First Aid and Medication

You should be clear about what decisions you can make about giving consent for medical treatment and this will be recorded in the child/young person’s Placement Plan.

You should have a fully equipped first aid box in the home and in each vehicle used to carry children.

Your Supervising Social Worker will make sure arrangements are in place to keep first aid boxes fully stocked when they do a Health and Safety check.

You should make sure that you take the opportunity to attend first aid and medication training opportunities when they arise. All carers must complete a First Aid course every three years.

First aid boxes should be kept in a safe accessible place, not within reach of small children, where the people who need to get access to them can do so.

The first aid box may be looked at in an unannounced visit.

Children’s first aid should be administered in accordance with your first aid training, if it is safe to do so, and contact your Supervising Social Worker as soon as possible. You must not delay the process of getting medical help.

You should always assess the situation and in a medical emergency, send for medical help and an ambulance or the Police if this is needed.

For more than minor injuries, before help arrives:

• Do not move the person other than to remove them from immediate danger or place them into the recovery position;
• Try to find out what has happened;
• Observe the child/young person; keep them calm, warm and quiet.
• If the person is unconscious;
• Make sure the person is safe. Preserve life. Contact the emergency services; 
  • Ensure they can breathe and place them in the recovery position;
  • Do not move them if they are likely to have spinal or other serious injury which may not be obvious;
  • Do not give anything by mouth;
  • Do not attempt to make them sit or stand;
  • Do not leave them on their own.

When medical help arrives, pass on any information available.

If a child who is placed with you has particular health needs, the child’s social worker should provide information and advice on specialist advisory or support groups.

Home Remedies / non-prescription medications may only be given to a child with the consent of the parent (if appropriate) or in consultation with the child’s social worker, the child if they are over 16 or after consulting with the child's GP and recorded in the Placement Plan.

Home Remedies / non-prescription medications are medicines that can be bought over the counter without prescription, including Paracetamol, Aspirin, homeopathic, herbal, aromatherapy, vitamin supplements or alternative therapies. Consideration should be given as to how long a child continues to use Home Remedies before you arrange to see their GP.

Although Aspirin may be purchased 'over the counter', without prescription; it must not be given to children unless prescribed by a medical practitioner.

Home Remedies / non-prescription medications must be kept in a locked cabinet that is only accessible to the approved adults within your family home, unless a child is permitted to keep their own Home Remedies, in which case the arrangements for this must be set out in the Placement Plan.

Home Remedies, other than Paracetamol, should only be given for a maximum of 48 hours. If the symptoms continue the child should see a GP before further dosages are given. Where children are not able to give Home Remedies themselves, care must be taken to make sure they take it correctly and with you there. Home remedies must only be given at the dose on the manufacturer’s instructions and should be recorded on the medication administration record.

A specialist allergy nurse/consultant will help develop a Health Care plan which should be shared with you and with all agencies working with the child/young person.

The Care and Placement Plan and Health Care Plan should contain the following:

• All known allergies and associated risks including spotting the signs and symptoms of an allergic reaction and anaphylaxis for the child/young person; 
• Preventative measures should be detailed in the Plan - for example taking daily antihistamines for hay fever, making sure cleaning products and gloves are hypoallergenic, and washing powder is suitable for skin conditions; 
• Actions to take when a young person has an allergic reaction.  The plan should describe exactly what to do and who needs to be contacted in the event of an emergency. For example, when to use an EpiPen and calling for an ambulance; 
• You should be aware of the Plan and should have been trained to administer an EpiPen by a suitable qualified health professional; 
• The child or young person should be educated around their allergies and what to do in an emergency - a young person may be able to self-administer their own EpiPen or take antihistamines. If this is the case this should be recorded; 
• Medication should be easily accessible so you and/or the child/young person can access their medication in an emergency situation; 
• You should keep a record of each episode and any medication given.

For further information see the NHS website or see Allergy UK Website.

The following steps must be followed:

• Check the medicine to make sure it is prescribed for the child, and it is within the expiry date;
• Make sure the child’s name, the name of the medication, and the dosage are correct;
• Give the medicine in accordance with the instructions;
• Record when you give the medicine including the date, time, how much, your name and signature;
• Record if the child refuses the medicine or the reason it was not given;  advice from the child’s GP should be sought as soon as possible;
• You should not attempt to administer another dose of medication if the dose of medication has been partially swallowed or spat out.  You should take advice from the GP or NHS 111;
• Medication should be kept in its original packaging with a pharmacy label on with the child’s name, dosage and instructions. It is not acceptable to have ‘as directed’ on the label, and the prescribing doctor should be asked to specify administration instructions;
• Foster carers can only administer the dosage stated on the pharmacy label, unless, in exceptional circumstances, a signed letter of confirmation, with an updated dosage is received from the GP or medical team.

Receipt of Medicines

All medicines from whatever source, including medication from hospital should be recorded.

The record should show:

• Date you received the medicine;
• Name, strength and dosage of medicine;
• Quantity received;
• Expiry date;
• Name of the child for whom medication is prescribed/purchased;
• Your signature for receiving the medicine.

Children’s Self Administration

Some children may wish to administer all or some of their prescribed medication. This should be agreed with their parents (if appropriate) or the child’s social worker as part of a Placement Planning meeting or in a subsequent review of the care plan. It is common for children to begin to take increasing responsibility for medication, such as inhalers. A risk assessment should be completed to outline whether this applies to home remedies and/or prescribed medication and the arrangements to be put in place for safe storage and for them to be supported to understand how to take responsibility for safe administration. Advice can be sought from the Looked After Children’s Nursing Team and your supervising social worker.

The Misuse of Drugs Act 1971 (as amended) prohibits certain activities in relation to ‘controlled drugs’, in particular their manufacture, supply and possession (except where permitted under Regulations.  Some children and young people are prescribed medication that fall into the category of controlled drugs such as morphine and pethidine for pain, methadone for withdrawal, Ritalin for hyperactivity, midazolam as a rescue medication for epilepsy.

ALL CONTROLLED DRUGS MUST BE STORED SAFELY BY BEING KEPT IN A LOCKED CABINET. IT IS STRONGLY RECOMMENDED THAT NO MORE THAN 28 DAYS' SUPPLY SHOULD BE KEPT AT A TIME.

See also: CQC information on Controlled Drugs.

Any medication that has passed its expiry date or is no longer required should be taken to a pharmacy for disposal. A record is required to identify what happens to medication in the home. This record should show:

• Date you finished the medicine or disposed of it/returned it to the pharmacy;
• Name and strength of medicine;
• Quantity taken;
• Name of the child for whom the medicine was prescribed/purchase;
• Your signature if you arranged disposal of the medicine;
• Children placed permanently and on daily medications – Foster carers will be required to keep the Supervising Social Worker informed of changes made by medical professionals as and when they take place.

First aid and records of all medicines that have been administered will be recorded in the daily record; if advice is sought from a GP, NHS 111 or pharmacist, you should record details of the discussions. Your supervising social worker and the child’s social worker should be informed of any first aid, medical advice or changes to medication.

If an accident or incident involving medication occurs, (the child is given more than the prescribed does, the medication prescribed is not given to the child, the child has an adverse reaction to medication, a child gets access to and consumes medication not prescribed for them, or the medication is given in the wrong route of administration) medical attention must be sought. Carers must notify their Supervising Social Worker as soon as possible (or the Emergency Duty Team should be contacted depending on the severity of the incident. Details of the error should be recorded on the medication sheet and foster carer daily record.