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Medication Policy

At Tots and Time Out and Bright Beginnings we promote the good health of children attending nursery and take necessary steps to prevent the spread of infection (see sickness and illness policy). If a child requires medicine we will obtain information about the child’s needs for this, and will ensure this information is kept up to date. 

We follow strict guidelines when dealing with medication of any kind in the nursery and these are set out below. 

The nursery WILL NOT administer any medication unless prior written consent is given for each and every medicine.

Illness

  • If any child is brought to the nursery in a condition in which he/she may require medication sometime during the day, the Nursery Manager will decide if the child is fit to be left at the nursery.

  • For information on infection control and infectious diseases visit the Public Health England website and view their document titled ‘Health protection in schools and other childcare facilities’.

  • If the child is deemed well enough to stay at the setting, the parent/ carer must be asked if any kind of medication has already been given, at what time and in what dosage and this will be recorded.

 

Medication in the Nursery Setting - General Guidance

  • Before administering medication to any child we will require written agreement from the parents

  • This agreement (usually a Medication Form) should include;

    • the child’s name

    • the name of the medication

    • the required dose and agreed time of administration

    • the reason for the medication

  • Medication is only accepted in its original labelled container 

  • Where the medication is an adrenaline pen or inhaler (where there may be only occasional emergency use), it will have the expiry date of the medication recorded on the appropriate form

  • For non-prescription medication the nursery reserve the right to determine the number of days the medication will be given before requesting parents/ carers further input or the advice of a healthcare professional. This will be based upon the individual child and condition

  • If at any time there is any doubt regarding the administration of medication to a child, practitioners will stop and check with the Nursery Manager before continuing.




 

  • Storage

    • All medication will;

      • Be stored in accordance with the manufacturer’s instructions on the container (e.g. cool dark place, refrigerated)

      • Be stored in a closed box

      • Be kept out of the reach of children

      • Be in their original containers

      • Have labels which are legible and in English

      • Be clearly marked with child’s name 

  • Emergency medication, such as inhalers and Adrenaline (EpiPens), will be within easy reach of staff in case of an immediate need, but will remain out of children’s reach

  • Any ‘stored’ medication such as Nursery stock of Paracetamol or a child’s inhaler, will be regularly checked to ensure the product is still within its expiry and therefore suitable for use. 

 

Medication Prescribed by a Doctor, Dentist, Nurse or Pharmacist

(Medicines containing aspirin will only be given if prescribed by a doctor)

  • Prescription only medicine will be given when prescribed by the above and only for the person named on the dispensing label on the bottle/container for the dosage stated

  • Medicines must be in their original containers 

  • For all medication the parent/carer must give prior written permission for the administration of each and every medication on a daily basis. 

  • The parent/ carer will complete the relevant daily form to enable the nursery to administer the medication(s) required. The form will include;

    • Name and strength of medication

    • Dose

    • Any additional requirements (such as to be taken with food)

    • Signature In and Out 

    • Reason for Medication

  • The written permission is only acceptable for the medication listed and cannot be used for similar types of medication, e.g. if the course of antibiotics changes

  • Parents must notify the nursery IMMEDIATELY if the child’s circumstances change, e.g. a dose has been given at home, or a change in strength/dose needs to be given

  • The nursery will only administer as per the information listed on the form

  • When the child is picked up from the setting, the parent/ carer must be given an update as to the times and dosage given throughout the day. The parent’s signature must be obtained confirming this information has been given

  • At the time of administering the medicine, a senior member of staff will ask the child to take the medicine, or offer it in a manner acceptable to the child at the prescribed time and in the prescribed form

  • If the child refuses to take the appropriate medication a note will be made on the form. Where medication is “essential” or may have side effects, discussion with the parent will take place to establish the appropriate response. This will be documented on the form accordingly.


 

Non-prescription Medication (also known as over the counter medicine)

  • If any child is brought to the nursery in a condition in which he/she may require medication sometime during the day, the manager will decide if the child is fit to be left at the nursery

  • The nursery will not administer any non-prescription medication containing aspirin

  • The nursery will only administer non-prescribed medication for a short initial period and only if necessary. After this time parents / carers will be advised to seek medical advice

  • The nursery reserve their right to refuse to administer medication if they feel that the child does not need the medication or deem further medical attention is required

  • For all medication the parent/carer must give daily written permission for the administration of each and every medication

  • Medicines must be in their original containers

  • This also applies to non-prescription creams or ointments for skin 

  • The parent / carer will complete the relevant form to enable the nursery to administer the medication(s) required. The form will include:

    • Name and strength of medication

    • Dose

    • Any additional requirements (such as to be taken with food)

    • Signature In and Out

    • Reason for Medication

  • The written permission is only acceptable for the medication listed and cannot be used for similar types of medication

  • Parents must notify the nursery IMMEDIATELY if the child’s circumstances change, e.g. a dose has been given at home, or a change in strength/dose needs to be given

  • The nursery will only administer as per the information listed on the form

  • When the child is picked up from the setting, the parent / carer must be given an update as to the times and dosage given throughout the day. The parent’s signature must be obtained confirming this information has been given

  • At the time of administering the medicine, a senior member of staff will ask the child to take the medicine, or offer it in a manner acceptable to the child at the prescribed time and in the prescribed form.

 

Emergency Medication

  • At new registration of a child to the setting, parents will be asked if they are happy to give consent to ‘emergency’ treatment being given. This would be only deemed necessary for specific circumstances. Parents/ carers will be asked to complete a form to give consent. This form will include:

    • The circumstances in which ‘emergency’ medication will be given e.g. High temperature (above 37.8˚c)

    • The specific medication (drug name) e.g. Paracetamol 

    • Dose to be administered will follow the guidance on the original container e.g. following age / dosage instructions

    • Statement that medication will only be given if the nursery is unable to contact the parent

  • An ‘emergency’ nursery stock of medication may be kept on site

  • Stock medication will be kept in accordance with manufacturer’s instructions on the container (e.g. cool dark place, out of the reach of children)

  • Stock will be checked at regular intervals by the designated trained first aider to ensure there is ample supply and is still within its expiry date

  • If a child experiences symptoms of illness, attempts will be made to contact the child’s parents before administering ‘emergency’ medication

  • Where parents cannot be contacted the Nursery Manager will take the decision as to whether the child is suitable to receive the ‘emergency’ medication based on the symptoms and medical history of the child given at registration

  • Administering ‘emergency’ non-prescription medication will be a last resort and the nursery staff will use other methods first to try and alleviate the symptoms. The child will be closely monitored until the parents collect the child. 

 

Injections, Pessaries, Suppositories

As the administration of injections, pessaries and suppositories represents intrusive nursing, we will not administer these without appropriate medical training for every member of staff caring for this child. This training is specific for every child and not generic. The nursery will do all it can to make any reasonable adjustments including working with parents and other professionals to arrange for appropriate health officials to train staff in administering the medication.  

 

Administration

  • As a general guideline before administering medication to a child the staff member should:

  • Wash their hands

  • Ensure a drink is available if appropriate (some medication can irritate and damage the throat and oesophagus if administered without a drink)

  • Check the label on the medication: name of child, dose, route of administration (e.g. by mouth, into ear/eye, rubbed on the skin), any special instructions and expiry date and ensure this is the same information on the Medication Form

  • If there is any doubt about any procedure staff should not administer, but seek advice from parent/ carer or health professional

  • If a child refuses the medication, they must not be forced. Staff can try to encourage them or perhaps get someone else to try. Under no circumstances should staff attempt to hide the medicine in food or drink, unless there in express written permission from parents to do so

  • It is normally considered poor practice to give medicines covertly, although in rare cases where the health professionals judge that it is in the child’s interests to do so, this is acceptable. Some children do find tablets difficult to swallow so may be given them, with their full knowledge, in, for example, a spoonful of jam. Even in these circumstances parents must give written instructions as some medicines can react with certain foods it is advisable they have sought advice from their pharmacist before doing this.

 

Staff Fitness to Work & Staff Medication

  • All nursery staff have a responsibility to work with children only where they are fit to do so

  • Staff must not work with children if they are infectious or too unwell to meet children’s needs. This includes circumstances where medication taken by staff affects their ability to care for children, for example, where it makes a person drowsy

  • If staff members believe their condition, including any condition caused by taking medication, is affecting their ability to care for children they must inform their line manager immediately

  • The nursery manager / person’s line manager/registered provider will decide if a staff member is fit to work, including circumstances where other staff members notice changes in behaviour suggesting a person may be under the influence of medication. This decision will include any medical advice obtained by the individual or from an occupational health assessment

  • Where staff may occasionally or regularly need medication, any such medication must be kept in the person’s locker/separate locked container in the staff room or nursery room. If the medication is required to be accessed in an emergency, such as an asthma inhaler, this should be easily accessible but safe from children 

  • In all cases medication must be stored out of reach of children. It must not be kept in the first aid box. It will be clearly labelled with the name of the member of staff.

 

Medication Errors

  • Occasionally mistakes may happen. In most cases, whether it is a missed dose or a medicine given in error there will be no harm done. It is important to be open and honest if errors occur

  • Parents should be contacted and the mistake explained to them:

    • In the case of a missed dose, the dose may be able to given at a later time. The parent may be able to advise

  • Where a dose has been given in error, it is important the child is monitored for any reactions and medical advice sought if there are concerns. It is important to inform the parent/ carer as this may happen after the child leaves the setting

  • The Nursery Manager will investigate all medication errors and put in preventative actions to ensure future errors do not occur.

Disposal of Medication

  • Tablets and capsules are occasionally dropped on the floor or spat out. In this case we will place the tablet in a labelled envelope and hand to the parents to be disposed of later

  • In no circumstances should it be flushed down the toilet or thrown in the bin

  • When a child leaves the setting, ceases to need medication or if a medicine has passed its expiry date, we will return any unused quantity to the parents. If this is not possible then we will take it to a local pharmacist for safe disposal.


 

This policy was adopted on

Signed on behalf of the nursery

Date for review

January 2019

 

July 2021

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