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Contents

1. Home Remedies
2. First Aid
3. Prescribed Medication
4. Disposal of Medication/Drugs
5. Monitoring and Notifications
6. Recording
7. Prescribed Medication Procedure for Tipton Road Residential Unit for Children with Learning Disabilities
8. Prescribed Medication Procedure for Home and Community Support Services

1. Home Remedies

Home Remedies are medicines, suitable for children, which can be bought 'over the counter' without prescription, including Paracetamol. See First Aid, Home Remedies and Prescribed Medicines Guidance

Aspirin

Although Aspirin may be purchased 'over the counter', without prescription; it may not be given to children unless prescribed by a medical practitioner.

Other Home Remedies

The Home Remedies that are approved to be given to children are listed in First Aid, Home Remedies and Prescribed Medicines Guidance, which also provides guidance on their use. 

The child's social worker may agree that the child retains and administers his/her own Home Remedies. If not, Home Remedies kept in the home must be stored safely, in a locked cabinet. 

If children are permitted to retain/administer their own Home Remedies, it should be stated in the Placement Information Record and suitable arrangements should be in place for storage and recording by the child. The child should be provided with lockable storage facilities.

However, these other Home Remedies should only be given to a child with appropriate consent or having consulted the child's GP to ensure that no adverse reactions may result. The GP should sign a form permitting staff to administer home remedies suitable for the ages of the children of the home.

No other Home Remedies, other than those listed in First Aid, Home Remedies and Prescribed Medicines Guidance, may be given to children without the written authorisation of a medical practitioner.

Home Remedies, other than Paracetamol, should only be given for a maximum of 48 hours. If the symptoms persist beyond that time the child should see a medical practitioner before further dosages are given. However, if Paracetamol is given for 24 hours and the symptoms still persist, the child should see a medical practitioner before further dosages are given.

Where children are not deemed to be capable of administering Home Remedies themselves, care must be taken to ensure they consume the product as required, preferably in the presence of a member or a carer.

Arrangements must exist in the home for regular stock checks to be undertaken of the Home Remedies kept in the home; and for the disposal of those no longer in use or out of date.

2. First Aid

Fully equipped First Aid boxes must be kept in each home and in each vehicle used to carry children.

Children may administer their own First Aid if they have a suitable First Aid certificate or under the supervision of a carer. The arrangements for this should be outlined in the child's Placement Information Record.

If children are not deemed to be capable of giving First Aid themselves or under supervision, it must be administered by a carer.

3. Prescribed Medication

The child's social worker may agree that the child retains and administers his/her own medication. If not, it should be stored safely, in a locked cabinet. Controlled medication should be kept in a separate cabinet or in a locked container within the medication cabinet. Medication that needs to be kept at a constant low temperature should be kept in a refrigerated medication chest or in a locked container within a refrigerator that is not used for food.

If children are permitted to retain/administer their own medicines, it should be stated in the Placement Information Record and suitable arrangements should be in place for storage and recording by the child.

In any case, prescribed medicines should be kept in their original containers, clearly marked with the name of the person for whom they have been prescribed; and they should only be given to the named person, as prescribed or set out on the container. Two signatures should be recorded against any medication administered.

Arrangements must exist in the home for regular stock checks to be undertaken of the medicines kept in the home; and for the disposal of those no longer in use or out of date.

4. Disposal of Medication/Drugs

Even if children are permitted to retain and administer their own First Aid, Home Remedies or Prescribed Medicines, arrangements must exist in the home for undertaking regular stock checks of these items and arranging for their disposal as necessary.

Where medication is stopped before completion of prescribed courses or becomes out of date, it should be disposed of in a manner agreed with a pharmacist or taken to a pharmacist for disposal; a receipt obtained and a record of the disposal made. 

Medication should not be disposed of in other ways, unless agreed with a Pharmacist.

5. Monitoring and Notifications

The manager of the home or Supervising Social Worker must ensure that arrangements exist for monitoring Home Remedies, First Aid or Prescribed Medicines given to children, and that these and other related health care procedures are adhered to.

Injuries, accidents, diseases or illnesses of a serious nature, should be notified to managers and others outside the home; as set out in Designated Managers Appendix.

6. Recording

Where children are permitted to retain and administer their own First Aid, Home Remedies or Prescribed Medicines, there should be a suitable record to monitor it; the child should also be given support as necessary to keep the record up to date.

In Foster Homes, the administration of First Aid, Home Remedies and Prescribed Medicines must be recorded on the Medication Chart.

In Children's Homes (Children with Disabilities), the administration of First Aid, Home Remedies and Prescribed Medicines must be recorded on the Boots Monitoring Form.

7. Prescribed Medication Procedures for Tipton Road Residential Unit for Children with Learning Disabilities

This operates alongside the above procedure. Also see Children with Disabilities Team Criteria Procedure.

• Medication  is administered by competently assessed staff only. Staff undergo annual assessments by NHS qualified nurses.
• The administration of medication is witnessed by another designated appropriately trained member of staff and both members of staff are responsible for signing medication sheets.
• All medication is received via Boots Pharmacy. A register of medication received from Boots is kept within the unit, showing date, named medication, young person's name and amount received, and staff signature on receipt.
• All unused or out of date medication is recorded in Boots MDS Return Book and Boots are notified by Tipton Road to make a collection.
• Any other medication that leaves the unit for any reason (i.e. taken on holiday, taken to school for administration, or home leave) is recorded in the register as above for medication received.
• The disposal of medication is undertaken by Boots Pharmacy, who collect and sign for any unused medication.
• Records of administration are recorded on "Boots Medication Administration Record sheets." Refusals are also recorded on these sheets as per coding provided by Boots.
• Mistakes/errors with administered medication. Manager or person in charge will be notified immediately by senior staff on duty. Advice sought from GP and parents/guardian notified.  Social Worker would also be updated.
• The following designated doctors are "attached" to Tipton Road to oversee and review medication:
  
  Dr. Adam Kirby MB ChB MRCPsych  (Consultant Psychiatrist)
  Dr. Kate Trezise (Specialist in Learning Disability Psychiatry)

• Controlled Drugs are stored separately in a locked section inside the locked main medication cupboard. The main cupboard is stored in a locked room.
  
  A register of controlled drugs is kept within the unit showing date, named medication, young person's name, amount received, amount given out, remaining amount and two staff signatures.

• Home remedies and non-prescribed medication will not used at Tipton Road for long-stay young people, unless recommended by a GP, due to the risk of possible side effects if taken alongside prescribed medication.
  
  However there are occasions when this may not be the case when young people are on "respite" care, and parents bring in medication that they want their child to take. Medication will then be administered and recorded by staff following Tipton Road's procedures.

• No young person will be given the responsibility of taking their own medication, nor be responsible for looking after their own medication.

The Manual For Care Homes, provided by Boots is always readily available within the unit for reference by staff.

8. Prescribed Medication Procedure for Home and Community Support Services

Only prescribed medication can be administered orally. A copy of the medication guidelines that accompany the prescribed medication is to be available on individual children's file. Consent from the parent/guardian must also be obtained. Home support staff are not required to assist in the administration of oral medication, this is the role of the child's parent/guardian.

Topical medications such as creams and ointments need to be written into the care plan. Written consent must be obtained from the parent or guardian giving authorisation for staff to assist in the administration.

Staff will need to have completed the certified medication training by a competent person. Have instruction on the administration of medications/creams/ointments that relate to individual children. The learning disability nurse will provide instruction and guidance regarding the administration of medication and health related activities within their sphere of competence, if the need arises.

Staff are to ensure that medication is administered from the correct container, clearly labelled for the child, as dispensed by a pharmacist. Community support staff need to ensure that medication is kept safe in their care for the duration of the session.

The administration of medication is to be witnessed by another member of staff. Parents are to be informed that medication has been administered. Both members of staff are responsible for signing medication record sheet.

In the event of a medication administration error staff are to seek medical advice and notify parent/guardian immediately. In such an event as this staff are to complete an incident form.

All staff need to complete the appointed first aid training.

In the event of an accident staff are to seek medical advice and notify parent/guardian immediately.

All accidents/incidents are to be reported, recorded and appropriate forms completed.

End