Administration of medication Policy

Administration of Medication Policy

Rosetta Early Learners

12/09/2022

Statement of Purpose

Children attend early learning and childcare settings with a wide range of medicinal requirements related to their individual needs. These needs can be short term (finishing a course of medication) and or long term (medication to keep them well). Staff will ensure procedures are followed to meet these needs.

Medication will only be administered to maintain the child’s health and wellbeing and/or when recovering from an illness. Most children with medical needs can participate in everyday day experiences within the setting. Throughout this guidance the term ‘parents’ is used to include all main caregivers.

Insurance

Procedures for Administration of Medication

We will only administer prescribed medication when it is essential to do so. Parents will provide written consent for their child to be given medication for a minor ailment or allergy. If children attend this setting on a part-time basis, parents should be encouraged to administer the medication at home.

In all circumstances, parents will administer the first dose of a course of medication and will advise the setting of any adverse reactions to the medication. Staff will only administer medication that:

Has been prescribed by a doctor or pharmacist.
Is in the original container or box along with the information leaflet, and
is clearly labelled with the child’s name and dosage instructions.

It is also important to be aware of the following:

Children's medicines will be stored in their original containers in a locked cupboard. They will be clearly labelled and inaccessible to children.
Medicine spoons and oral syringes must be supplied by the parent if required.

Medications may only be used for the child whose name appears on the medicine. This includes emergency adrenaline injections (e.g. an EpiPen). Parents must 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:

The full name of the child and date of birth
The name of the medication and strength
If the child has had medication prior to arrival at the setting, the time and dosage amount should be noted.
Dosage to be given in the setting.
Signature, printed name of the parent and date.
Verification by the parent at the end of the session.

NB: No medication may be given without these details being provided.

If the child spits out or vomits the medicine, no further dose should be given, and the parent should be informed. If a child is given too much medication, or medication is given to the wrong child, staff will inform the parent immediately. Further advice / instructions should be sought from a doctor. If a child on medication must be taken to hospital, the child’s medication should be taken in a sealed plastic box, which contains a copy of the signed parental consent form, and which is clearly labelled with the child’s name and name of the medication. This procedure complies with the safeguarding of information sharing, including General Data Protection Regulations (GDPR) procedures.

Reducing Risk

Systems are in place which are checked at every point to reduce risk in administering medication:

The consent forms are checked and completed with the parent and colleague before medication is administered.
The staff member administering the medication should have another colleague check dispensed and expiry dates.
Ensure that the medication is for a current condition (for example, something prescribed for a condition six months ago might not be appropriate now).
If a medicine, not dispensed recently, is still appropriate for use (for example liquid antibiotics usually only have a seven to ten-day shelf life and eye drops should be discarded 28 days after opening and returned to the parent).
Review consents every 3 months and at the start of term.
Any special instruction in relation to storage or administration of medication will be complete and adhered to.

Seeking Medical Advice (NHS 24)

If a child becomes ill during a session, when the parent is not present, then a staff member will call the parent or emergency contact. If no contact can be made, the key worker may call NHS 24 if deemed necessary and follow advice given.

The Care Inspectorate has been advised that, on rare occasions, NHS 24 has advised individual services to administer an over the counter (OTC) medicine such as paracetamol immediately. The Care Inspectorate has clarified the temporal aspect of this advice with NHS 24, who have advised “administration as soon as is reasonably possible” is the correct interpretation.

Services will not (and should not) contact NHS 24 on a routine basis for advice on every presentation of an ailment. Where a service has contacted NHS 24 and advice to administer a medicine is given, the Care Inspectorate will and should view this as a non-routine duty of care situation. As such a care service’s response in this situation should not be viewed against the framework for the routine management of medication in such services (as found in the best practice guidance). The response of each care service to the non-routine situations will be dependent on the context.

Storage of Medicines

All medication is stored safely in a locked cupboard below 25° or in a fridge between 2°-8° in an area where children cannot access alone. Medication for individual children will be stored in separate containers with a lid and labelled clearly with the child’s name and date of birth.

Staff are responsible for ensuring medicine is handed back at the end of the day to the parent. Medication will also be returned to the parent once the course of medication has been completed.

For some conditions, medication may be kept in the setting. Staff must check that any medication held to administer on an ‘as and when required’ basis, or on a regular basis, is in date. Any out-of-date medication must be returned to the parent. Children who have long term medical conditions and who may require ongoing medication must have a complete medical care plan. A record will be kept of any medication used by the children that is retained within the setting. Lifesaving medication needs to be accessible to those trained to administer it.

Child Personal Medication Plan

A personal medication 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 child’s personal medication plan should include the measures to be taken in an emergency. The child’s personal medication 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 child’s personal medication plan and each contributor, including the parent, signs the consent for compliance with Data Protection, including GDPR and confidentiality of information.

Managing medicines on trips and outings

Medication for a child is taken in a sealed plastic box clearly labelled with the child’s name and name of the medication. There should be a copy of the signed parental consent form in the box. On no account may medicine be decanted into other containers or packets or envelopes. The original pharmacy labelled medication should be within the box.

Relevant medical details for all children participating in an outing will be taken by accompanying staff. Original copies will be left in the setting. Medication will be administered to the child before leaving home or the setting where possible. For children who may require medication during the trip, this should be administered by appropriate staff.

Roles and Responsibilities

Parental Role

It is the responsibility of the parents to ensure that the child is well enough to attend the setting. The parent will inform staff of any medication that is currently being administered. Parents will also inform the setting if the child has received the medication at home, when it was administered and how much was given to ensure the correct dosage instructions are being followed.

Parents will be required to complete (and regularly update) a Parental Medication Permission Form giving permission for staff to administer the medication. A new form will be completed for each new medication required by the child. Parents will be asked to sign and acknowledge the medication given to their child each day. Parents will inform the setting if the child stops taking medication.

Staff Role

Staff will ensure that they have the required written permission from the parent for the setting to administer the medication. Each time a staff member administers medication to a child, an Administration of Medication form will be completed and signed. A second member of staff will witness the administering of the medication and then countersign the form once the medication has been given. Staff will need to complete the Administration of Medication Form each time medication is given, noting the date, time and dosage.

Settings must risk-assess the number of trained personnel who must be present to deal with medicinal needs. It is up to staff within the setting to ensure that all spoons, syringes, spacers for inhalers etc. are labelled, stored with the child’s medication, and cleaned appropriately after use. Infection control issues in terms of applying creams, eye drops etc. need to be considered.

Staff will ensure children’s individual care and support is consistent and stable by working together with families in a way that is well coordinated for consistency and continuity of their child’s care needs. A named member of staff (usually a manager) will ensure that all other staff and volunteers know who is responsible for the medication of children with particular needs. Staff will ensure the parent signs the form daily to acknowledge the medication given to the child. Parental consent should be time limited depending on the condition.

Long Term Medication

Children who require medication for long term conditions such as epilepsy, diabetes, or asthma need to have all relevant information recorded in their care support plan.

Staff Training

Where a condition requires specialist knowledge, staff will be required to undergo training from a qualified health professional in order to be able to administer the necessary medication.

Staff should also be trained to recognise the symptoms if medication has to be given on a ‘when required basis’. This information will be recorded in the Administration of Medication form. Training should be reviewed and refreshed on a three yearly cycle to ensure staff have the most up to date knowledge.

Insurance

Early Years Scotland’s (EYS) insurance provider is Ansvar Insurance.

The service must ensure that written consent is given by parents and carers for the use or administration of medication provided by them. A clear policy on how to deal with emergencies and staff are well trained in emergency procedures. Rosetta is fully compliant with the Health and Social Care Standards, 1.15, 1.23, 3.14, 4.15, and the following procedures are adhered to.

Ansvar requires settings that are administering lifesaving or emergency invasive medication, such as breathing apparatus, colostomy bags, feeding tubes, EpiPen or adrenaline injections for anaphylactic shock (caused by a reaction to nut products or other allergic reactions), or rectal diazepam for epilepsy, to request an extension to their insurance cover. This will also involve gaining parental/guardian’s consent and ensuring that training is provided for staff by a health professional prior to the child being left at the setting without their parent or guardian. Arranging an extension to your insurance cover and accessing consent forms can be done by contacting Early Years Scotland directly, either by emailing info@earlyyearsscotland.org or by phoning 0141 221 4148.

Ansvar treat inhalers for asthma and nebuliser as oral medication. The setting’s own consent form should be completed and signed by the parent and should be retained in the child’s file. Rosetta will ensure that staff training by a health professional such as the child’s GP/District Nurse/Child Nurse Specialist /Community Paediatric Nurse or approved first aid training agency is undertaken in the use of inhalers, prior to the child being left at the setting without their parent/guardian.

Sun Awareness and Protection

Statement of Purpose

Early Learning and Childcare settings need to be aware of the importance of protecting children from the sun. Both children and staff should apply sunscreen, be encouraged to wear protective clothing, drink water and stay in the shade as far as possible. Staff should be good role models for the children in relation to sun safety.

Sunscreen

Sunscreen should be applied at least 30mins before the children go outside. For children who attend the setting on a part time basis Rosetta will request parents apply the cream at home before attending. If the cream has to be applied by the setting a consent should be signed by the parent in the care plan allowing the setting to do so. The setting will provide sunscreen unless otherwise required by the family. Staff should record when the cream was applied to ensure correct procedures in relation to the application of the sunscreen are being followed.

The most important information on sunscreen is the SPF (which shows how strong the protection against UVB is), and star rating (which ranks the level of UVA protection). Look for at least SPF 15 but higher factors are preferable and 4 or more stars.

You won’t get the level of the protection on the bottle unless you put enough sunscreen on. An adult needs about two teaspoonfuls to cover their face and upper arms. It’s also important to reapply sunscreen regularly.

Appropriate Clothing

Children should be encouraged to wear clothing that provides good protection from the sun, for example, sun hats, long sleeved tops or sunglasses. Information in relation to sun awareness and protection will be made available to parents through newsletters and/or the noticeboard.

Outdoor Activities

Outdoor activities will be held in the shade as far as possible. The setting will try to avoid being outdoors in the middle of the day and children will be encouraged to drink water regularly. Children who do not wish to go outside should be allowed to stay indoors. Children wishing to return indoors to the playroom from outside should be able to do so.

Monitoring of this Policy

It will be the responsibility of the manager to ensure that new or temporary staff are familiar with this policy and to monitor that it is being implemented by all staff and parents. This will be achieved through observation of staff practice and regular communication with parents. All relevant medication forms will be checked and updated on a regular basis. Parents will be made aware of this policy through the enrolment procedures and the parents’ handbook. This policy will be reviewed annually to ensure that it is relevant and up to date.

Appendix 1 – Administration of Medication:

Reviewing and Procedures for Accidental Administration.

In line with advice from Care inspectorate health-related-policy-and-procedure-template-policy-for-all-services.pdf (careinspectorate.com)

Reviewing dates of medication.

If medication is being administered or held in the setting as a long-term need, there must be reviewing procedures of the medication every 3 months.

Contingency procedures for accidental administration of medication in the following circumstances:

Event 1 – Child has been given the wrong dose of medication.

Staff member to Contact the family/emergency contact.
Staff member to Contact family GP/ or NHS 24 for advice.
Staff member should have all details of the proper dosage and state what the accidental dosage was to the GP/NHS 24.
Report incident to the Care Inspectorate.
Staff Member to log incident in child`s chronology with all details of resulting actions and impact of actions noted.

Event 2 – Medication had been given to the wrong child.

Staff member to contact family /emergency contact
Staff member to Contact family GP/ or NHS 24 for advice.
Staff member should have all details of the proper dosage and state what the accidental dosage was to the GP/NHS 24.
Report incident to the Care Inspectorate
Staff Member to log incident in child`s chronology with all details of resulting actions and impact of actions noted.

Event 3 –Child refuses or spits out the medication.

Staff member to contact family /emergency contact for immediate advice.
Staff member should log details in the child`s medication administrating form.
Staff member should log advice given by family/actions taken to resolve the problem in the medication form.
Staff Member to log incident in child`s chronology with all details of resulting actions and impact of actions noted.

Links to national policy:

Health and Social care standards: My Support, My Life

https://beta.gov.scot/publications/health-social-care-standards-support-life/

Health and Social Care Standards, 1.15, 1.19, 1.23, 1.24, 2.23, 3.4, 3.14, 3.15, 3.16, 3.17, 3.18, 3.19, 4.11, 4.15

Management of medication in daycare of children and childminding services

http://hub.careinspectorate.com/media/189567/childrens-service-medication-guidance.pdf

Find out more:

Community pharmacists and NHS 24

www.nhs24.com

Fever Management

http://www.nhsinform.co.uk/health-library/articles/f/feverchildren/introduction