While it is not our policy to care for sick children, who should be at home until they are well enough to return to the setting, we will agree to administer medication as part of maintaining their health and well-being or when they are recovering from an illness. We ensure that where medicines are necessary to maintain health of the child, they are given correctly and in accordance with legal requirements.
In many cases, it is possible for children’s GPs to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the setting. If a child has not had a medication before, it is advised that the parent keeps the child at home for the first 48 hours to ensure there are no adverse effects, as well as to give time for the medication to take effect.
Our staff are responsible for the correct administration of medication to children. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures.
- Children taking medication must be well enough to attend the setting.
- We only administer medication when it has been prescribed for a child by a doctor (or other medically qualified person). It must be in-date and prescribed for the current condition.
- Children’s prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children. On receiving the medication, the member of staff checks that it is in date and prescribed specifically for the current condition.
- Non-prescription medication, may be administered, but only with prior written consent of the parent and only when there is a health reason to do so. We will not give children medication for them being ‘a bit unwell’ or ‘under the weather’, if this is needed they are too unwell to attend.
- Parents must give prior written permission for the administration of medication. The staff member receiving the medication will ask the parent to sign a consent form stating the following information. No medication may be given without these details being provided:
- the full name of child and date of birth
- the dosage and times to be given in the setting
- the method of administration
- how the medication should be stored and its expiry date
- the signature of the parent, their printed name and the date
- The administration of medicine is recorded accurately on our medication form each time it is given and is signed by the person administering the medication and a witness. Parents are shown the record at the end of the day and asked to sign the form to acknowledge the administration of the medicine. The medication record book records the:
- date and time of the dose
- signature of the person administering the medication and a witness who verifies that the medication has been given correctly
- parent’s signature (at the end of the day).
- If the administration of prescribed medication requires medical knowledge, we obtain individual training for the relevant member of staff by a health professional.
- If rectal diazepam is given, another member of staff must be present and co-signs the record book.
- We monitor the medication records to look at the frequency of medication given in the setting. For example, a high incidence of antibiotics being prescried for a number of children at similar times may indicate a need for better infection control.
Storage of medicines
- All medication is stored safely in the locked medicine cupboard or refrigerated as required.
- The child’s key person is responsible for ensuring medicine is handed back at the end of the day to the parent.
- For some conditions, medication may be kept in the setting to be administered on a regular or as-and-when- required basis. We check that any medication held in the setting, is in date and return any out-of-date medication back to the parent.
Medication is stored in the locked medicine cupboard, located in the office.
Medication requiring refrigeration is kept in the kitchen fridge.
Children who have long term medical conditions and who may require ongoing medication
- We carry out a risk assessment for each child with a long term medical condition that requires on-going medication. Other medical or social care personnel may need to be involved in the risk assessment.
- Parents will also contribute to a risk assessment. They should be shown around the setting, understand the routines and activities and point out anything which they think may be a risk factor for their child.
- For some medical conditions, key staff will need to have training in a basic understanding of the condition, as well as how the medication is to be administered correctly. The training needs for staff form part of the risk assessment.
- The risk assessment includes vigorous activities and any other activity that may give cause for concern regarding an individual child’s health needs.
- The risk assessment includes arrangements for taking medicines on outings and advice is sought from the child’s GP if necessary where there are concerns.
- An individual health plan for the child is drawn up with the parent; outlining the key person’s role and what information must be shared with other adults who care for the child.
- The individual health plan should include the measures to be taken in an emergency.
- We review the individual health plan every six months, or more frequently if necessary. This includes reviewing the medication, e.g. changes to the medication or the dosage, any side effects noted etc.
- Parents receive a copy of the individual health plan and each contributor, including the parent, signs it.
Life-saving medication and invasive treatments
Life-saving medication and invasive treatments may include adrenaline injections (Epipens) for anaphylactic shock reactions (caused by allergies to nuts, eggs etc) or invasive treatment such as rectal administration of Diazepam (for epilepsy).
- The key person responsible for the intimate care of children who require life-saving medication or invasive treatment will undertake their duties in a professional manner having due regard to the procedures listed above.
- The child’s welfare is paramount, and their experience of intimate and personal care should be positive. Every child is treated as an individual and care is given gently and sensitively; no child should be attended to in a way that causes distress or pain.
- The key person works in close partnership with parents/carers and other professionals to share information and provide continuity of care.
- Children with complex and/or long-term health conditions have a health care plan (04.2a) in placewhichtakes into account the principles and best practice guidance given here.
- Key persons have appropriate training for administration of treatment and are aware of infection control best practice, for example, using personal protective equipment (PPE).
- Key persons speak directly to the child, explaining what they are doing as appropriate to the child’s age and level of comprehension.
- Children’s right to privacy and modesty is respected. Another practitioner is usually present during the process.
Fora child who requires invasive treatment the following must be in place from the outset:
- a letter from the child’s GP/consultant stating the child’s condition and what medication if any is to be administered
- written consent from parents allowing members of staff to administer medication
- proof of training in the administration of such medication by the child’s GP, a district nurse, children’s nurse specialist or a community paediatric nurse
- a healthcare plan
Copies of all letters relating to these children must be sent to the insurance provider for appraisal. Confirmation will then be issued in writing confirming that the insurance has been extended. A record is made on the medication sheet of the intimate/invasive treatment each time it is given.
- Children who require physiotherapy whilst attending the setting should have this carried out by a trained physiotherapist.
- If it is agreed in the health care plan that the key person should undertake part of the physiotherapy regime then the required technique must be demonstrated by the physiotherapist personally; written guidance must also be given and reviewed regularly. The physiotherapist should observe the practitioner applying the technique in the first instance.
- Practitioners recognise that children with SEND are particularly vulnerable to all types of abuse, therefore the safeguarding procedures are followed rigorously.
- If a practitioner has any concerns about physical changes noted during a procedure, for example unexplained marks or bruising then the concerns are discussed with the designated person for safeguarding and the relevant procedure is followed.
Treatments such as inhalers or Epi-pens must be immediately accessible in an emergency.
- The Human Medicines Regulations (2012)