Medication

 At Willow Den Scotland, we promote the good health of children attending nursery and take necessary steps to prevent the spread of infection (see Sickness and Illness (Children) 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 the Care Inspectorate guidance on the Management of medication in Daycare of Children¹ and Childminding Services when dealing with medication of any kind in the nursery and this is set out below. 

If anyone becomes unwell whilst at nursery, we will contact their parent/carer immediately and they will be sent home. Due to the nature of Covid-19, a key symptom of which is a high temperature, non-prescribed medication will not be administrated unless in emergency situations (with prior permission). Any verbal permission given will be noted with date and time on the medication forms on the online learning diary. 

Prescribed medication will be reviewed on a case-by-case basis, taking into account the reason for the medication and the safety of the child and the member of staff administrating it. For this, permissions will be requested on our online learning diary where possible.  

Medication records can be found on the online learning diary as per our Medication procedures.  

All medication must be signed in and out on the online learning diary by a qualified member of staff. 

Medication prescribed by a doctor, dentist, nurse or pharmacist 

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

• Prescription medicine will only be given to the person named on the bottle for the dosage stated 
• Early learning and childcare practitioners should not give the first dose of a new medication to a child. Parents should have already given at least one dose to ensure that the child does not have an adverse reaction 
• Medicines must be in their original containers with their instructions printed in English and where possible early learning and childcare practitioners should always read and retain the information which is supplied with the medicine 
• Those with parental responsibility for any child requiring prescription medication should hand over the medication to the most appropriate member of staff who will then note the details of the administration on the appropriate form and another member of staff will check these details 

• Those with parental responsibility must give prior written permission for the administration of each and every medication. However, we will accept written permission once for a whole course of medication or for the ongoing use of a particular medication under the following circumstances: 

1. The written permission is only acceptable for that brand name of the medication and cannot be used for similar types of medication, e.g. if the course of antibiotics changes, a new form will need to be completed 

2. The dosage on the written permission is the only dosage that will be administered. We will not give a different dose unless a new form is completed 

3. Parents must notify us 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 not administer a dosage that exceeds the recommended dose on the instructions unless accompanied by written instructions from a relevant health professional such as a letter from a doctor or dentist 
• The parent must be asked when the child has last been given the medication before coming to the nursery, and the staff member must record this information on the medication form. Similarly, when the child is picked up, the parent or guardian must be given precise details of the times and dosage given throughout the day. The parent’s signature must be obtained at both times 
• At the time of administering the medicine, a qualified 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. (It is important to note that staff working with children are not legally obliged to administer medication). 
• Every dose given will be logged, signed and counter signed by a second staff member on the child’s online medication form.  
• If the child refuses to take the appropriate medication or spits it out, then a note will be made on the medication form on the online learning diary and parents will be informed.  
• Where medication is ‘essential’ or may have side effects, discussion with the parent will take place, to establish the appropriate response. 

Long Term Medication 

Long term medication is any medication which will stored within the nursery long term. This can be for a medication that is used regularly or for emergencies. 

Long term medication: 

• Will have one initial sign in and then 3 monthly reviews.  
• Must be prescribed from a health care professional. 
• Will be stored in long term medication box, clearly labelled with the child’s name. 
• Will be administered by qualified staff who will log each dose given. Parents will be informed of this at pick up. 
• Will be signed out when medication is finished or no longer needed. 
• Disposal of medication will be parent’s responsibility. Any signed out medication will be returned to parent/carer. 

Non-prescription medication 

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

• The nursery will only administer non-prescription medication such as topical creams or eye drops for a short initial period, following instructions on the medication label or the condition of the child. After this time medical attention should be sought. 
• Under advice from emergency services or in life saving situations non-prescription medication maybe administered. Consent will be confirmed at registration.  
• If the nursery feels the child would benefit from medical attention rather than non-prescription medication, we reserve the right to refuse nursery care until the child is seen by a medical practitioner. 
• If a child needs liquid paracetamol or similar medication during their time at nursery, such medication will be treated as prescription medication with the responsibility being with the parent to provide the medicine. 
• We do not keep an emergency communal nursery supply of fever relief and anti-histamines on-site (as per Management of medication in Daycare of Children² and Childminding Services). If a child does exhibit the symptoms that would require non-prescription medication during the day, e.g. a high temperature the nursery will make every attempt to contact the child’s parents. 
• For any non-prescription cream for skin conditions prior, written permission, must be obtained from the parent and the onus is on the parent to provide the cream which should be clearly labelled with the child’s name. Such items will be stored in accordance with non-refrigerated medication and located within the grey kiosk at Spartans.  

Where parents cannot be contacted then staff members on site will help to reduce the child’s temperature, contact the child’s emergency contact and seek further medical advice if the child shows other signs of being unwell – for example -, they are floppy and drowsy, or staff are concerned about them.

 As per our Sickness and Illness (Children) Policy, if any child is brought to the nursery in a condition in which he/she may require medication sometime during the day, the manager or senior staff will decide if the child is fit to be left at the nursery. If the child is staying, the parent must be asked if any kind of medication has already been given, at what time, and in what dosage and this must be stated on the medication form.

As with any kind of medication, staff will ensure that the parent is informed of any non-prescription medicines given to the child whilst at the nursery, together with the times and dosage given. 

Willow Den can only administer medication with prior written consent. Consent to give permission for emergency medication to be adminsitered (where the first does rule does not apply) is sought at registration.

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.   

Controlled medication (e.g. Ritalin) 

In addition to the general administration procedures, the dosage and administration of controlled drugs should be witnessed by a second adult. Both adults should sign when recording this administration. 

The drugs (where this is in tablet form) should also be counted in/out to record not only how many have been administered, but also how many are left. 

Schedule 2 Controlled Drugs like Ritalin, must be stored in a locked receptacle within a locked cupboard which can only be opened by authorised people. 

See ‘Willow Den’s Administration of Controlled Drugs Record’. 

Emergency medication (e.g. inhalers and Epipen) 

If medication must be given on a ‘when required’ basis, it is important that staff ask if any medication has been given to the child prior to arriving at the service. 

Parents should be informed when medication was administered and in what circumstances when the child is collected from the service, or sooner if that is required by parents. 

The first dose ‘rule’ does not include emergency medication such as an adrenaline pen where the risk of not giving it could outweigh any adverse reaction. This should be explicit in the consent given. 

For medication that is stored in a locked cabinet (or a locked fridge) that a child might need in an emergency, all staff should know where to obtain keys to the medicine cabinet. The Senior/ Early Years staff member in charge holds the keys.

Spare keys are kept:

Spartans – in the office within Spartans Community Football Academy

Falkirk Wheel – In the office within the Falkirk Wheel management offices upstairs from the visitor centre

Bannockburn House – In a location to be agreed with Bannockburn House staff prior to opening

Where medication is required in an emergency there should be a protocol (in addition to the permissions) setting out the procedure for administration and follow up required. This is likely to come from a medical professional such as an epilepsy nurse. 

Medication management during trips and outings 

Agreement should be made between the service and parents/carers before a trip or outing. A record will be made about how medication will be stored and administered. A note of this should be kept in the child’s file. 

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 where they are infectious or too unwell to meet children’s needs. This includes circumstances where any medication taken affects their ability to care for children, for example, where it makes a person drowsy. If any staff member believes that their condition, including any condition caused by taking medication, is affecting their ability they must inform their line manager and seek medical advice. 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 offices where staff may need easy access to the medication. Emergency medication (e.g. epipens or inhalers) should be kept on the staff members person at all times. In all cases it must be stored out of reach of the children. It must not be kept in the first aid box and should be labelled with the name of the member of staff.

Storage 

1. Medication that does not require refrigeration is stored in the locked medicine box. This box is located out of reach of children.  

• A room thermometer is used to ensure the location (e.g. kiosk or container) does not exceed the maximum room temperature of 25 degrees C 

• Medication requiring refrigeration is stored in the fridge, in a closed plastic labelled container. The fridge is located away from the children’s immediate area and accessible to EY staff team. A fridge lock is in place for security.  

• A fridge thermometer measures the temperature. This is kept a temperature between 2 degrees C and 8 degrees C.  

• The temperature is checked each day using a maximum and minimum thermometer.  

• Staff record both the maximum and minimum temperature.  

2. Emergency medication, such as inhalers and EpiPens, will be within easy reach of staff in case of an immediate need, but will remain out of children’s reach. Senior Staff will always keep such medicine on their person, within their bumbag.  

3. All medications must be in their original containers, labels must be legible and not tampered with or they will not be given. All prescription medications should have the pharmacist’s details and notes attached to show the dosage needed and the date the prescription was issued. This will all be checked, along with expiry dates, before staff agrees to administer medication.  See administration of Medication Procedure. 

4. The staff area will be locked at all times when it is upsupervised, and the key will be kept upon the Senior Practitioner at all times. Arrangements to hold spare keys will be agreed with each setting. See individual site notices for location.