Medical Requirements Including Allergy & Anaphylaxis & Medication

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.

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. The nursery will call parents before administering emergency medication to ensure no
medication was given at home that day and to inform them. If the parents are not contactable the
nursery manager or deputy (all PFA trained) will risk assess administration in the best interests of the
child which may mean they going ahead where permission had previously been given.

If a child has not been given a medicine before, it is advised that parents keep them at home for 48
hours and 72 hours for antibiotics, 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, parents
MUST notify nursery staff on or prior to arrival. 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
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.

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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

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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.