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. You should make sure that you take the opportunity to attend health and safety training opportunities when they arise.

First aid boxes should be kept in a safe accessible place.

The first aid box may be looked at in an unannounced visit and as part of your annual review.

If a child is at risk or requires first aid, you should apply first-aid 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.

If it’s a medical emergency, you should:

1. Call for help immediately — dial 999:
2. Request an ambulance if urgent medical care is needed and follow advice given;
3. Ask for the Police if the situation requires it (e.g., if there is danger, a crime, or safeguarding concern).

If you suspect a child or young person has taken drugs or another harmful substance:

• Do not move the child/young person unless you need to remove them from immediate danger or place them into the recovery position if it is safe to do so;
• Try to find out what has happened (substance taken, quantity, and time);
• Collect any drugs or spillages (e.g. vomit) for analysis by medical practitioners;
• Do attempt to and make them sick;
• Observe the child/young person; keep them calm, warm and quiet whilst waiting for help.
• If the child/young person is unconscious:
  • Ensure their airway is clear and they can breathe and place them in the recovery position if it is safe to do so;
  • Do not move them if you suspect a spinal or serious injury (which may not be obvious);
  • Do not attempt to make them sit or stand;
  • Do not leave them unattended until help arrives.

When medical help arrives, pass on any information available, including any samples and any medication being taken. 

What you should know when a child has been placed with Health Needs

If a child/young person has particular health needs, the child’s social worker will provide information and guidance about:

• Their specific health requirements;
• The medical practitioner(s) who will support you in meeting those needs;
• Any relevant specialist advisory or support groups that can offer additional help and advice.

Medication Management

You must have guidance on giving prescribed drugs for children and advice on the use of home remedies.

You are expected to complete records when you administer any medication or when there has been a medical incident i.e. hospital admission, consultant/GP appointments.

If you accept responsibility to administer medication (which would be classed as a delegated health care tasks for example injections, administering rectal medication or tube feeding etc.), the following criteria should be met:

• The child’s parent has given written consent;
• You are instructed in the technique by a qualified nurse or doctor who is satisfied that you are competent to do it. You should also be aware of any possible reactions to the medication and the necessary steps to correct such an occurrence;
• The registered medical practitioner should offer supervision around the task or medication given.

Any health-related issues should always be discussed in supervision meetings and recorded.

You will receive training in relation to the management and administration of medication.

Home Remedies may only be given to a child/young person with the consent of the parent, and the child if over 16 and has capacity or after consulting with the child's GP/Pharmacist and recorded in the Placement Plan.

Home Remedies are medicines that can be bought over the counter without prescription, including Paracetamol, Aspirin, homeopathic, herbal, aromatherapy, vitamin supplements or alternative therapies.

Home Remedies must be kept in a locked cabinet that is only accessible to you, 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.

The Home Remedy advice sheet must be followed. Particular attention must be paid to the dosage and administration guidance, including how long the child/young person can continue taking the Home Remedy before a GP appointment or pharmacy support should be made. This will differ depending on the Home Remedy.

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.

For further advice on what a pharmacist can support with, please see: How pharmacies can help (NHS).

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 about 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, the method of administration such as orally, injection, tablet, syrup, inhaler etc. and the dosage are correct;
• Give the medicine in accordance with the instructions and be aware of any contraindications when the medication is unsafe to use;
• 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;
• You should not attempt to administer another dose of medication if the dose of medication has been partially swallowed or spat out. In this situation seek advice from a medical practitioner on what the best course of action is.

Receipt of Medicines

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

The record should show:

• Date you got 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.

Some children and young people are prescribed controlled drugs. Examples of controlled drugs are morphine and pethidine for pain, methadone for withdrawal and methylphenidate for hyperactivity.

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

See also: CQC information on Controlled Drugs.

Medication should be disposed of when:

• The expiry date has been reached;
• The course of treatment is completed;
• The medication has been discontinued.

Unless instructed by a GP/Pharmacy, unused/expired medicines should be returned to the Pharmacy, and a receipt obtained.

Return or disposal of medication should be recorded on the child's/young person’s Medication Administration Record (MAR), and the receipt attached.