Illness

Medication Policy

Revised February 2014 in Accordance with Public Health Guidance

Illness & Medication Policy

Every Child Matters Outcome: Be Healthy and Stay Safe

Every child is a unique child who is constantly learning and can be resilient, capable,confident and self-assured.

Millers Dene Day Care promotes the good health of all children, taking necessary steps to prevent the spread of infection and will take appropriate action when children are ill.

It is our policy here at Millers Dene Day Care to ensure that we promote the health and well-being of all children in our care.

Millers Dene Day Care will administer medication provided by parents when essential and where it would be detrimental to the child’s health and well-being not to administer the medication.

Medication must be provided in the original container as dispensed by a pharmacist and include the instructions for administration.

The settings will not accept medicines that have been taken out of the container as originally dispensed nor make changes to dosages on parental instructions.

It is helpful, where clinically appropriate, if medicines are prescribed in dose frequencies which enable it to be taken outside setting hours. Parents could be encouraged to ask the prescriber about this.

The Early Years Foundation Stage (2012) that:

“3.42 The provider must promote the good health of children attending the setting.”

Prescription Medication

It is preferable that medicine administered to children in the setting isprescribed by a Doctor, Dentist, a qualified Nurse Prescriber or pharmacist prescriber as a ‘Prescription’.

Prescribed Medication

However here at Millers Dene we understand that the administration of some medication that is prescribed by a nurse practitioner or pharmacy may be essential to a child’s health and well-being at times such as Calpol for high temperatures and teething. This also includes teething gels and sachets.

Ofsted (2013) States:

“The Statutory Framework states that ‘medicines must not usually be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist’.

When we use the word ‘prescribe’ we mean medicine that is recommended.

When we use the word ‘prescription’ we mean written instructions from a doctor or dentist.

Most pharmacists cannot write prescriptions and can only prepare the medicine as instructed by a doctor or dentist. However, they can recommend (prescribe) over-the-counter medicines such as teething gels, when children are teething, or painkillers, when children have a temperature.”

It is important that parents are aware that while it is not our policy to care for sick children, who should be at homeuntil they are well enough to return to the setting, we will agree toadminister medication as part of maintaining their health and well-beingor when they are recovering from an illness.

We also ask parents to remember that staff are not legally obliged to administer medication, they do so voluntarily.

Emergency administration of Calpol

An emergency supply of calpol will be stored on the premises for an emergency situation, for example a dangerously high temperature. This will be administered by a member of the management team, only after the following steps have been taken…..

  • cool the child by natural methods
  • contact all emergency contacts for collection

Permission can be sought over the phone and calpol administered whilst child is waiting to be collected.

If no one can be contacted and management feel this is an emergency situation, calpol will be administered. (Consent and confirmation that a child has had calpol before will be sought on registration).

Short -Term Medical Needs

Many children will need to take medicines during the day at some time during their time in a setting. This will usually be for a short period only, perhaps to finish a course of antibiotics,to apply a cream this includes nappy cream or calpol for teething etc. To allow children to do this will minimise the time that they need to be absent. However such medicines should only be taken at the setting where it would be detrimental to a child’s health if it were not administered during the setting day.

Long-Term Medical Needs

The setting will ensure sufficient information about the medical condition of any child with long-term medical needs if obtained. If a child’s medical needs are inadequately supported this may have a significant impact on a child’s experiences and the way they function in or out of the setting. The impact may be direct in that the condition may affect cognitive or physical abilities, behaviour or emotional state. Some medicines may also affect learning leading to poor concentration or difficulties in remembering.

The setting will need to know about any particular needs before a child is admitted, or when a child first develops a medical need. For children who attend hospital appointments on a regular basis, special arrangements may also be necessary. The setting will develop a written health care plan for such children, involving the parents and relevant health professionals.

This will include:

  • Details of a child’s condition
  • Special requirement e.g. dietary needs, pre-activity precautions
  • And any side effects of the medicines
  • What constitutes an emergency
  • What action to take in an emergency
  • What not to do in the event of an emergency
  • Who to contact in an emergency
  • The role the staff can play

Staff Training

A health care plan may reveal the need for some staff to have further information about a medical condition or specific training in administering a particular type of medicine or in dealing with emergencies. Staff will not give medicines without appropriate training from health professionals. Millers Dene Day Care will arrange appropriate training in collaboration with local health services when necessary.

Administering Medicines

No child will be given medicines without their parent’s written consent.

Any member of staff giving medicines to a child should check:

  • the child’s name
  • prescribed dose
  • expiry date
  • written instructions provided by the prescriber on the label or container

If in doubt about any procedure staff will not administer the medicines but check with the parents or a health professional before taking further action. If staff have any other concerns related to administering medicine to a particular child, the issue will be discussed with the parent, if appropriate, or with a health professional attached to the setting. The settingwillkeep written records each time medicines are given. Staff will complete and sign a record each time they administer medicine to a child. The dosage and administration of all medication will be witnessed by a second staff member. Staff will not accept any medication ‘just in case’ even if prescribed for example “if his/her cough gets worse” with the exception of teething. However it may be necessary for children who have a history of febrile convulsions to have their own emergency bottle of calpol to be administered if they develop a high temperature.

Refusing Medicines

If a child refuses to take medicine, staff will not force them to do so, but will note this in the records and follow agreed procedures which will be set out in the individual child’s health care plan. Parents will be informed of the refusal on the same day. If a refusal to take medicines results in an emergency, the setting’s emergency procedures will be followed.

Record Keeping

It is the parent’s responsibility to inform the setting about the medicines that their child needs totake and provide details of any changes to the prescription or the support required.

Howeverstaff will make sure that this information is the same as that provided by the prescriber.

Medicines should always be provided in the original container as dispensed by apharmacist and include the prescriber’s instructions. In all cases it is necessary to check that written details include:

  • name of child
  • name of medicine
  • dose
  • method of administration
  • time/frequency of administration
  • any side effects
  • expiry date

Staff will check that any detailsprovided by parents, or in particular cases by a paediatrician or specialist nurse, are consistent with the instructions on the container.

Written records of all medicines administered to children will be kept andstaff will ensure that parents sign the medicationrecord to acknowledge the entry.

Visits & Outings

The setting will encourage children with medical needs to participate in safely managed visits. The setting will consider what reasonable adjustmentswill be made to enable children with medical needs to participate fully and safely on visits. Staff will carry out risk assessments for such children.

When additional safety measures need to be taken for outside visits, it may be that an additional supervisor, a parent or another volunteer might be needed to accompany a particular child. Arrangements for taking any necessary medicines will also be taken into consideration. Staff supervising excursions will always be aware of any medical needs, and relevant emergency procedures. A copy of any health care plans will be taken on visits in the event of the information being needed in an emergency.

If staff are concerned about whether they can provide for a child’s safety, or the safety of other children on a visit, they will seek parental views and medical advice from the health service or the child’s GP.

Staff responsibility

All staff will be made aware of individual medical conditions and needs; they will be informed of what procedures and actions may take place.

The child’s parents and health professionals should provide this information.

All staff will be aware of the likelihood of an emergency arising and what action to take if one occurs.

Storing Medicines

Large volumes of medicines will not be stored. Staff will only store, supervise and administer medicine that has been prescribed for an individual child.

Medicines will be stored strictly in accordance with product instructions (paying particular note to temperature) and in the original container in which dispensed.

Prescription Medication

Staff will ensure that prescription medication is supplied in its original container and is clearly labeled with the name of the child, the name and dose of the medicine and the frequency of administration.

Prescribed Medication

For prescribed medication staff will ensure that it is supplied in the original container and clear instructions are provided on the container for administration, staff must ensure that medication is labeled.

Where a child needs two or more prescribed medicines, each should be in a separate container.

Staff are responsible for making sure that medicines are stored safely. All emergency medicines, such as asthma inhalers and adrenaline pens, will be readily available to children and will not be locked away. Other non-emergency medicines will be kept in a secure place not accessible to children.

A few medicines need to be refrigerated. They can be kept in a refrigerator containing food but should be in an airtight container and clearly labeled.There will be restricted access to a refrigerator holding medicines.

Disposal of Medicines

Staff will not dispose of medicines. Parents are responsible for ensuring thatdate-expired medicines are returned to a pharmacy for safe disposal. If parents do not collect all medicines,they will be taken to a local pharmacy for safe disposal.

Hygiene and Infection Control

All staff will be familiar with normal precautions for avoiding infection and followbasic hygiene procedures. Staff will use disposable gloves and take care when dealing with spillages of blood or other body fluids and disposing ofdressings or equipment.

Health Care Plan

The main purpose of an individual health care plan for a child with medical needs is to identify the level of support that is needed. Not all children who have medical needs will require an individual plan.

An individual health care plan will clarify for staff, parents and the child the help that will be provided. It is important for staff to be guided by the child’s GP,paediatrician or community nurse.

Staff will agree with parents how often they will jointly review the health care plan.

It is sensible to do this at least once a year, but much depends on the nature of the child’s particular needs; some will need reviewing more frequently.

Staff will judge each child’s needs individually.

Those who may need to contribute to a health care plan include:

  • medical professionals
  • the day care manager
  • the parent or carer
  • the child (if appropriate)
  • key person
  • care assistant or support staff (if applicable)
  • staff who are trained to administer medicines
  • staff who are trained in emergency procedures

Confidentiality

The day care manager and staff will always treat medical information confidentially. The day care managershould agree with the parent, who else should have access to records and other information about their child’s medical needs.

Sick children

If a child becomes ill or develops a high temperature whilst attending the setting the following steps will be taken:

  • The child will be made comfortable and staff will try to reduce a temperature naturally (remove clothing, cold face cloth, drink of cold water, sit in a cool place)
  • The parent will then be contacted and asked to collect the child
  • The parent will be advised to contact their GP if staff suspect the child is
  • infectious (please see Illness and Childhood Diseases information at end of policy, this information will be given to parents in booklet form at registration)
  • The child will then be able to return to the setting when the exclusion period has passed and they are well enough to cope with the daily activities of the setting

Staff Illness

Staff members are required to inform management of any sickness or illness as soon as is reasonably possible. The exclusion and recuperation policy applies to everyone including staff, children and students.

We have children and staff members within the nursery who have lowered immune systems and it is vital that you inform management immediately of any infections and illness during the working day or at 7.30am via telephone at the beginning of a working day. You must also inform management even if a Doctor gives you the all clear to come to work.

Staff members who are taking medication must also inform management in case of a reaction or side effects.

Illness/Disease / Symptoms / Incubation / Exclusion / Comments
Chicken Pox / The rash consists of blisters that appear on the skin of the affected area. / 14 – 21
Days / Anyone with chickenpox should be excluded from work/setting for five days from onset of rash or until spots have crusted over / Women who have never had chickenpox and come into contact with someone who has the virus during pregnancy should seek advice from their family doctor, midwife or gynecologist urgently
Conjunctivitis / This is an infection of the covering of the eyeball and the inside of the eyelid. The white of the eye becomes reddened and there may be a discharge. The eye usually feels very itchy and bright light may hurt. / 1- 3
Days / It may be necessary to recommend exclusion of affected children until they recover or until they have had
antibiotics for 24 hours.
Diarrhoea / vomiting / Main symptoms are vomiting,
diarrhoea and abdominal pain which may occur singly or in combination. / Prompt exclusion for forty eight hours after symptoms cease
(48 hour rule) / Often rest and fluids are the main stay of treatment The causes are varied, but strict attention to personal hygiene, such as hand washing, is important to reduce the spread of the disease.
German
Measles (Rubella) * / Usually the rash is the first sign, although there may be mild
catarrh, headache or vomiting at the start. The rash takes the form of small pink spots all over the body. / 14 – 21
Days / It is recommended that the child is excluded for five days from onset of rash, / Rubella occurring in a woman in the early months of pregnancy may cause
congenital defects in the unborn child. Female staff or mothers who are
pregnant when a case occurs should
consult their GP or ante natal clinic (regardless of their immune status) so that
an antibody test can be performed if necessary.
Illness/Disease / Symptoms / Incubation / Exclusion / Comments
Hand, Foot and Mouth Disease / In this mild illness, a fever is common with vesicles (blisters) in the mouth and red, raised rash on the hands and feet. As time goes on, the rash develops into small blisters. / 3 – 5
Days / Child should be excluded until fully recovered / The most effective method of prevention is through effective hand washing, correct wearing of protective clothing (gloves) and disposal of used tissues.
Measles * / Measles starts with what appears at first to be an ordinary cold, sore eyes,
sneezing, coughing and a runny nose. These symptoms are accompanied by a fever. / 10 – 15
Days / The child should be excluded from
setting for five days from onset of rash. / Measles can be a very serious disease and may very occasionally be fatal.
Complications such as meningitis or
encephalitis can lead to brain damage and other complications can permanently
damage the lungs.
Meningitis and
meningococcal septicaemia * / Severe headaches, fever, vomiting, drowsiness, discomfort from bright light, neck stiffness and a rash of small red, purple spots or bruises.
The rash does not blanche (go white) under pressure from a glass rolled over it (this is known as the glass test). This last sign is evidence of the serious
blood-poisoning (septicemia) form of infection. / 2 – 10
Days / Until clinical
recovery / It is vital to report cases promptly and discuss the above issues with the HPU in order that accurate information can be given and appropriate action taken.
Mumps * / The first symptoms of mumps are usually a raised temperature and general malaise. Following this there is stiffness or pain in the jaws or neck. Then the glands in the cheeks and the angle of the jaws swell up and are painful. / 18 – 21
Days / Exclusion should be for five days from onset of swollen glands. / Measles, mumps and rubella are all
preventable by vaccine and all children should be vaccinated against them with the Measles, Mumps and Rubella (MMR) vaccine at 12-l5 months, unless
contra-indicated.