First Aid and Medication

The fostering agency wants all children to live in an environment that promotes and safeguards their health and wellbeing. You play a key role in protecting and promoting children's health.

In relation to all medication and first aid, this must be discussed, agreed and recorded in the Placement Plan along with all delegated authority. Consents should be given and recorded.

All medication – whether bought over the counter from a pharmacy, supermarket or other outlet or prescribed - must be stored in a locked cabinet kept below 25C to which only you as the carers will have access. The only exception to this is where the child's social worker has agreed following a risk assessment that the child may retain and administer his or her own medication in which case the medication must be securely stored by the child as agreed as part of the risk assessment. These exceptional arrangements must also be specified in the child's Placement Plan.

All medicines must be kept in their original packaging so it is known who it was prescribed for and when, instructions for use and the expiry date. The patient information leaflet that comes in the package must also be kept as well – this gives important information about the medicine such as side effects and storage instructions.

Home remedies are medicines, suitable for children, which can be bought 'over the counter' without prescription, including Paracetamol.

You will receive training in relation to the management and administration of medication.

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

Other home remedies may only be given to a child with the consent of the parent (which should be recorded in the Placement Plan) and the child (if over 16) or having consulted the child's GP to ensure that no adverse reactions may result.

Your Supervising Social worker will check the First Aid equipment as part of completing the Health and safety Checklist.

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 deemed not to be capable of administering home remedies themselves, care must be taken to ensure they consume the product as required, in the presence of a foster carer.

A specialist allergy nurse/consultant will help develop a Health Care plan which should be shared with you and with all agencies working with the child/young person.

The Care and Placement Plan and Health Care Plan should contain the following:

• All known allergies and associated risks including spotting the signs and symptoms of an allergic reaction and anaphylaxis for the child/young person;
• Preventative measures should be detailed in the Plan - for example taking daily antihistamines for hay fever, making sure cleaning products and gloves are hypoallergenic, and washing powder is suitable for skin conditions;
• Actions to take when a young person has an allergic reaction. The plan should describe exactly what to do and who needs to be contacted in the event of an emergency. For example, when to use an Epi Pen and calling for an ambulance;
• You should be aware of the Plan and should have been trained to administer an Epi Pen by a suitable qualified health professional;
• The child or young person should be educated around their allergies and what to do in an emergency - a young person may be able to self-administer their own EpiPen or take antihistamines. If this is the case this should be recorded;
• Medication should be easily accessible so you and/or the child/young person can access their medication in an emergency situation;
• You should keep a record of each episode and any medication given.

For further information see the NHS Website or see Allergy UK Website.

Fully equipped first aid boxes must be kept in your home and in each vehicle used to carry children. You must ensure that suitable arrangements exist to keep first aid boxes equipped.

First aid boxes must be kept in a safe accessible place, not within reach of small children, where the people who need to get access to them can do so. The first aid box may be looked at by the Supervising Social Worker in an unannounced visit.

Children may administer their own first aid under your supervision or you may administer it.

You will attend first aid training including refresher training as required by the fostering agency.

If a child is at risk or requires first aid/medical attention, you should apply first-aid procedures if it is safe to do so and notify your Supervising Social Worker as soon as possible. However, you must not compromise or delay the process of getting medical help by doing so. If in any doubt, call medical help.

If there is a risk of serious harm or injury, or you are unable to manage safely, the Police should be notified.

You should always assess the situation and in a medical emergency, send for medical help and an ambulance.

Before assistance arrives:

• Do not move the person other than to remove them from immediate danger or place them into the recovery position;
• Try to clarify why the emergency has occurred;
• Collect any drug samples or spillages (e.g. vomit) for medical analysis;
• Do not induce vomiting;
• Keep the person calm, under observation, warm and quiet;
• If the person is unconscious:
  • Ensure that they can breathe and place in the recovery position;
  • Do not move them if a fall is likely to have led to spinal or other serious injury which may not be obvious;
  • Do not give anything by mouth;
  • Do not attempt to make them sit or stand;
  • Do not leave them unattended or in the charge of another child;
  • For needle stick (sharps) injuries:
  • Encourage wound to bleed. Do not suck;
  • Wash with soap and water. Dry and apply waterproof dressing;
  • If used/dirty needle, seek advice from doctor.

When medical help arrives, pass on any information available, including vomit and any drug samples.

No further action, beyond making the situation safe and attempting to confiscate harmful drugs or substances, should be taken without authorisation from the Supervising Social Worker or Fostering Agency Manager, preferably in consultation with the relevant child's social worker.

Children who have complex health needs may require invasive personal care and this must be discussed, agreed and recorded in their Placement Plan, together with consent and any training requirements for the invasive personal care agreed and the number of carers needed to undertake the task.

An invasive personal care practice is a required act of caring which involves an invasion of the person's body. Examples of invasive care include injections, or the insertion of a tube into an orifice. Although physiotherapy does not fall within this definition, it raises similar issues in terms of the encroachment of a young person's physical space and should be treated in the same way as invasive practices.

There are two types of situation in which you may need to give invasive personal care:

1. Routine administration. The young person needs invasive care on a regular basis. Examples: insulin injections, tube feeding, administering medication via gastrostomy;
2. Predictable emergencies. It is likely that an emergency will arise at some time, and invasive care may be needed to deal with it. Examples: rectal valium for epilepsy or Epipen for anaphylactic shock.

First aid and records of all medicines that have been administered must be recorded by you. If advice is sought from a General Practitioner/NHS 111/Pharmacist, you should include details of the discussions within the carer log records as confirmation. If an accident occurs you will need to record this on a 'Fostering Incident Form' (in Local Resources) and inform your Supervising Social worker within 24 hours.