Medical Requirements Including Allergy & Anaphylaxis

Staff who hold a PFA (Paediatric First Aid) certificate receive training in regard to allergy and anaphylaxis as part of their course. At least one first aider will always be present during every session. If a child with specific medical requirements is allocated a place at the Nursery, the place can only be accessed once a risk assessment has taken place and the staff have been fully trained to provide the additional support the child may need, (e.g. : EpiPen training and protocol for a child with anaphylaxis). If any child has food allergies their parent will be consulted about what they may eat or drink at nursery including what parents provide for their lunch. A regularly updated allergy list is kept in key locations in the nursery and is to be checked when needed and at all snack, lunch and cooking sessions. Children who have food allergies will be closely supervised during snack and the lunch period and during cooking activities to maintain a safe environment for them, and to discourage contact with the food of others in the group. Alternative treats will be provided or requested from the parent for their child to be able to participate in special events as needed. MEDICATION Administration of medicine Staff who hold a Paediatric First Aid certificate can administer medication to children; ensuring consent forms are completed, medicines are stored and checked correctly and records are kept. Administering medicines during the child’s session will only be done if absolutely necessary. Non-prescription medication, creams, ointments or eye drops (excluding medicines containing aspirin) may be administered by staff for specific short term conditions which can be treated with medication that can normally be obtained directly from a chemist. For example, Calpol for teething pain, eye drops for infected eyes. This is permitted at the manager’s discretion with the usual consent and conditions above. 65 WHYTEBEAMS NURSERY The nursery will also keep their own supply of antihistamine (Piriteze brand) and fever relief (Calpol infant brand) that may be administered in the event of a medical emergency such as but not limited to a high fever or bee or wasp sting. Permission will be sought via enrolment form or separately if necessary. If a child has not been given a medicine before, it is advised that parents keep them at home for 48 hours to ensure no adverse effect, and to give it time to take effect. If your child has required paracetamol or ibuprofen for any reason before attending nursery, we ask parents to notify nursery staff. Medication may mask symptoms and we may decide that the child should be cared for at home. Consent for administering medication Only a person with parental responsibility (PR) or a foster carer may give consent. A childminder, grandparent, parent’s partner who does not have PR, cannot give consent. When bringing in medicine, the parent must inform the setting manger or deputy. The manager or deputy will receive the child’s medication and ask the parents to complete a consent form. No medication will be administered without this. The medication consent and administration form will go in the red folder in the medication trolley and the medication list updated. All staff including the key person will be informed via in house communication. Regular medication will be noted on the child’s file by the keyworker but time specific medication such as antibiotics will not. Staff who receive the medication, check it is in date and prescribed specifically for the current condition. It must be in the original container (not decanted into a separate bottle). It must be labelled with the child’s name and original pharmacist’s label if prescribed. Medication dispensed by a hospital pharmacy will not have the child’s details on the label but should have a dispensing label. Staff must check with parents and record the circumstance of the events and hospital instructions as relayed to them by the parents. Storage of medicines We require long term medications, such as inhalers to be kept onsite at all times, therefore parents may need to seek a spare from the GP or pharmacy. Medication will be stored safely in a named zip lock bag in the medication trolley. Refrigerated medication is stored in the kitchen fridge. All staff including the key person will be informed via in house communication. The manager, deputy or key person is responsible for ensuring medicine is handed back at the end of the day to the parent, where appropriate. The parent is equally responsible for checking they have received it back. A healthcare plan/medical needs form will be completed if deemed necessary. The manager or deputy will regularly check that medication and creams are in date and return any out-of-date medication to the parent. Expiry dates will also be checked at the time of administration. Parents do not access where medication is stored, only staff may access, to reduce the possibility of a mix-up with medication for another child, or staff not knowing there has been a change. Record of administering medicines The record of medicines administered is kept in the file in the medication trolley with the medication, out of reach on the in the little room. Past records are filed securely as required. Staff are taught how to complete the forms at induction, however these are usually completed by a manager or deputy. The staff member administering the medication must complete the medication administration record. The medicine record book records: name of child name and strength of medication 66 WHYTEBEAMS NURSERY the date and time of dose given dose given (eg. 5ml) and how if relevant signed by person administering the medication (first aid trained staff only) signature of a staff witnessing the medication being given correctly according to these procedures. verified by parent signature or person collecting at the end of the day. It is the responsibility of the person collecting the child to inform the parent that medication has been administered. No child may self-administer. If children are capable of understanding when they need medication, e.g. for asthma, they are encouraged to tell their key person or other staff what they need. This does not replace staff vigilance in knowing and responding. The medication records are monitored to look at the frequency of medication being given. For example, a high incidence of antibiotics being prescribed for a number of children at similar times may indicate a concern over infection control. Children with long term medical conditions requiring ongoing medication Risk assessment is carried out by management for children that require ongoing medication where appropriate. Other medical or social care personnel may be involved in the risk assessment. Parents contribute to risk assessment. They are shown around the setting, understand routines and activities and discuss any risk factor for their child. For some medical conditions, key staff will require basic training to understand it and know how medication is administered. Training needs is part of the risk assessment. Risk assessment includes any activity that may give cause for concern regarding an individual child’s health needs. Risk assessment also includes arrangements for medicines on outings; advice from the child’s GP’s is sought, if necessary, where there are concerns. Medical Needs or Health care plan form is completed with the parent and relevant information is shared with staff who care for the child. The plan is reviewed every six months (more regularly if needed). This includes reviewing the medication, for example, changes to the medication or the dosage, any side effects noted etc. Managing medicines on trips and outings Children are accompanied by their key person, or other staff member who is fully informed about their needs and medication. Medication is taken in a zip lock bag labelled with the child’s name, name of medication, copy of the consent form and a card to record administration, with details as above. The parent or person collecting must sign the record as usual. If a child on medication has to be taken to hospital, the child’s medication is taken along in a zip lock bag, clearly labelled as above. Staff taking medication Staff taking regular medication should inform their manager. The medication must be stored securely in staff bags in the kitchen out of reach of children. The manager must be made aware of any contra-indications for the medicine so that they can risk assess and take appropriate action as required. Life Vac - Life Saving Resuscitation Device We have a Life Vac on site (a lifesaving resuscitation device) from the UK based genuine supplier. The device is designed to be used as a last resort, if all attempts to unblock an airway using Basic Life Support from a first aider have failed. You can find information here about the device. www.lifevac.uk 67 WHYTEBEAMS NURSERY Digital Ear Thermometer We have an ear thermometer with removable hygiene caps on site to check the temperature of children when a raised or high temperature is suspected. Children who develop a high temperature at nursery will need to be collected promptly by a parent or carer and cared for at home until they are better. We may administer Calpol at nursery if necessary and where we have permission to do so to. Children can return 24 hours after any fever has passed and they are well enough.