6.1 Administering medicines

Policy statement

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.

The Manager is responsible for the correct administration of medication to children who attend the setting. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures. In her absence the Deputy Manager will be responsible for the overseeing of administering medication. We notify our insurance provider of all required conditions, as laid out in our insurance policy.

Procedures

Children taking prescribed 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.
We do not administer non-prescription medication, such as pain or fever relief (e.g., Calpol) and teething gel.
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.

Medication dispensed by a hospital pharmacy will not have the child’s details on the label but should have a dispensing label. Staff must check with parents and record the circumstance of the events and hospital instructions as relayed to them by the parents.

Parents must give prior written permission for the administration of medication or application of nappy cream. 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 name of medication and strength

the dosage and times to be given in the setting
how the medication should be stored and its expiry date
the signature of the parent, their printed name and the date
batch number

The administration of medicine is recorded accurately in our medication record book 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 record book to acknowledge the administration of the medicine. The medication record book records the:

name of the child
name and strength of the medication
date and time of the dose
dose given
batch number
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 by a health professional.
No child may self-administer. Where children are capable of understanding when they need medication, for example with asthma, they should be encouraged to tell a member of staff what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication.
The medication record book is monitored to look at the frequency of medication given in the setting. For example, a high incidence of antibiotics being prescribed 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 a cupboard or refrigerated as required.
We ensure medicine is handed back at the end of the day to the parent.

Medicines kept on the premises

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.
This medication is stored in a cupboard in the kitchen which is inaccessible to the children. It is recorded on the inside of the cupboard door where it is signed in and out. Any medication kept on the premises must be returned to the parent at the end of each term.
This medication is stored in clear files (or bags provided by the parents) with a photograph of the child).

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. This is the responsibility of our manager alongside the health and safety representative and key person. 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 all 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 our 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.
Each term parents are asked to sign to state that nothing has changed.

Managing medicines on trips and outings

Children are accompanied by their key person, or other staff member who is fully informed about their needs and medication.
Medication for a child is taken in a sealed plastic box clearly labelled with the child’s name, the original pharmacist’s label and the name of the medication. Inside the box is a copy of the consent form and a card to record when it has been given, including all the details that need to be recorded in the medication record as stated above. For medication dispensed by a hospital pharmacy, where the child’s details are not on the dispensing label, we will record the circumstances of the event and hospital instructions as relayed by the parents.
On returning to the setting the card is stapled to the medicine record book and the parent signs it.
If a child on medication has to be taken to hospital, the child’s medication is taken in a sealed plastic box clearly labelled with the child’s name and the name of the medication. Inside the box is a copy of the consent form signed by the parent.
This procedure should be read alongside the outings procedure.

Staff taking medication

Staff taking medication must inform their manager. The medication must be stored securely in staff lockers or a secure area away from the children. The manager must be made aware of any contra-indications for the medicine so that they can risk assess and take appropriate action as required.