Sickness and Medication

Sickness and Medication Policy

Inc Managing children who are sick, infectious, with medical conditions or with allergies

 

Policy statement

While it is not our policy to care for sick children, who should be at home until they are well enough to return to the setting, we will agree to administer medication as part of maintaining their health and well-being or when they are recovering from an illness.

In many cases, it is possible for children’s GPs to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the setting. If a child has not had the medication before, it is advised that the parent keeps the child at home for the first 48 hours to ensure there are no adverse effects, as well as to give time for the medication to take effect.

These procedures are written in line with guidance in Managing Medicines in Schools and Early Years Settings; the manager is responsible for ensuring all staff understand and follow these procedures.

The key person is responsible for the correct administration of medication to children for whom they are the key person. This includes ensuring that parent consent forms have been completed, that medicines are stored correctly and that records are kept according to procedures. In the absence of the key person, management are responsible for the overseeing of administering medication.

 

Procedures

§  Children taking prescribed medication must be well enough to attend the setting.

§  Only medication prescribed by a doctor (or other medically qualified person) is administered. It must be in-date and prescribed for the current condition (medicines containing aspirin will only be given if prescribed by a doctor).

§  Children's prescribed medicines are stored in their original containers, are clearly labelled and are inaccessible to the children.

§  Parents 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. No medication will be given without these details being provided:

-        - the full name of child and date of birth;

-        - the name of medication and strength;

-        who prescribed it;

-        - the dosage to be given in the setting;

-        - how the medication should be stored and its expiry date;

-        - any possible side effects that may be expected; and

-        - the signature of the parent, their printed name and the date.

Insert details here of who receives the child’s medication and asks the parent to complete a consent form.

State how staff will be aware of this.

Management or deputy, staff are aware from the policy and verbally been informed.

§  The administration of medicine is recorded accurately in our medication record book each time it is given and is signed by the key person/manager. Parents are shown the record at the end of the day and asked to sign the record book to acknowledge the administration of the medicine. The medication record book records the:

-        name of the child;

-        name and strength of the medication;

-        date and time of the dose;

-        dose given and method;

-        signature of the key person/manager; and

-        parent’s signature.

Storage of medicines

§  All medication is stored safely in a locked cupboard or refrigerated as required. Where the cupboard or refrigerator is not used solely for storing medicines, they are kept in a marked plastic box.

§  The child’s key person is responsible for ensuring medicine is handed back at the end of the day to the parent.

§  For some conditions, medication may be kept in the setting to be administered on a regular or as-and-when- required basis. Key persons check that any medication held in the setting, is in date and return any out-of-date medication back to the parent.

Insert details here of how and where medicines are stored in your setting. State how staff are informed of this.

In the First Aid compartment of the fridge or in the locked staff cupboard in the blue room.

§  If the administration of prescribed medication requires medical knowledge, individual training is provided for the relevant member of staff by a health professional.

§  No child may self-administer. Where children are capable of understanding when they need medication, for example with asthma, they should be encouraged to tell their key person what they need. However, this does not replace staff vigilance in knowing and responding when a child requires medication.

 

Children who have long term medical conditions and who may require ongoing medication

Nominated lead person responsible –

Mrs Samantha Lavender and Mrs Rachel Tatler

§  A risk assessment is carried out for each child with medical conditions. This is the responsibility of the manager alongside the key person. Other medical or social care personnel may need to be involved in the risk assessment.

§  Parents will also contribute to a risk assessment. They should be shown around the setting, understand the routines and activities and point out anything which they think may be a risk factor for their child.

§  Management will ensure that for some medical conditions, staff will need to have training in a basic understanding of the condition, as well as how the medication is to be administered correctly. The training needs for staff form part of the risk assessment.

§  The risk assessment includes vigorous activities and any other activity that may give cause for concern regarding an individual child’s health needs.

§  The risk assessment includes arrangements for taking medicines on outings.

§  Management will ensure that all staff including any bank staff are all made aware of individual child’s conditions and what to do in an emergency.

§  A health care plan for the child is drawn up with the parent, pre-school management and a health care professional who can best advise on the particular needs of the child; outlining diagnosis, signs and symptoms and details of any medication they may be taking. If a meeting cannot be agreed with a Health Care Professional, parent/carer and pre-school management, a detailed letter on letterheaded paper will be required to support the care plan which will be completed by setting and parent/carer.

§  The health care plan should include the measures to be taken in an emergency.

§  The health care plan is reviewed every six months. This includes reviewing the medication, e.g. changes to the medication or the dosage, any side effects noted etc. And should be reviewed with a health care professional, parent/carer and pre-school management.

§  Children will be unable to attend setting until a health care plan and risk assessment are complete

Managing medicines on trips and outings

§  If children are going on outings, staff accompanying the children must include the key person for the child with a risk assessment, or another member of staff who is fully informed about the child’s needs and/or medication.

§  Medication for a child is taken in a sealed plastic box clearly labelled with the child’s name and the name of the medication. Inside the box is a copy of the consent form and a card to record when it has been given, including all the details that need to be recorded in the medication record as stated above.

§  On returning to the setting the card is stapled to the medicine record book and the parent signs it.

§  If a child on medication has to be taken to hospital, the child’s medication is taken in a sealed plastic box clearly labelled with the child’s name and the name of the medication. Inside the box is a copy of the consent form signed by the parent.

§  As a precaution, children should not eat when travelling in vehicles.

§  This procedure is read alongside the outings procedure.

If staff have 3 days unauthorised absences within a 12 week span, without producing a doctors note, disciplinary action will be taken.

Exceptions will be made for admittance to Hospital.

If a member of staff has been signed off work by a GP, a sick note will need to be produced and a Sc2 will need to be completed and sent to the management. Upon return a return to work interview will have to take place.

For non prescribed medicine i.e. calpol etc. parents will be asked to administer these before the child attends Pre School.

 

Legal framework

§  The Human Medicines Regulations (2012)

Managing children who are sick, infectious, or with allergies

(Including reporting notifiable diseases)

 

Policy statement

We provide care for healthy children through preventing cross infection of viruses and bacterial infections and promote health through identifying allergies and preventing contact with the allergenic substance.

Procedures for children who are sick or infectious

§  If children appear unwell during the day – have a temperature, sickness, diarrhoea or pains, particularly in the head or stomach – the manager calls the parents and asks them to collect the child, or send a known carer to collect the child on their behalf.

§  If a child has a temperature, they are kept cool, by removing top clothing and sponging their heads with cool water, but kept away from draughts.

§  The child's temperature is taken using a forehead thermometer strip, kept in the first aid box.

§  In extreme cases of emergency, the child should be taken to the nearest hospital and the parent informed.

§  Parents are asked to take their child to the doctor before returning them to the setting; the setting can refuse admittance to children who have a temperature, sickness and diarrhoea or a contagious infection or disease.

§  Where children have been prescribed antibiotics, parents are asked to keep them at home for 48 hours before returning to the setting.

§  After sickness or diarrhoea, parents are asked to keep children home for 48 hours from the last bout of sickness or diarrhoea or until a formed stool is passed.

§  The setting has a list of excludable diseases and current exclusion times. The full list is obtainable from

§  www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1194947358374 and includes common childhood illnesses such as measles.

Reporting of ‘notifiable diseases’

§  If a child or adult is diagnosed as suffering from a notifiable disease under the Health Protection (Notification) Regulations 2010, the GP will report this to the Health Protection Agency.

§  When the setting becomes aware, or is formally informed of the notifiable disease, the manager informs Ofsted and acts on any advice given by the Health Protection Agency.

HIV/AIDS/Hepatitis procedure

§  HIV virus, like other viruses such as Hepatitis A, B and C, are spread through body fluids. Hygiene precautions for dealing with body fluids are the same for all children and adults.

§  Single-use vinyl gloves and aprons are worn when changing children’s nappies, pants and clothing that are soiled with blood, urine, faeces or vomit.

§  Protective rubber gloves are used for cleaning/sluicing clothing after changing.

§  Soiled clothing is rinsed and either bagged for parents to collect.

§  Spills of blood, urine, faeces or vomit are cleared using mild disinfectant solution and mops; any cloths used are disposed of with the clinical waste.

§  Tables and other furniture, furnishings or toys affected by blood, urine, faeces or vomit are cleaned using a disinfectant.

Nits and head lice

§  A parent may be asked to keep the child away until the infestation has cleared.

§  On identifying cases of head lice, all parents are informed and asked to treat their child and all the family if they are found to have head lice.

Procedures for children with allergies

§  When parents start their children at the setting they are asked if their child suffers from any known allergies. This is recorded on the Registration Form.

§  If a child has an allergy, a health care plan is completed to detail the following:

-        The allergen (i.e. the substance, material or living creature the child is allergic to such as nuts, eggs, bee stings, cats etc).

-        The nature of the allergic reactions e.g. anaphylactic shock reaction, including rash, reddening of skin, swelling, breathing problems etc.

-        What to do in case of allergic reactions, any medication used and how it is to be used (e.g. Epipen).

-        Control measures - such as how the child can be prevented from contact with the allergen.

-        Review.

§  This form is kept in the health care plans for staff to see.

§  Parents train staff in how to administer special medication in the event of an allergic reaction.

§  Generally, no nuts or nut products are used within the setting.

§  Parents are made aware so that no nut or nut products are accidentally brought in, for example to a party.

Pre-school aims to practice a nut free policy although we recognise that this cannot be guaranteed. This policy serves to set out all measures to reduce the risk to those children and adults who may suffer an anaphylactic reaction if exposed to nuts to which they are sensitive. The Pre-school aims to protect children who have allergies to nuts yet also help them, as they grow up, to take responsibility as to what foods they can eat and to be aware of where they may be put at risk.

Definition

Anaphylaxis (also known as anaphylactic shock) is an allergic condition that can be severe and potentially fatal.

Anaphylaxis is your body’s immune system reacting badly to a substance (an allergen), such as food, which it wrongly perceives as a threat.

The whole body can be affected, usually within minutes of contact with an allergen, though sometimes the reaction can happen hours later.

This policy refers to nuts but at present includes sesame seeds, pine kernels, coconut and sunflower seeds.

Symptoms

The symptoms of anaphylaxis usually start between 3 and 60 minutes after contact with the allergen. Less commonly, they can occur a few hours or even days after contact.

An anaphylactic reaction may lead to feeling unwell or dizzy or may cause fainting due to a sudden drop in blood pressure.

Narrowing of the airways can also occur at the same time, with or without the drop in blood pressure. This can cause breathing difficulties and wheezing.

Other symptoms:

·        swollen eyes, lips, genitals, hands, feet and other areas (this is called angioedema),

·        itching,

·        a strange metallic taste in the mouth,

·        sore, red, itchy eyes,

·        changes in heart rate

·        a sudden feeling of extreme anxiety or apprehension

·        itchy skin or nettle-rash (hives)

·        unconsciousness due to very low blood pressure

·        abdominal cramps, vomiting or diarrhoea, or nausea and fever.

Anaphylaxis varies in severity. Sometimes it causes only mild itchiness and swelling, but in some people it can cause sudden death.

Anaphylaxis can lead to death if breathing becomes severely obstructed or if blood pressure becomes extremely low (known as shock).

If symptoms start soon after contact with the allergen and rapidly get worse, this indicates that the reaction is more severe.

Staff

The onus falls on all staff to read and follow this policy both in school and when out on trips and outings.

Caution must be taken at certain times of year such as Easter and Christmas.  If Staff distribute confectionary care must be taken to ensure that no nuts are included in the product.

The provider must have:

-        a letter from the child's GP/consultant stating the child's condition and what medication if any is to be administered;

-        written consent from the parent or guardian allowing staff to administer medication; and

-        proof of training in the administration of such medication

At all times the administration of medication must be compliant with the Safeguarding and Welfare Requirements of the Early Years Foundation Stage and follow procedures based on advice (DfES 2005).

Oral medication, please see separate asthma policy, regarding this.