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Contents

1. Introduction and Purpose
2. Training and Dissemination
3. Storage and Control of Medication
4. Documentation and Recording of Medication
5. Consent for a child or young person to receive medication
6. Delegation of Nursing Procedures
7. Monitoring Children Administering their own Medication
8. Emergency Administration of Medication
9. Errors
10. Disposal of Medication
11. Policy Review

1. Introduction and Purpose

1.1	This policy document is concerned with the control and administration of medication to children and young people in care. It is designed to act as a point of reference, and provide a framework of good practice for use by all foster carers and residential social work staff. This Policy draws on regulations and guidance relating to the issues of medication in a range of documents.
1.2	This policy sets out the minimum standards to be achieved in relation to the administration of medication. The policy aims to ensure that medicines are used appropriately, that there is a safe and effective procedure for the control and administration of medication and that effective monitoring and record keeping of all medicines is in existence.

2. Training and Dissemination

2.1	It is the responsibility of the Service Manager and Designated Nurse, Children in Care to ensure all foster carers and staff are familiar with the requirements of the Medication Policy.
2.2	The policy will be disseminated through a process of familiarisation during training sessions for foster carers and staff and its Implementation will be closely monitored.

3. Storage and Control of Medication

3.1	All items of medication should be stored in designated, locked cupboard, in conditions in line with storage instructions from the pharmacist. Medication must be stored at a suitable temperature and away from humid areas.
3.2	If the medication needs to be stored in a refrigerator, it should be placed in a compartment or container within the refrigerator that can be secured and that unauthorised persons cannot access.
3.3	When medication is removed from its storage place it must remain under the direct supervision of the person assuming responsibility for it.
3.4	Children who require their medication to be available immediately, for example those with asthma who need immediate access to an inhaler, should be encouraged to hold the medicine on them at all times. The child should be supported by carers and staff to ensure that they use their medication in a responsible and appropriate way.

4. Documentation and Recording of Medication

4.1	A detailed record of every item of prescribed medication must be accurately recorded on either the ‘Record of prescribed medication’ form or the ‘Record of non-prescribed medication’ form within the child / young person’s personal file. (These forms are accessible via the Forms button at the top of this chapter).
4.2	The individual record of medication administered must be signed by the foster carer or social worker administering the medication immediately after the child has taken it. The record must not be signed in retrospect.
4.3	A detailed record of every item of medication should be kept on the personal file of each child. Some conditions or symptoms are considered appropriate for ‘treatment’ using a homely remedy type of medication.
4.4	The term ‘Homely remedy’ describes any item of medication that has been purchased ‘over the counter’ from a pharmacist, and is being used to treat a minor ailment, for example Paracetamol to relieve pain, or cough mixture to soothe a cough. The term does not describe the use of alternative treatment that might be herbal in nature, or have aromatherapy origins. Foster carers and staff must know what each medicine is for, and its side effects.
4.5	There is a recognised need in foster care and residential homes to be able to treat minor ailments, as would a parent for a child, without necessarily consulting the child’s / young person’s doctor. Following discussion with the child’s social worker, in line with the guidance of the Royal Pharmaceutical Society (1994) this would involve seeking appropriate advice from a local pharmacist, and purchasing medicines from them as deemed necessary.
4.6	If a child is already on a course of prescribed medication, a doctor should be consulted before any homely remedy is used. Under no circumstances should Aspirin or products containing Aspirin be administered to children under the age of 12 years.

5. Consent for a child or young person to receive medication

5.1	Only foster carers and staff who have been given parental consent and are familiar with the procedures outlined in this policy should be allowed to administer medication. (Parental Consent for a Child / Young Person to Receive Medication Form is accessible via the Forms button)

6. Delegation of Nursing Procedures

6.1

Only foster carers and staff who have undertaken specific training and demonstrated their competence to undertake the administration of prescribed medication / procedure for an identified child should be allowed to undertake the procedure. (Delegation of Nursing Procedures Form is accessible via the Forms button).

7. Monitoring Children Administering their own Medication

7.1

Details of self-administered medication should be on the child or young person’s file as previously outlined. The use of medication should be monitored on a daily basis, with the child / young person encouraged to keep a diary or notebook detailing frequency of use of self administered medication and to positively reinforce appropriate use.

7.2

Oral Contraceptives – Some young women might be taking or thinking about taking a prescribed contraceptive pill. In the event of her sharing this information with carers, two possibilities arise in relation to managing this: Some young women may wish to retain the medication and be responsible for regularly taking the pills themselves. Where this situation applies the carer would follow the guidance for self-administration of medication. Some young women might involve carers by asking them to retain the pills and dispense them on a daily basis. Where this situation applies follow the procedure for Section 4, Documentation and Recording of Medication.

8. Emergency Administration of Medication

Where a child has a history of fitting, of severe asthma attacks or other medical emergencies than he/she may require emergency administration of medicine either orally or rectally. In these cases the following must apply:

• The medicine must be prescribed by a medical practitioner.
• The medicine must be in date and have clear dosage instructions.
• The medicine must be stored in a locked but quickly accessible cabinet and at the correct temperature.
• There must be an individual medical protocol attached to the care plan setting out the signs and symptoms of any likely emergency and the correct timescales and procedure for administration of emergency medication. This protocol must be agreed with parents/carers of the child and by a medical practitioner.
• Staff who may have to administer these medications should have training in their administration by a medical practitioner and have refresher training at least every two years.

9. Errors

8.1	Any error of administration must be reported to the carer's fostering social worker or the residential manager immediately, and appropriate professional advice sought at that time
8.2	Errors must be accurately recorded
8.3	Errors that come to light in relation to the self-administration of medication must be dealt with when the error has been noticed or reported.

10. Disposal of Medication

9.1	Medicines should be disposed of when: Their expiry date has been reached, or The course of treatment is completed or stopped.
9.2	Medicines should be returned to the pharmacist for disposal. The date of their return should be clearly recorded on the child’s record of medication.
9.3	Under no circumstances should medication prescribed to treat the symptoms of an individual child be retained and used for treating any other child.

11. Policy Review

10.1	This policy and its implementation will be subject to annual review by the Designated Nurse, Service Manager and senior management team.
10.2	Feedback from all staff working to the policy will be welcomed and should be addressed in the first instance to the Designated Nurse.

End