First Aid and Storage of Medication

Each home must have a qualified First Aider on duty at all times.

First Aid boxes should have a white cross with a green background must be held in each home and should be carried in each of the vehicles used for the transportation of children.

Each box has an inventory that must include the full quantity of each item stipulated in the box. When an item has been used, then it should be replaced as soon as possible.

Recording: Each child should have permission for staff to administer first aid and non-prescription medication from a person with Parental Responsibility for them recorded in the relevant plan. Permission should be sought and arranged by the child’s social worker.

The administration of First Aid must be recorded in the First Aid Log, Accident Book (if there has been an accident), individual child's Daily Record and Medication Administration Record (MAR).

A specialist allergy nurse/consultant will help develop a Health Care plan which should be shared 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;
• All staff should be aware of the Plan and should have been trained to administer an EpiPen by a suitable qualified health professional;
• The child/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 staff and/or the child/young person can access their medication in an emergency situation;
• A record should be kept of each episode and any medication given should be recorded on Medication Administration Record (MAR) sheet.

For further information please contact the child or young person’s health professional who deals with their allergies and check the NHS website or see Allergy UK Website.

It is acceptable to keep a supply of non prescribed medication in the Home's medicine cabinet to give to young people who have a mild medical condition i.e. a headache.

These are some suggestions for medication that can be purchased from the chemist and kept in the medicine cabinet. Medicines contained should be listed and none added without the authorisation of the Manager.

• Paracetamol or ibuprofen for pain relief;
• Cold and cough remedies;
• Antiseptic lozenges for sore throats;
• Eyewash (for soothing soreness and rinsing away grit in the eye);
• Antiseptic wipes and cream;
• Anti-sting / bite cream;
• Calamine lotion for skin irritation;
• Muscle rubs and pain relief gel;
• Sun protection cream (factor 15 or above);
• Aftersun cream;
• A thermometer.

Do not keep aspirins in the Home as they are not suitable for children aged under 16.

Similarly be very careful with Paracetamol as these can be very dangerous if taken in large amounts. Remember some over the counter cough/cold medicines may contain Paracetamol.

A consent form needs to be signed by the family carer/person with Parental Responsibility for over the counter medication to be administered from an itemised list.

For older children who wish to self administer non-prescription medication, a full risk assessment must be undertaken.

Tablets may not actually be what the label states they are, therefore they should be destroyed. If prescribed medication, a new prescription should be obtained if necessary from the GP. Medication returning with a child after a visit to relative/other should also be destroyed.

Therefore only send out enough with the child to cover the visit in order to avoid wastage.

Each home should keep the following records:

It is important for all Care Staff in the Children's Home to have had First Aid Training and that this training is kept up to date.

There is an expectation that all staff working in the Children's Home will attend First Aid Training courses.

Care Staff will keep their knowledge up to date and attend refresher First Aid courses on a regular basis.

It is the Home Manager's responsibility to make sure that all staff attend initial and follow up First Aid training.

When arranging the Home's staffing rota the Home Manager and the Senior will ensure that a member of Staff who holds a First Aid qualification is on each shift.

All medicines must be administered strictly in accordance with the prescriber’s instructions (or as advised on the packet in relation to Homely Remedies). Only the prescriber (e.g. GP) can vary the dose. Medicines must be locked away in the locked storage areas when not in use. Before administration, staff should:

• Wash their hands;
• Make sure they have a pen and any required record sheets;
• Enough glasses for each young person receiving medication;
• A jug of water.

The procedure for administration is as follows:

• Check the young person’s identity (a photo is normally kept in the young person’s file). Only one young person should be administered medication at a time, this reduces the risk of mistakes being made;
• Check the young person’s medical profile;
• Check the medication on the individual medication records corresponds with that on the young person’s medical profile;
• Check the Individual medication record sheet to ensure that someone else has not already given the medication;
• Check the expiry date and use by date (where appropriate) on the medication;
• Check the amount to be given at that time;
• If opening a new container, add the date;
• Measure or count the dose without touching the medicine;
• If the medicine is a solid (such as a tablet) then carefully place into an appropriate container and offer to the young person. They may wish to put it in their hand or swallow straight from the container;
• If the medicine is a liquid, take care not to drip onto the label. If the amount to be measured is less than 5ml, then use a medicine syringe otherwise use a medicine spoon or measure as preferred by the young person;
• If the medicine is a cream or ointment, then it should be squeezed directly onto the young person's finger for them to apply. If required to be applied by staff, then latex/pvc gloves must be worn;
• When administering a controlled drug, a second member of staff, must check the dose prior to it being administered;
• Watch the young person as they take their medicine to ensure administration is successful;
• Offer the young person a drink of water (where appropriate);
• Check that the medication is recorded in all the required records;
• Print and sign your name against date and time of each medicine administered;
• Record when medicine has been refused / not taken and the reasons why;
• If a young person is absent when medication is due - this should be recorded;
• Do not sign for any medicines that you have not administered or witnessed yourself;
• If a young person refuses to take medication, under no circumstances should they be forced to do so;
• Medication must be kept in the original labelled (by the Pharmacy) containers and not put into weekly/daily medical boxes;
• After administration the medicines should be returned to the cabinet immediately and the cabinet locked;
• Each time you give medication, remember that it is important to consider the time of administration. Care should be taken to ensure that if the medicine is required to be taken before food, that this is done. Similarly the administration of some medicines such as eye drops or inhalers may not be suitable to be given at meal times. Not all medicine administration times will fall in line with meal times.

See also Lone Working Procedure.

If a child spends time away from the home, either on home visits, holidays or time spent at school, any medication due to be taken must be kept in the original labelled container.

Any medication taken away from the home should be appropriately recorded on the individual child's Medication Administration Record (MAR), showing what medication has been taken away/handed over to parents/ carers.  The person receiving the medication should countersign the record. 

If the parent/ carers wishes, a copy of the MAR should be handed over to them, so that a record of administration can be kept; this may be handed back to the home when the child returns.

If the person who is responsible for the child is a member of staff, then they must complete the documents for administration while they are away as normal.

The medication should always be handed over to someone responsible for the child.

This applies to specialist or skilled healthcare tasks, for example:

• For diabetic children;
• Physiotherapy programme;
• For the use of Buccal Midalozam;
• For the use of Rectal Diazepam.

If a child requires a skilled health task to be undertaken, this will only be carried out by trained staff, with the written authorisation of the prescribing Doctor in relation to the child concerned, and as set out in a Placement Plan or other written Health Care Plan.

Appropriate training will be provided, together with written guidance, as to how the skilled tasks will be performed and recorded.

If an overdose is suspected, hospital treatment should be sought without delay. Staff should try to find out what the child/young person has taken and if possible take a sample to give to a medical practitioner.

Possible signs of an overdose:

• Mild nausea/vomiting;
• Paler skin;
• Blue lips or fingernails;
• Not waking up or reacting to a loud noise;
• Shallow or disrupted breathing;
• Gurgling, snorting or snoring /choking sounds;
• Slow or very faint pulse.

It can take a long time between taking the substance and the first signs of an overdose; children/young people may verbally 'boast' about having taken an overdose: even when there are no signs, but staff must consider that there is a chance an overdose has been taken and they must act in caution and seek medical attention.

What to do if someone is reacting to an overdose:

• Lie them on the floor;
• Put them in the recovery position;
• Call the ambulance - 999 - inform the operator of the overdose;
• Do not leave the child/young person alone, make sure they don't roll onto their back;
• Inform the ambulance team what the person has taken; try to gather all the packaging you can find;
• Get some help, keep other children and young people away (but don't dismiss any valuable information that they may be trying to pass it on to you).

DON'T

• Walk the child/young person around;
• Put the child/young person in a cold bath/layer them up to heavily to generate warmth;
• Give them a drink.

Recording and Review

Please refer to the Self Harm and Suicide Procedure.