As a setting we promote the good health of children attending and take necessary steps to prevent the spread of infection (please refer to the sickness policy). If a child requires medicine we will obtain information about the child’s needs for this, and will ensure this information is kept up to date.

We follow strict guidelines from NDNA publications and OFSTED when dealing with medication of any kind in the setting and these guidelines are set out below.
The setting will not administer any medication unless prior written consent is given for each individual medication

Illness

If any child is brought into the setting in a condition in which he/she may require medication sometime during the day, the setting manager will decide if the child is fit to be left at the nursery
If the child is deemed well enough to stay at the setting, the parent/carer must be asked if any kind of medication has already been given within the last 24hrs, at what time and in what dosage. This will then be recorded on the child’s medication form.

Medication in the setting – General Guidance

Before administering medication to any child we will require written agreement from the parents
This agreement (Medication Form) will include:
–       Child’s name
–       Name of medication
–       Required dose
–       Time of administration
–       Reason for medication
Medication is only accepted in its original , unopened labelled container
If at any time there is any doubt regarding the administration of medication to a child, practitioners will stop and check with  the setting Manager before continuing.

All medication will:

–       Be stored in accordance to the manufacturer’s instructions on the container (e.g. store in fridge or cool dark place)
–       Be kept out of child’s reach
–       Be in the original container
–       Have labels which are in English
–       Be clearly marked with child’s name
–       Have an expiry date

Emergency medication such as inhalers and Epi pens will be within easy reach of staff in case of an immediate need, but will still remain out of child’s reach
Any ‘stored’ medication such as setting  paracetamol or piriton will be regularly checked to ensure the product is still within its expiry and therefore suitable for use
Any antibiotics requiring refrigeration must be clearly labelled and stored in a transparent bag to avoid cross contamination and kept in a fridge inaccessible to children.

Prescribed Medication

Prescription medicine will only be given when prescribed by a Doctor, Dentist, Nurse or Pharmacist and for the person named on the bottle for the dosage stated
Medicines must be in their original containers with their instructions printed in English
Those with parental responsibility for any child requiring prescription medication should hand over the medication to the most appropriate member of staff who will then note the details of the administration on the appropriate form and another member of staff will check these details
Those with parental responsibility must give prior written permission for the administration of each and every medication. However, we will accept written permission once for a whole course of medication or for the ongoing use of a particular medication under the following circumstances:

1.    The written permission is only acceptable for that brand name of medication and cannot be used for similar types of medication, e.g. if the course of antibiotics changes, a new form will need to be completed

2.    The dosage on the written permission is the only dosage that will be administered. We will not give a different dose unless a new form is completed

3.    Parents must notify us IMMEDIATELY if the child’s circumstances change, e.g. a dose has been given at home, or a change in strength/dose needs to be given.
The setting will not administer a dosage that exceeds the recommended dose on the instructions

The parent must be asked when the child has been given the medication within the last 24hrs before coming to setting; and the staff member must record this information on the medication form. The parent’s signature must be obtained

When the child is picked up, the parent or guardian must be given precise details of the times and dosage given throughout the day. The parent’s signature must be obtained.

Medication will be administered based on a 24hr clock. Therefore, if a medication says 3 times a day this will be calculated every 8 hours and 4 times a day will be calculated every 6 hours. Based around our times of 11am and 3pm.

At the time of administering the medicine, a senior member of staff will ask the child to take the medicine, or offer it in a manner acceptable to the child at the prescribed time and in the prescribed form. (It is important to note that staff working with children are not legally obliged to administer medication).

If the child refuses to take the appropriate medication, then a note will be made on the form.

If the child spits out, refuses or is sick soon afterwards, another dose will NOT be given and the parent will be contacted. Any further concerns arise the parent/carer will be notified. The parent/carer MUST sign to acknowledge that the medication has been given.

Medication in our out of school clubs will be given by the Manager or Deputy Manager, however we do recognise that children have the right to take responsibility about their own welfare.

Where appropriate and depending on the child’s capabilities we do encourage self-medication enabling children to foster a respect for medicines.

When a child is self-administering there should be a prior written request from the parent/carer which states whether or not the child is self-administering or needs assistance. Regardless of the administering methods the child is at all times supervised in doing so. The administration of medication is documented accordingly and where appropriate the child self-medicating also signs the medication form.

Where medication is “essential” or may have side effects, discussion with the parent will take place to establish the appropriate response.

Non-prescription medication

The setting will only administer non-prescription medication for a short initial period and only if necessary. After this time Parents/Carers will be advised to seek medical attention.

If any child is brought to the setting in a condition in which he/she may require medication sometime during the day, the manager will decide if the child is fit to be left at the nursery. If the child is staying, the parent must be asked if any kind of medication has already been given, at what time and in what dosage, if the child then requires a second dose then the child must be sent home and this must be stated on the medication form

The setting will not administer an non-prescribed medication containing aspirin
If the setting feels the child would benefit from medical attention rather than non-prescription medication, we reserve the right to refuse care until the child is seen by a medical practitioner

For all medication the Parent/Carer must give prior written permission for the administration of each individual medication

Medicines must be in their unopened, original containers. On the registration form, parents can consent to their child being given a liquid paracetamol or antihistamine in particular circumstances such as an increase in the child’s temperature or a suspected allergic reaction. This may be administered in an emergency if the setting CANNOT contact the parent.

An emergency setting supply of fever relief (e.g paracetamol) and antihistamines (e.g. Piriton) will be stored on site. This will be checked at regular intervals by the designated trained first aider to make sure that it complies with any instructions for storage and is still in date.

If a child does exhibit the symptoms for which consent has been given to give non-prescription medication during the day, the setting will make every attempt to contact the child’s parents. Where parents cannot be contacted then the manager will take the decision as to whether the child is safe to have this medication based on the time the child has been in the setting, the circumstances surrounding the need for this medication and the medical history of the child on their registration form. The staff will use other methods first to try and alleviate the symptoms, e.g. for an increase in temperature the setting will remove clothing, use fanning, tepid cooling with a wet flannel. The child will be closely monitored until the parents collect the child.

For any non-prescription cream for skin conditions e.g. Sudocrem, prior written permission must be obtained from the parent and the onus is on the parent to provide the cream which should be clearly labelled with the child’s name
Parents/carers must notify the setting immediately if the child’s circumstances have changed e.g. dosage or times given at home. Any significant changes must be recorded on a new medication form and resigned by the parent/carer
As with any kind of medication, staff will ensure that the parent is informed of any non-prescription medicines given to the child whilst at the setting, together with the times and dosage given. The parent/carers signature must be obtained to confirm this information has been given to them.

Emergency medication

On the registration form, parents can consent to their child being given emergency medical treatment including medication, in particular circumstances such as an increase in the child’s temperature or a suspected allergic reaction.
If a child experiences symptoms of illness, attempts will be made to contact the child’s parents before administering ‘emergency’ medication
Where parents cannot be contacted the setting manager will take the decision as to whether the child is suitable to receive the ‘emergency’ medication based on the symptoms and medical history of the child given on registration.
An emergency setting supply of fever relief (e.g. paracetamol) for a temperature of above 38˚c and antihistamines (e.g. Piriton) will be stored on site. This will be checked at regular intervals by the designated trained first aider to make sure that it complies with any instructions for storage and is still in date
If a child does exhibit the symptoms for which consent has been given to give non-prescription medication during the day, the setting will make every attempt to contact the child’s parents. Where parents cannot be contacted then the manager will take the decision as to whether the child is safe to have this medication based on the time the child has been in the setting, the circumstances surrounding the need for this medication and the medical history of the child on their registration form. The staff will use other methods first to try and alleviate the symptoms, e.g. for an increase in temperature the setting will remove clothing, use fanning, tepid cooling with a wet flannel. The child will be closely monitored until the parents collect the child

Injections, pessaries, suppositories

As the administration of injections, pessaries and suppositories represents intrusive nursing, we will not administer these without appropriate medical training for every member of staff caring for this child. This training is specific for every child and not generic. The setting will do all it can to make any reasonable adjustments including working with parents and other professionals to arrange for appropriate health officials to train staff in administering the medication.

Administration

As a general guideline before administering medication to a child the staff member should:
–   Wash their hands
–   Ensure a drink is available if appropriate
–   Check the label on the medication, name of child, dose, method of administration, expiry date and any special instructions. This is checked by the person administering the medication and counter signed by another member of staff.
If in any doubt about the procedure staff should not administer, but seek advice from the parent/carer or a health professional
·   If a child refuses the medication, they must not be forced. Staff can try to encourage them or perhaps get someone else to try. Under no circumstances should staff attempt to hide the medicine in food or drink, unless this is  expressed in written permission to do so from the parent.

Storage

All medication for children must have the child’s name clearly written on the original container and kept in the medication cupboard, which is out of reach of all children.
Any antibiotics requiring refrigeration must be clearly labelled and stored in a transparent bag to avoid cross contamination and kept in a fridge inaccessible to children.
All medications must be in their original containers, labels must be legible and not tampered with or they will not be given. All instructions should be printed in English. All prescription medications should have the pharmacist’s details and notes attached to show the dosage needed and the date the prescription was issued. This will all be checked, along with expiry dates, before staff agree to administer medication

Staff medication

·         All the setting staff have a responsibility to work with children only where they are fit to do so.
·         Staff must not work with children where they are infectious or too unwell to meet children’s needs. This includes circumstances where any medication taken affects their ability to care for children, for example, where it makes a person drowsy.
·         If any staff member believes that their condition, including any condition caused by taking medication, is affecting their ability they must inform their line manager and seek medical advice.
·         The manager/person’s line manager/registered provider will decide if a staff member is fit to work, including circumstances where other staff members notice changes in behaviour suggesting a person may be under the influence of medication. This decision will include any medical advice obtained by the individual or from an occupational health assessment.
Where staff may occasionally or regularly need medication, any such medication must be kept in the staff medication cabinet. If the medication is required to be accessed in an emergency, such as an asthma inhaler, this should be easily accessible but safe from the children
In all cases medication must be stored out of reach of children. It must not be kept in the first aid box. It will be clearly labelled with the name of the member of staff.

Medication Errors

Occasionally mistakes happen. In most cases, whether it is a missed dose or medicine given in error there will be no harm done. It is important to be open and honest if errors occur.
Parents/carers should be contacted and the mistakes explained to them:
–   In cases of a missed dose, the dose may be able to be given at a later time, parents will advise.
Where a dose has been given in error, it is important the child is monitored for any reactions and medical advice sought if there are concerns. It is important to inform the parent/carer as this may happen after the child leaves the setting.
The setting manager will investigate all medication errors and put in preventative actions to ensure future errors do not occur

Disposal of Medication

Tablets and capsules are occasionally dropped on the floor or spat out. In this case we will   place the tablet in a labelled envelope and hand to the parents to be disposed of later.
·  In no circumstances should it be flushed down the toilet or thrown in the bin.
When a child leaves the setting, ceases to need medication or if the medicine has passed its expiry date, we will return any unused quantity to the parents. If this is not possible then we will take it to a local pharmacist for safe disposal.