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13.5 First Aid Home Remedies and Medication

SCOPE OF THIS CHAPTER

This chapter relates to children placed in residential care. It covers first aid, home remedies and medication, storage and the necessary recording.

RELEVANT LEGISLATION AND GUIDANCE

The Children’s Homes (Amendment) Regulations 2011

Children's Homes Regulations and Quality Standards 2015

The Health and Wellbeing Standard

Also see: Promoting the Health and Wellbeing of Looked After Children


Contents

  1. First Aid
  2. Home Remedies  
  3. Key First Aid/Medication Records held in the Home

    Appendix 1: Administration of Medication Guidance

    Appendix 2: Specific Issues re Administration of Medication

    Appendix 3: Administration Away from the Home

    Appendix 4: Skilled Health Tasks

    Appendix 5: Personal Child Health Record (Red Book)

    Appendix 6: Address of Community Trust Pharmacists


1. First Aid

  • Each Home must have a qualified First Aider on duty at all times;
  • First Aid boxes must be held in each home and vehicle used for the transportation of children, they should have a white cross with a green background;
  • The medicine book must include the full quantity of each item stipulated in the box. When an item has been used, then it should be replaced as soon as possible. Antiseptic wipes should be used where necessary (not TCP).

Recording

The administration of First Aid must be recorded in the First Aid Log, (if there has been an accident) Accident Book, individual Child's Daily Record and Medication Administration Record (MAR).


2. Home Remedies

  • Each home's Statement of Purpose should list the Home Remedies that may be used; this list should be approved by a local GP/Medical Practitioner;
  • Homely Remedies are medicines that can be bought over the counter, including, Aspirin, homeopathic, herbal, aromatherapy, vitamin supplements or alternative therapies.

Homely Remedies are only for the use of the young people in the home, with the approval of relevant social workers (and set out in children's Placement Plans) or as prescribed by a GP and with the approval of parents/carers where possible

  • Home Remedies should be purchased for named individual children; the containers should be labelled with the child's name;
  • When a Homely remedy container is opened, staff should record the date of opening to ensure it is not kept beyond its expiry date;
  • No child may be permitted to 'self-administer' Home Remedies unless approved by their social worker, with the arrangements outlined in the Placement Plan.

Recording

The administration of any Home remedies must be recorded in individual Child's Daily Record and Medication Administration Record (MAR).

*Paracetamol must not be given for more than two consecutive days without the approval of a GP/Medical Practitioner.


3. Key First Aid/Medication Records held in the Home

Each Home should keep the following records:

Record Purpose
First Aid Log To record any administration of First Aid
Accident Book (Recorded electronically on SR3/5 Well worker system) To record any accidents
Medical Record Individual record for each child, details of health related issues, medication used, name of GP
Medication Administration Record (MAR) Individual record for each child to record any medication (or Home Remedies) administered etc

3.1 Ordering On-going Medication

Some young people will have prescribed medication, which is on-going. This should be ordered on monthly basis where possible. Responsibility for ordering these medicines is that of the Registered Manager or a delegated person/member of staff.

When ordering, a note must be made of:

  • The name of the young person;
  • The name, strength, form and quantity of the medicine;
  • The name of the surgery/G.P.;
  • When the prescription will be ready.

When ordering, staff should check stock levels before ordering. To minimise wastage and reduce risks of errors, stock levels should be kept to a minimum (No more than six weeks stock).

3.2 Collecting Prescriptions

Staff should collect prescriptions from the GP/surgery and check to make sure that they have received all the prescriptions they have ordered and the quantities are correct before taking to the pharmacy. If a medicine has directions of 'as directed' or 'as before' then the surgery should be asked to amend the prescription. A photocopy of the prescription should be made and stored until the medicine is received back from the pharmacy. Staff should check with the pharmacy as to when the prescriptions will be ready for collection (they may be able to wait on it).

3.3 Receiving/Collecting Medicines

Staff must take their ID when collecting medicines or controlled drugs.

When the medicines are collected, staff should check the medicine against the photocopied scripts that they have. Any discrepancies should be brought to the attention of the pharmacy and rectified as soon as possible. The shift leader must ensure that medication is put away properly by two competent members of staff.

The Pharmacy will be able to give advice on:

  • Potential side effects;
  • Advice on how the medicine should be taken;
  • Advice on whether the medicine may be affected by any other medicine;
  • Whether the medicine should be stored in the fridge;
  • If the medicine is a Controlled Drug.

Staff should ensure that the medicine has been properly labelled. If the medicine does not have a dispensing label on it then it should be returned to the pharmacy. Staff should also make sure that they have received a Patient Information Leaflet from the pharmacy. If it hasn't been received then the pharmacy should be contacted and one requested.

The receipt of medication should be recorded on the individual child's Medication Administration Record (MAR), if a Controlled Drug has been prescribed, 2 staff should record/sign the record.

3.4 Administration

NOTE: all staff must be familiar with the following detailed guidance on the administration of medication:

Guidance Required Where to find it
For detailed guidance on the administration of medication Appendix 1: Administration of Medication Guidance
For guidance on specific issues, e.g. refusal to co-operate, if a child is missing/absent, covert administration Appendix 2: Specific Issues re Administration
For the administration of medication away from the home e.g. if a child is on holiday or having contact with his/her parents Appendix 3: Administration Away from the Home
Skilled Health Tasks, e.g. for children with Diabetics Appendix 4: Skilled Health Tasks

Medication should be administered as set out on the label or instructed by the GP/Medical Practitioner.

No child may be permitted to 'self-administer' unless approved by their social worker, with the arrangements outlined in the Placement Plan.

Administration should be recorded on the individual child's Medication Administration Record (MAR), if a Controlled Drug has been administered, 2 staff should record/sign the record. Residential homes may also have their own, specialist systems for recording, which compliment this procedure

3.5 Storage and Expiry Dates

All medicines must be kept in a safe/secure place, e.g. a locked cabinet that does not exceed 25C*. A key should be held by a senior/responsible member of staff identified on shift planning records

Medicines that are taken internally should be stored separately to those used externally in the medicine cabinet, with liquids preferably on the bottom shelf.

* Medicines that require refrigerated storage should be kept in either a dedicated lockable fridge (in the staff office) or a locked box inside the food fridge. In both cases the maximum and minimum temperature should be recorded on a daily basis on the handover sheet. Both these temperatures should be between 2 and 8C.

All medicines have expiry dates, usually clearly stated on the label, upon expiry, they should be disposed of, see below.

3.6 Disposal

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.

This should be recorded on the individual child's Medication Administration Record (MAR), and the receipt attached), if a Controlled Drug has been disposed of, 2 staff should record/sign the record.


Appendix 1: Administration of Medication Guidance

Click here to view Appendix 1: Administration of Medication Guidance.


Appendix 2: Specific Issues re Administration of Medication

Click here to view Appendix 2: Specific Issues re Administration of Medication.


Appendix 3: Administration Away from the Home

Click here to view Appendix 3: Administration Away from the Home.


Appendix 4: Skilled Health Tasks

Click here to view Appendix 4: Skilled Health Tasks.


Appendix 5: Personal Child Health Record (Red Book)

Click here to view Appendix 5: Personal Child Health Record (Red Book).


Appendix 6: Address of Community Trust Pharmacists

Click here to view Appendix 6: Address of Community Trust Pharmacists.

End