First Aid and Medication

As a Carer you will at times have to provide medication to children/young people placed with you. 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 and or delegated authority document.

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, where the people who need to get access to them can do so and they should be suitably stocked. First Aid boxes should not be stored within reach of small children.

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.

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.

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;
• Collect any drugs or spillages (e.g. vomit) for analysis;
• Do not try and make them sick;
• Observe the child/young person; keep them calm, warm and quiet.
• If the person is unconscious:
  • 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, including samples of vomit and any drugs.

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.

You must have guidance on giving prescribed drugs for children and advice on if you can give drugs not on prescription. It is really important that you understand the reasons for taking the medicine, the dosages etc and also the contraindications. It would be good practice to ensure you have a list of medicines on your person at all times in the event of any medical emergency.

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.

Where a child or young person has attended A&E or an ambulance has been called you must inform their Social Worker and your Supervising Social Worker as soon as possible.  

If you accept responsibility to give medicines either by 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.

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 with the consent of the parent, the child if over 16 or after consulting with the child's GP 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. 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 may not be given to children unless prescribed by a medical practitioner.

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.

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.

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 Epi Pen and calling for an ambulance;
• You should be aware of the Plan and should have been trained to administer an Epi Pen 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;
• You should not attempt to administer another dose of medication if the dose of medication has been partially swallowed or spat out.

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.

Administration of Medication and Safe Storage

The Fostering Agency takes a responsible approach to ensuring that any medication administered in a foster placement to a Child or Young Person, is accurately recorded by the Foster Carer as part of safe practice. Foster Carers will use the medication record for this purpose. The Placement Planning Meeting will address the area of the administration of medication and treatment, however, it is recognised that during the course of a placement, a Child or Young Person may be prescribed medication or begin to take non-prescribed medication.

Administration of Medication

The medical consent for a Foster Carer to administer medication or treatment to a Child or Young Person will have been addressed in the Placement Planning Meeting along with the Delegated Authority Proforma which gives clarity as to areas of authority the Foster Carer has with regard to health care.

• As part of this process the relevant forms/permissions will have been completed/received in conjunction with the Child or Young Person’s Social Worker and any other relevant health care professionals will have been/will be consulted with if there are any concerns in relation to health;
• Foster Carers must ensure that they regularly keep the Child or Young Person’s Social Worker and Supervising Social Worker up to date with any health changes with regard to the Child or Young Person they care for, including any need for prescribed medication or non-prescribed medication;
• Where a Young Person is already self-administrating or requests to self-administer prescribed medication that has been prescribed on a longer-term basis, this will discussed and decisions clearly stated as part of the Placement Planning Meeting and Placement Plan. Where this occurs during the course of a placement the Foster Carers, Young Person’s Social Worker, and Supervising Social Worker must discuss this and relevant agreement/consent forms must be in place before this can occur, where agreed as appropriate;
• In such circumstances, the Young Person’s Social Worker must have consulted with the relevant health professional, and have this information available for the Placement Planning Meeting or where this occurs during the course of the placement. The person/s holding parental responsibility for the Young Person should also be informed of the prescribed medication by the Young Person’s Social Worker including the proposed administration arrangements;
• In relation to non-prescribed medication or short-term medication arrangements for the administration of medication will also be discussed and agreed;
• Foster Carers must ensure there is no delay in the administration of medication for a Child or Young Person and must complete the Medication Record when they are administrating medication to a Child or Young Person in their care whether prescribed or non-prescribed. Safe Storage of Medication All medication must be stored in the original packaging and instructions for its storage must be adhered too. Medication must be kept out of reach of Children and Young People or locked away. Young People who wish to, and who can safely keep their own medication, do so where this has been agreed as part of the placement planning process. Foster Carers however must be vigilant in this area to prevent other Children or Young people from having access to this medication where clear guidelines will be discussed with the Young Person of the safe storage of their medication and also monitored.

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

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.

First aid and records of all medicines that have been given 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. If an accident occurs, which results in a visit to GP/hospital, it should be recorded.