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6.1 Administering medicines
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.
In many cases, it is possible for children's GP's 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 medication before, especially a baby/child under 2, it is advised that the parent keeps the child at home for the first 48 hours to ensure no adverse effects as well as to give time for the medication to take effect.
These procedures are written in line with current guidance in 'Managing Medicines in School and Early Years Settings'; the manager is responsible for ensuring all staff understand and follow these procedures.
The key person is responsible for the correct administration of medication to children for whom they are the key person. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures. In the absence of the key person, the manager is responsible for the overseeing of administering medication.
- Children taking prescribed medication must be well enough to attend the setting.
- Only medication prescribed by a doctor (or other medically qualified person) is administered. It must be in-date and prescribed for the current condition.
- NB Children's paracetamol (un-prescribed) is administered only for children under the age of one year with verbal consent of the parents in that case of a high temperature. This is to prevent febrile convulsion and where a parent or named person is on their way to collect the child.
- Children's prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children.
- Parents give prior written permission for the administration of medication. The staff receiving the medication must ask the parent to sign a consent form stating the following information. No medication may be given without these details being provided:
- Full name of child and date of birth;
- Name of medication an strength
- Who prescribed it;
- dosage to be given in the setting;
- how the medication should be stored and the expiry date;
- any possible side effects that may be expected should be noted; and
- signature, printed name of parent and date
Health and hygiene
- The administration is recorded accurately each time it is given and is signed by staff. Parents sign the record book to acknowledge that administration of medicine. The medication record book records:
- Name of child
- name and strength of medication;
- the date and time of dose;
- dose given and method; and is
- signed by key person/manager; and is verified by parent signature at the end of the day.
- We use the Pre-school Learning Alliance's publication Medication Record for recording administration of medicine and comply with the detailed procedures set out in the publication.
Storage of medicines
- All medication is stored safely in a locked cupboard or refrigerated. Where the cupboard or refrigerator is not solely for storing medicines, they are kept in a marked plastic box.
- The child's key person is responsible for ensuring the medicine is handed back at the end of the day to the parent.
- For some conditions, medication may be kept at the setting. Key persons check that any medication held to administer on an as when required basis, or on a regular basis, is in date and returns any out-of-date medication back to the parent.
- Medication is either stored in the fridge on in the store cupboard; this is out the reach of children. Staff are advised of this upon induction.
- If the administration of prescribed medication requires medical knowledge, individual training is provided for the relevant member of staff or by a health professional.
- If rectal diazepam is given another member of staff must be present and co-signs the record book.
- 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 their key person what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication.
Children who have long term medical conditions
and who may require on-going medication
- A risk assessment is carried out for each child with long term medical conditions that require on-going medication. This is the responsibility of the manager alongside the key person. Other medical or social care personnel may need to be involved in the ris k 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 is part of the risk assessment.
- The risk assessment includes vigorous activities and other nursery 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 the child's GP's advice is sought if necessary where there are concerns.
- A health care plan for the child is drawn up with the parent; outlining the key person's role and what information must be shared with other staff who care for the child.
- The health care plan should include the measures to be taken in an emergency.
- The health care plan is reviewed every six months or more 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 health care plan and each contributor, including the parents, signs it.
Managing medicines on trips and outings
- If children are going on outings, staff accompanying the children must include the key person for the child with a risk assessment, or another member of staff who is fully informed about the child's needs and/or medication.
- Medication for a child is taken in a sealed plastic box clearly labelled with the child's name, name of the medication, inside the box is a copy of the consent form and a card to record when it has been given, with the details as given above.
- On returning to the setting the card is stapled to the medicine book record 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, name of the medication. Inside the box is a copy of the consent form signed by the parent.
- As a precaution, children should not eat whilst travelling in vehicles.
- This procedure is read alongside the outings procedure.