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.

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 that need to access them can do so and they should be suitably stocked.

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 is 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 to place them into the recovery position;
• 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 not attempt to 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.

Home Remedies may only be given to a child/young person  with the consent of the parent, if  the young person is 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.

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 Placement Plan 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  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.