high priority.  Nursery School-this offeres free education to 3-4year olds during term time, usually only morning or afternoon sessions. While this is great for the child it does not offer a lone solution for most working parents.Playgroups- again offer a few limited hours at a time only.  national day nursery association

Tax Relief-Employer Supported Childcare

The childcare voucher scheme is not means tested and therefore available to all. This is paid directly to childcareres from the parents employer; currently £243 per parent per month. This needs to be arranged directly with your employer. Contact your Human Resources depatment. www.hmrc.gov.uk/childcare

Who will be taking care of my child?

  • How long have staff been working in the role?
  • Children need to develop stable relationships with the adults caring for them. That is more likely to happen where there is not rapid staff turnover.
  • What training have they had for the job? What qualifications do they have? What experience do they have?
  • Better-trained staff are thought to provide better quality care and education. There is no doubt that experience counts when looking after children. Look for flexibility and a responsible attitude to work if this is the sole carer for your child.
  • Do you enjoy working with children and why?
  • It is important that adults providing early education and care enjoy their work. Theirs is the job of providing young children with a variety of stimulating and exciting opportunities to learn and develop to the best of their abilities, in a nurturing and secure environment.
  • Why did you leave your previous job?
  • Frequent job changes suggest previous difficulties. Continuity is key.
  • Ask about Sickness record.
  • If you are dependant on one other person to care for your child- frequent sick leave and problematic illness behaviour is extremely frustrating. Check this with previous employers.
  • Please can I see your police check, first aid certificate etc?
  • Don’t be afraid to ask.

Where will my child be cared for?

  • Can I look around the building to see the rooms and any outside play space?
  • Settings need to be safe, warm, welcoming and stimulating. Look for a variety toys and equipment and enough space so children can move around without falling over each other. Consider toileting/changing facilities.
  • Where can they play outside?
  • Where will my child rest?
  • Younger children need to rest during the day. Rest areas should be quiet, dimly lit, and appropriately furnished.

What will my child do all day?

  • Access to activities
  • Children need stimulating, varied interesting activities. What is on offer, do children get any choices?
  • What kind of food and drink will be provided?
  • At a minimum, look for evidence that children get some fresh fruit and vegetables, and are able to access water when they need it.
  • Will my child be with a regular group of children? How old are they? How will their timetable fit in with my child?
  • Being part of a regular group can have many benefits, learning to make friends, sharing, group activities, either with a peer group or with children of differing ages. What do you what for your child?

How is difficult and challenging behaviour dealt with?

  • Challenging behaviour needs to be dealt with sensitively. Strategies for understanding rather than reprimanding children are most effective. Consistency is important.
  • How will I know how my child is progressing? Are they Happy?
  • You should expect regular meetings with your child's carer.
  • In nurseries, you should be in contact with a member of staff with responsibility for collecting and coordinating information on their development. Ask for a daily activity/progress/meals diary from your Child minder or Nanny.
  • Look for changes in behaviour when you are home. Ask your child.

Pointers to Quality Childcare facilities

  • Children appear happy, content and actively engaged with what they are doing.
  • Child care providers have a genuinely caring and friendly relationship with the children; a calm atmosphere with no raised voices.
  • The setting is safe, adequately lit and maintained to a good standard of hygiene.
  • A broad range and generous supply of toys and equipment easily accessible to children.
  • Adequate personal space for children to play.
  • Calm area with subdued lighting where very young children can rest and sleep.
  • Comfortable area where children can relax.
  • Toys, books and displays that represent and promote different cultures in a positive way.
  • Clean, appropriately sized toilets and hand basins with individual or disposable towels provided.
  • A secure and safe outdoor recreation area. Good childcare staff expect you to ask questions and will be happy to answer them

 Annabel Copeman 2009