5.1.5 First Aid, Home Remedies and Prescribed Medicines

1. Reception and Administering of Prescribed Medication/Drugs

The following guidance applies to the reception and administration of prescribed medicines.

1. Always follow guidance on the packet;
2. Staff and Foster Carers must have completed training on medication before assuming responsibility for the administration of medication;
3. When receiving medication, check that it is the correct medication and the name of the child is on the container; if the name on the container is different, the medication cannot be administered;
4. Check the dosage and times that the medication is to be given. Negotiate with the child when to take it;
5. Measure and administer the dose as required and check relevant records to ensure it has not already been given;
6. Medication must not be put out in advance of administration;
7. Observe, if possible, that it has been taken;
8. Check that there is a suitable amount of the medication available and the expiry date;
9. Check that the course is completed;
10. Unless it is agreed following a risk assessment that the child will store and administer the medication, it must be stored in a place out of reach from children in a locked cabinet;
11. The fact that it has been stored must be recorded and the record must be signed and dated by the person receiving/storing it;
12. Staff/carers or Foster Carers should not normally be expected to administer medication that requires assistance from a nurse or involves intimate contact with the child, such as suppositories, unless they have received training and consent has been given;
13. Children should not be administered both prescribed and non-prescribed medicines unless advice has been obtained from their pharmacist or GP that it is safe to do so;
14. For staff working within Children's Homes when removing medication from locked cabinets, ensure that the cabinet is locked if left unsupervised. Foster Carers must ensure medication is stored securely and appropriately out of reach of children;
15. Note and account for warnings provided, such as 'may cause drowsiness;
16. The child may refuse the medicine; if so, it must never be forced or the child tricked into taking it;
17. For staff within Children's Homes the administration (or refusal) must be recorded and the record signed and dated by the staff member administering;
18. For staff within Children's Homes return the container to the locked cabinet, record that the medication has been administered. Foster Carers must keep a written record of all medication, treatment and first aid given to children during the placement.

1.2 Reception into Short Breaks Homes

• The medication must be signed for by the receiving member of staff and signed as discharged by the parent/carer/escort;
• Medication must not be mixed in the same bottle. Staff cannot accept receipt of medication that is not provided in the original container with the pharmacy label.

2. Reception and Administering of Non-Prescribed Medication/Drugs

1. Always follow guidance on the packet;
2. Although no prescription is required, Aspirin and Aspirin products may not be administered to a child unless prescribed by a medical practitioner;
3. Other non-prescribed medicines may not be administered unless there is consent from the parent(s) or child of 16 and over;
4. Non-prescribed medicines may only be obtained from reputable Pharmacists;
5. Unless it is agreed following a risk assessment that the child will store and administer the medication, it must be stored in a place out of reach from children in a locked cabinet;
6. The fact that it has been stored must be recorded and the record must be signed and dated by the person receiving it;
7. Before administering non-prescribed medicines, check the following:
   • What is the expiry date?
   • Why does the child want it?
   • Is the child allergic to it?
   • What is the correct dose?
   • When was the last dose administered?
8. After one hour, check that the child is feeling better - if not, seek medical advice;
9. Do not administer both prescribed and non-prescribed medicines unless advice has been received from the pharmacist or GP that it is safe to do so;
10. When removing medication from locked cabinets, ensure that the cabinet is locked if left unsupervised;
11. The administration (or refusal) must be recorded and the record signed and dated by the staff member administering;
12. Return the container to the locked cabinet, record that the medication has been administered.

3. Storage within Children's Homes

• Medication will be stored in a cabinet secured to a structural wall of a room not normally frequented by children;
• Medication cabinets are for the sole purpose of the storage of medication for the use of children accommodated in the home;
• Staff medication cannot be stored in the home's medication cabinet;
• Internal and external medication should be stored on different shelves/different parts of the cabinet. Internal medications should be stored above external medications;
• Medications requiring refrigeration must be kept in a refrigerator in a lockable box and labelled with the child's name.

4. Controlled Drugs within Children's Homes

• Controlled drugs must be kept in a locked compartment within the medicine cabinet;
• The receipt, administration and disposal of controlled drugs must be recorded and signed for by 2 staff.

5. Covert Administration

• Do not mix medication into drinks or food and do not crush tablets or open capsules without permission from a medical professional and parent/carer;
• All other methods of administration must be explored before considering whether to give medicine covertly. It must be agreed that it is in the best interests of the child to have the medicine;
• Written guidelines must be drawn up if medicine is to be given covertly and these must be signed by a medical professional and parent/carer.

6. School/Home Transport

• When children need to take medication to school from the children's home it must be booked out of the home to the escort/driver of the transport and it must be signed for by the staff member and the escort/driver;
• Where there may be a need for the medication to be administered during the journey the escort/driver must be trained and there must be a signed treatment plan;
• On return to the home the medication must be booked back in.

7. Home Remedies

Home Remedies are medicines, suitable for children, which can be bought 'over the counter', without prescription, including Paracetamol.

The Home Remedies listed below are the only remedies that may be used by children, unless others have been authorised by a medical practitioner - in writing. For dosages, follow manufacturer's directions or seek advice of a medical practitioner or pharmacist.

8. Children Holding their Own Medication

As a rule, young people of 16 and above should be encouraged to take responsibility for their own health; this includes holding and taking their own medication. In some cases, children under 16 will be supported to hold and take their own medication.

This should be discussed as part of the placement planning and included in the Placement Plan/Placement Information Record where appropriate.

It will not always be known when a child has medication. Staff and carers will always try and work in partnership with them around health needs but recognise that they have the right to choose otherwise. Within this context, if there are concerns about a child's health, staff/carers should always seek medical advice.

If it is known that a child is holding prescribed medication, this should be clearly recorded: in residential care, this will be in the Prescribed Medication Book and on the drug record sheet. This may be on a temporary basis only, for example where the child has an overnight stay away.

The child should be encouraged to take the medication appropriately, and this should include giving reminders on a regular basis.

If there are concerns that a child is not managing his or her medication appropriately, there should be a review of the arrangements.