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W874 [WCAG21 2.4.1 (A)] Add a skip navigation link as the first link on the page:
If your document has structure then you should add a skip navigation link to make it easier for accessible users to get to the page's content. To ensure detection, skip navigation links should point to a <main> element, or an element with role='main'. See Understanding 2.4.1, and Skip Navigation. <!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN"
"http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
2 P967 [WCAG21 3.1.1 (A)] Use the 'lang' attribute to denote the primary language of the document:
You should always identify the primary natural language of a document using a 'lang' attribute on the <html> element. See WCAG 2.1 HTML Technique H57. <html xmlns="http://www.w3.org/1999/xhtml">
3 <head>
4 <meta name="viewport" content="width=device-width, initial-scale=1.0"/>
5 W605 Duplicate tag found: See matching tag on line: 22
A duplicate tag has been found with the same attributes. Although this should not affect the page, it indicates that a mistake may have been made. <meta http-equiv="Content-Style-Type" content="text/css" />
6 W605 Duplicate tag found: See matching tag on line: 23
A duplicate tag has been found with the same attributes. Although this should not affect the page, it indicates that a mistake may have been made. <meta http-equiv="Content-Script-Type" content="text/javascript" />
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8 <title>
8 First Aid, Home Remedies and Medication | Next Stage 4Life
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22 W605 Duplicate tag found: See matching tag on line: 5
A duplicate tag has been found with the same attributes. Although this should not affect the page, it indicates that a mistake may have been made. <meta http-equiv="Content-Style-Type" content="text/css" />
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A duplicate tag has been found with the same attributes. Although this should not affect the page, it indicates that a mistake may have been made. <meta http-equiv="Content-Script-Type" content="text/javascript" />
24 W609 The 'content-type' HTTP header specifies a character set of UTF-8, which is different to the value
given here:
The 'content-type' HTTP header specifies a different character set to that specified in the tag. In this case the HTTP header takes precedence. <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1" />
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46 Contents
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47 Local Resources
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48 </ul>
49 </div>
49 <div id="search">
50 <form action="search/search.html" id="cse-search-box" style="margin: 0px;">
51 I899 [WCAG21 1.3.2 (A)] Layout tables must represent their content in a meaningful sequence:
Screen readers can struggle to read out tables sensibly, so it is often better to use alternative mark-up and CSS to layout content. Try disabling the table mark-up to see if it still makes sense. See WCAG 2.1 Failure F49. <table width="97%" border="0" cellspacing="0" cellpadding="0">
52 <tr>
53 <td>
53 E885 [WCAG21 1.1.1/1.3.1/3.3.2/4.1.2 (A)] User interface controls should have a label or an accessible
name:
Associate form controls with <label> tags, or use the 'aria-label' or 'aria-labelledby' attributes to label controls where it might be confusing or not possible to use a label. See WCAG 2.1 Failure F68. <input type="text" name="zoom_query" class="search_input" size="20" id="zoom_searchbox" value="Search this
manual" onfocus="this.value=(this.value=='Search this manual') ? '' : this.value;"
onblur="this.value=(this.value=='') ? 'Search this manual' : this.value;" style="margin-right: 5px;" />
53 </td>
54 <td>
54 <input type="submit" value="Go"/>
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56 </table>
57 </form>
57 </div>
57 </div>
58 <div id="topper">
58 </div>
60 <div id="printReady">
61 <div id="container">
62 <div id="content_frame_overflow">
62 <div class="content_text">
63 <h1 class="h1">
63 First Aid, Home Remedies and Medication
63 </h1>
64 <div class="scope_box" style="padding-bottom: 0px; padding-top: 15px;">
65 <h2 class="h3">
65 REGULATIONS AND STANDARDS
65 </h2>
66 <p>
66 <a
href="http://qualitystandards.proceduresonline.com/homes/p_quality_standards.html#health"
target="_blank">
66 The Health and Well-being Standard
66 </a>
66 </p>
67 <h3 class="h3">
67 RELEVANT GUIDANCE
67 </h3>
68 <p>
68 <a
href="https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/413368/Promoti
ng_the_health_and_well-being_of_looked-after_children.pdf" target="_blank">
68 Promoting the Health and Well-being of Looked-after Children
68 </a>
68 </p>
69 <p>
70 <a
href="https://www.nice.org.uk/guidance/sc1/chapter/recommendations#care-home-staff-giving-non-
prescription-and-over-the-counter-products-to-residents-homely" target="_blank">
70 Managing Medicines in Care Homes NICE Guidelines
70 </a>
70 </p>
71 <p>
71 <a href="http://www.hse.gov.uk/riddor/" target="_blank">
71 Health and Safety Executive Website
71 </a>
71 </p>
72 <h3 class="h3">
72 RELATED CHAPTERS
72 </h3>
73 <p>
73 <a href="p_accidents.html">
73 Recording and Reporting of Accidents Procedure
73 </a>
73 </p>
74 <p>
74 <a href="p_hlth_assm_pln.html">
74 Health Care Assessment and Plans Procedure
74 </a>
74 </p>
75 <p>
75 <a href="p_self_harm.html">
75 Self Harming and Suicidal Behaviour Procedure
75 </a>
75 </p>
76 <p>
76 <a href="p_health.html">
76 Health Notifications and Access to Services Procedure
76 </a>
76 </p>
77 </div>
78 <h2 class="h2_underlined">
78 <br />
79 Contents
79 </h2>
81 <ol>
82 <li>
82 <a href="#first">
82 First Aid
82 </a>
82 </li>
83 <li>
83 <a href="#home">
83 Home Remedies
83 </a>
83 </li>
84 <li>
84 <a href="#key">
84 Key First Aid and Medication Records held in the Home
84 </a>
84 <br />
85 <br />
86 <a href="#app1">
86 Appendix 1: Administration of Medication Guidance
86 </a>
86 <br />
87 <br />
88 <a href="#app2">
88 Appendix 2: Specific Issues Re Administration of Medication
88 </a>
88 <br />
89 <br />
90 <a href="#app3">
90 Appendix 3: Administration away from the Home
90 </a>
90 <br />
91 <br />
92 <a href="#app4">
92 Appendix 4: Skilled Health Tasks
92 </a>
92 <br />
93 <br />
94 <a href="#app_five">
94 Appendix 5: Guidance: Intentional Overdose
94 </a>
94 </li>
95 </ol>
96 <h2 class="h2_underlined">
96 <br />
97 1.
97 <a name="first" id="first">
97 </a>
97 First Aid
97 </h2>
98 <p>
98 Each Home must have a qualified First Aider on duty at all times.
98 </p>
99 <p>
99 First Aid boxes should have a white cross with a green background must be held in each home and
should be carried in each of the vehicles used for the transportation of children.
99 </p>
100 <p>
100 Each box has an inventory that must include the full quantity of each item stipulated in the
box. When an item has been used, then it should be replaced as soon as possible.
100 </p>
101 <p>
101 Recording: Each child should have permission for staff to administer first aid and
non-prescription medication from a person with Parental Responsibility for them recorded in the
relevant plan. Permission should be sought and arranged by the child's social worker.
101 </p>
102 <p>
102 The administration of First Aid must be recorded in the First Aid Log, Accident Book (if there
has been an accident), individual child's Daily Record and Medication Administration Record
(MAR).
102 </p>
103 <h2 class="h2_underlined">
103 <br />
104 2.
104 <a name="home" id="home">
104 </a>
104 Home Remedies
104 </h2>
105 <p>
105 Home Remedies are medicines that can be bought over the counter, including Paracetamol*,
aspirin, homeopathic, herbal, aromatherapy, vitamin supplements or alternative therapies.
105 </p>
106 <p>
106 Home Remedies can only be used by the young people in the home with the approval of relevant
social workers (as set out in children's Placement Plans) or as prescribed by a GP.
106 </p>
107 <p>
107 Home Remedies should be purchased for a named individual child.
107 </p>
108 <p>
108 When a Home Remedy container is opened, staff should record the date of opening to ensure it is
not kept beyond its expiry date.
108 </p>
109 <p>
109 No child may be permitted to 'self-administer' Home Remedies unless approved by their social
worker, with the arrangements outlined in the Placement Plan.
109 </p>
110 <p>
110 Consideration should be given as to how long a child continues to use Home Remedies before they
arrange to see their GP.
110 </p>
111 <p>
111 Recording: The administration of any Home Remedies must be recorded in individual child's Daily
Record and Medication Administration Record (MAR).
111 </p>
112 <p>
112 *Paracetamol must not be given for more than two consecutive days without the approval of a
GP/Medical Practitioner.
112 </p>
113 <h2 class="h2_underlined">
113 <br />
114 3.
114 <a name="key" id="key">
114 </a>
114 Key First Aid and Medication Records held in the Home
114 </h2>
115 <p class="bold">
115 Each home should keep the following records:
115 </p>
116 <table title="medical records" width="95%" border="1" cellspacing="0" cellpadding="5">
117 <tr class="greytableheader">
118 <td>
118 Record
118 </td>
119 <td>
119 Purpose
119 </td>
120 </tr>
121 <tr>
122 <td width="50%" class="table_row_lightblue">
122 First Aid Log
122 </td>
123 <td>
123 To record any administration of First Aid.
123 </td>
124 </tr>
125 <tr>
126 <td class="table_row_lightblue">
126 Accident Book
126 </td>
127 <td>
127 To record any accidents.
127 </td>
128 </tr>
129 <tr>
130 <td valign="top" class="table_row_lightblue">
130 Medical Record
130 </td>
131 <td>
131 Individual record for each child, details of health related issues, medication used, name of
GP.
131 </td>
132 </tr>
133 <tr>
134 <td valign="top" class="table_row_lightblue">
134 Medication Administration Record (MAR)
134 </td>
135 <td>
135 Individual record for each child to record any medication (or Home Remedies) administered
etc.
135 </td>
136 </tr>
137 </table>
138 <h3 class="h3">
138 Medication
138 </h3>
139 <h3 class="h3">
139 3.1 Ordering Ongoing Medication
139 </h3>
140 <p>
140 Some young people will have prescribed medication, which is ongoing. This should be ordered on
monthly basis where possible. Responsibility for ordering these medicines is that of the
Registered Manager or a delegated person/member of staff.
140 </p>
141 <p>
141 When ordering, a note must be made of:
141 </p>
142 <ul>
143 <li>
143 The name of the young person;
143 </li>
144 <li>
144 The name, strength, form and quantity of the medicine;
144 </li>
145 <li>
145 The name of the surgery/G.P;
145 </li>
146 <li>
146 When the prescription will be ready.
146 </li>
147 </ul>
148 <p>
148 When ordering, staff should check stock levels before ordering. To minimise wastage and reduce
risks of errors, stock levels should be kept to a minimum.
148 </p>
149 <h3 class="h3">
149 3.2 Collecting Prescriptions
149 </h3>
150 <p>
150 Staff should collect prescriptions from the GP/surgery and check to make sure that they have
received all the prescriptions they have ordered and the quantities are correct before taking to
the Pharmacy. If a medicine has directions of 'as directed' or 'as before' then the surgery
should be asked to amend the prescription. A photocopy of the prescription should be made and
stored until the medicine is received back from the Pharmacy. Staff should check with the
Pharmacy as to when the prescriptions will be ready for collection.
150 </p>
151 <h3 class="h3">
151 3.3 Receiving/Collecting Medicines
151 </h3>
152 <p>
152 Staff must take their ID when collecting medicines or controlled drugs.
152 </p>
153 <p>
153 When the medicines are collected, staff should check the medicine against the photocopied
prescriptions that they have. Any discrepancies should be brought to the attention of the
Pharmacy and rectified as soon as possible.
153 </p>
154 <p>
154 The Pharmacy will be able to give, and advice should be sought upon:
154 </p>
155 <ul>
156 <li>
156 Potential side effects;
156 </li>
157 <li>
157 Advice on how the medicine should be taken;
157 </li>
158 <li>
158 Advice on whether the medicine may be affected by any other medicine;
158 </li>
159 <li>
159 Whether the medicine should be stored in the fridge;
159 </li>
160 <li>
160 If the medicine is a Controlled Drug.
160 </li>
161 </ul>
162 <p>
162 Staff should ensure that the medicine has been properly labelled. If the medicine does not have
a dispensing label on it then it should be returned to the Pharmacy. Staff should also make sure
that they have received a Patient Information Leaflet from the Pharmacy.
162 </p>
163 <p>
163 The receipt of medication should be recorded on the individual child's Medication Administration
Record (MAR), if a Controlled Drug has been prescribed, 2 staff should record/sign the record.
163 </p>
164 <h3 class="h3">
164 3.4 Administration
164 </h3>
165 <p>
165 <span class="bold">
165 NOTE
165 </span>
165 : all staff must be familiar with the following detailed guidance on the administration of
medication:
165 </p>
166 <table title="Links to Appendix" width="95%" border="1" cellspacing="0" cellpadding="5">
167 <tr class="greytableheader">
168 <td>
168 Circumstances
168 </td>
169 <td>
169 Relevant Guidance
169 </td>
170 </tr>
171 <tr>
172 <td class="table_row_lightblue">
172 For detailed guidance on the administration of medication.
172 </td>
173 <td valign="top">
173 <a href="#app1">
173 Appendix 1: Administration of Medication Guidance
173 </a>
173 </td>
174 </tr>
175 <tr>
176 <td width="50%" class="table_row_lightblue">
176 For guidance on specific issues, e.g. refusal to co-operate, if a child is missing/absent,
covert administration.
176 </td>
177 <td valign="top">
177 <a href="#app2">
177 Appendix 2: Specific Issues re Administration
177 </a>
177 </td>
178 </tr>
179 <tr>
180 <td class="table_row_lightblue">
180 For the administration of medication away from the home e.g. if a child is on holiday or
having contact with his/her parents.
180 </td>
181 <td valign="top">
181 <a href="#app3">
181 Appendix 3: Administration away from the home
181 </a>
181 </td>
182 </tr>
183 <tr>
184 <td class="table_row_lightblue">
184 Skilled Health Tasks, e.g. for children with Diabetes.
184 </td>
185 <td valign="top">
185 <a href="#app4">
185 Appendix 4: Skilled Health Tasks
185 </a>
185 </td>
186 </tr>
187 </table>
188 <p>
188 Medication should be administered as set out on the label or instructed by the GP/Medical
Practitioner.
188 </p>
189 <p>
189 No child may be permitted to 'self-administer' unless approved by their social worker, with the
arrangements outlined in the Placement Plan.
189 </p>
190 <p>
190 Administration should be recorded on the individual child's Medication Administration Record
(MAR), if a Controlled Drug has been administered, 2 staff are required to record/sign the
record.
190 </p>
191 <h3 class="h3">
191 3.5 Storage and Expiry Dates
191 </h3>
192 <p>
192 All medicines must be kept in a safe/secure place, e.g. a locked cabinet that does not exceed
25°C. A key to this cabinet should be held by a senior/responsible member of staff on duty.
192 </p>
193 <p>
193 Medicines that are taken internally should be stored separately to those used externally in the
medicine cabinet, with liquids preferably on the bottom shelf.
193 </p>
194 <p class="tiny_text">
194 *Medicines that require refrigerated storage should be kept in either a dedicated lockable
fridge (in the staff office) or a locked box inside the food fridge.
194 </p>
195 <p>
195 All medicines have expiry dates, usually clearly stated on the label, upon expiry, they should
be disposed of, see below.
195 </p>
196 <h3 class="h3">
196 3.6 Disposal
196 </h3>
197 <p>
197 Medication should be disposed of when:
197 </p>
198 <ul>
199 <li>
199 The expiry date has been reached;
199 </li>
200 <li>
200 The course of treatment is completed;
200 </li>
201 <li>
201 The medication has been discontinued.
201 </li>
202 </ul>
203 <p>
203 Unless instructed by a GP/Pharmacy, unused/expired medicines should be returned to the Pharmacy,
and a receipt obtained.
203 </p>
204 <p>
204 Return or disposal of medication should be recorded on the individual child's Medication
Administration Record (MAR), and the receipt attached, if a Controlled Drug has been disposed
of, 2 staff are required to record/sign the record.
204 </p>
205 <h2 class="h2_underlined">
205 <br />
206 <a name="app1" id="app1">
206 </a>
206 Appendix 1: Administration of Medication Guidance
206 </h2>
207 <p>
207 All medicines must be administered strictly in accordance with the prescriber's instructions (or
as advised on the packet in relation to Homely Remedies). Only the prescriber (e.g. GP) can vary
the dose. Medicines must be locked away in the locked storage areas when not in use. Before
administration, staff should:
207 </p>
208 <ul>
209 <li>
209 Wash their hands;
209 </li>
210 <li>
210 Make sure they have a pen and any required record sheets;
210 </li>
211 <li>
211 Enough glasses for each young person receiving medication;
211 </li>
212 <li>
212 A jug of water.
212 </li>
213 </ul>
214 <p>
214 The procedure for administration is as follows:
214 </p>
215 <ul>
216 <li>
216 Check the young person's identity (a photo is normally kept in the young person's file). Only
one young person should be administered medication at a time, this reduces the risk of
mistakes being made;
216 </li>
217 <li>
217 Check the young person's medical profile;
217 </li>
218 <li>
218 Check the medication on the individual medication records corresponds with that on the young
person's medical profile;
218 </li>
219 <li>
219 Check the Individual medication record sheet to ensure that someone else has not already given
the medication;
219 </li>
220 <li>
220 Check the expiry date and use by date (where appropriate) on the medication;
220 </li>
221 <li>
221 Check the amount to be given at that time;
221 </li>
222 <li>
222 If opening a new container, add the date;
222 </li>
223 <li>
223 Measure or count the dose without touching the medicine;
223 </li>
224 <li>
224 If the medicine is a solid (such as a tablet) then carefully place into an appropriate
container and offer to the young person. They may wish to put it in their hand or swallow
straight from the container;
224 </li>
225 <li>
225 If the medicine is a liquid, take care not to drip onto the label. If the amount to be
measured is less than 5ml, then use a medicine syringe otherwise use a medicine spoon or
measure as preferred by the young person;
225 </li>
226 <li>
226 If the medicine is a cream or ointment, then it should be squeezed directly onto the young
person's finger for them to apply. If required to be applied by staff, then latex/pvc gloves
must be worn;
226 </li>
227 <li>
227 When administering a Controlled Drug, a second member of staff, must check the dose prior to
it being administered;
227 </li>
228 <li>
228 Watch the young person as they take their medicine to ensure administration is successful;
228 </li>
229 <li>
229 Offer the young person a drink of water (where appropriate);
229 </li>
230 <li>
230 Check that the medication is recorded in all the required records;
230 </li>
231 <li>
231 Print and sign your name against date and time of each medicine administered;
231 </li>
232 <li>
232 Record when medicine has been refused / not taken and the reasons why;
232 </li>
233 <li>
233 If a young person is absent when medication is due- this should be recorded;
233 </li>
234 <li>
234 Do not sign for any medicines that you have not administered or witnessed yourself;
234 </li>
235 <li>
235 If a young person refuses to take medication, under no circumstances should they be forced to
do so;
235 </li>
236 <li>
236 Medication must be kept in the original labelled (by the Pharmacy) containers and not put into
weekly/daily medical boxes;
236 </li>
237 <li>
237 After administration the medicines should be returned to the cabinet immediately and the
cabinet locked;
237 </li>
238 <li>
238 Each time you give medication, remember that it is important to consider the time of
administration. Care should be taken to ensure that if the medicine is required to be taken
before food, that this is done. Similarly the administration of some medicines such as eye
drops or inhalers may not be suitable to be given at meal times. Not all medicine
administration times will fall in line with meal times.
238 </li>
239 </ul>
240 <h2 class="h2_underlined">
240 <br />
241 <a name="app2" id="app2">
241 </a>
241 Appendix 2: Specific Issues Re Administration of Medication
241 </h2>
242 <h3 class="h3">
242 Swallowing Problems
242 </h3>
243 <p>
243 Staff may find that some young people may struggle with swallowing their medicines. The young
person's G.P should be contacted for an alternative. Under
243 <span class="bold">
243 no
243 </span>
243 circumstances should staff take it on themselves to crush tablets without seeking advice from
the G.P or Pharmacist. Any advice given should be recorded.
243 </p>
244 <h3 class="h3">
244 Medication Refusal
244 </h3>
245 <p>
245 When a young person refuses to take their medicine, then the G.P. should be contacted for
advice. This information must be recorded and followed. Young people cannot be forced to take
their medicines.
245 </p>
246 <h3 class="h3">
246 If a Young Person is Absent when the Medicine is Due
246 </h3>
247 <p>
247 When a young person is absent and their medication is due, this should be recorded. When the
young person returns, then staff must consider the time delay and seek advice if required from
the Pharmacist, the G.P or
247 <a href="https://www.nhs.uk/hasc-advice/pages/symptom-checker-advice.aspx" target="_blank">
247 NHS Choices website
247 </a>
247 (as appropriate depending on the time of day). To miss taking a medicine completely can be
dangerous depending on the medical condition.
247 </p>
248 <h3 class="h3">
248 Covert Administration
248 </h3>
249 <p>
249 Covert administration is where a medicine is hidden in food and the person does not know that
they are taking it. Staff must not hide any medicine in food or perform any other types of
covert administration.
249 </p>
250 <h3 class="h3">
250 <a name="lone" id="lone">
250 </a>
250 Lone Working
250 </h3>
251 <p>
251 In some homes, staff may be required to work on their own for a period of time. It may be the
case that the administration of a medicine will have to happen during this period. Staff should
ensure that they double check for themselves and make a record of any medical administration
required during the period of time for when they were lone working.
251 </p>
252 <p>
252 This can be a problem when administering Controlled Drugs. It is important that the young person
receives their medicine at the correct time therefore the member of staff administering the
medicine, must also record that they were lone working in the register. It is not acceptable for
another staff member to sign the register when they come in. You cannot be a witness to
something you have not seen happen.
252 </p>
253 <h3 class="h3">
253 Spilled Medicines
253 </h3>
254 <p>
254 When a medicine has been dropped on the floor or spilled then this must be safely disposed of
and a note must be made in the records. A second dose should be offered to the young person
(where a medication has spilled, leaving the remainder short for the completion of the course of
the prescription, advice should be sought from the G.P as to how to make-up for the lost
dosage).
254 </p>
255 <p>
255 When medicine has been spat out then this medication must be cleared away following the correct
procedures and a note made in the records. However a second dose must not be offered, as staff
will not know how much has been absorbed. If this persists the G.P should be contacted.
255 </p>
256 <h3 class="h3">
256 Detached or Illegible labels
256 </h3>
257 <p>
257 If a label becomes detached from a container or is illegible, then staff must seek advice from
the Pharmacist. Until this advice is received then the container should not be used.
257 </p>
258 <h3 class="h3">
258 Secondary Dispensing
258 </h3>
259 <p>
259 Staff must ensure that medicines stay in the containers supplied and labelled by the Pharmacist.
Medicines must not be placed in daily or weekly medicine trays.
259 </p>
260 <h3 class="h3">
260 Medication Errors
260 </h3>
261 <p>
261 In the event of an error being made in the administration of any medication, advice must be
sought from the young person's G.P. or another medical practitioner/ help line (e.g. NHS
Choices) immediately or as soon as the error has been discovered. Staff must record the advice
that they have been given.
261 </p>
262 <h3 class="h3">
262 Verbal Alterations
262 </h3>
263 <p>
263 There may be times when it is necessary to stop or change the dose of a young person's
medication without receiving a new prescription. Verbal requests to change medication by the G.P
must be confirmed in writing before any changes are permitted. These changes must be recorded on
all relevant medication records including the Individual Medication Record in the young
person's file. Staff must note the change, the name of the Doctor, the time the confirmation of
alteration was received and the date. Staff must not alter the dispensing labels. A note may be
added saying 'Refer to record for new instructions'. Staff should check the next prescription to
make sure these new changes have been implemented.
263 </p>
264 <h3 class="h3">
264 Adverse Drug Reaction
264 </h3>
265 <p>
265 Any adverse drug reaction or suspected adverse drug reaction should be reported to the G.P
before further administration is considered. Advice should be sought on whether the medicine
should be stopped or the treatment carries on. Staff must record the advice that they have been
given indicating the date and time and authorising Practitioner.
265 </p>
266 <h3 class="h3">
266 Drug Recalls
266 </h3>
267 <p>
267 When a Drug Recall Notification is received then staff should check the medication to see if the
home is holding any stock. If there is none in stock then the notification should be signed,
dated and filed for reference.
267 </p>
268 <p>
268 When stock if found that is listed on the drug recall, then staff must follow the directions
given after isolating the stock.
268 </p>
269 <h2 class="h2_underlined">
269 <br />
270 <a name="app3" id="app3">
270 </a>
270 Appendix 3: Administration away from the Home
270 </h2>
271 <p>
271 See also
271 <a href="#lone">
271 Lone Working
271 </a>
271 .
271 </p>
272 <p>
272 If a child spends time away from the home, either on home visits, holidays or time spent at
school, any medication due to be taken must be kept in the original labelled container.
272 </p>
273 <p>
273 Any medication taken away from the home should be appropriately recorded on the individual
child's Medication Administration Record (MAR), showing what medication has been taken
away/handed over to parents/ carers. The person receiving the medication should countersign the
record.
273 </p>
274 <p>
274 If the parent/ carers wishes, a copy of the MAR should be handed over to them, so that a record
of administration can be kept; this may be handed back to the home when the child returns.
274 </p>
275 <p>
275 If the person who is responsible for the child is a member of staff, then they must complete the
documents for administration while they are away as normal.
275 </p>
276 <p>
276 The medication should always be handed over to someone responsible for the child.
276 </p>
277 <h2 class="h2_underlined">
277 <br />
278 <a name="app4" id="app4">
278 </a>
278 Appendix 4: Skilled Health Tasks
278 </h2>
279 <p>
279 This applies to specialist or skilled healthcare tasks, for example:
279 </p>
280 <ul>
281 <li>
281 For diabetic children;
281 </li>
282 <li>
282 Physiotherapy programme;
282 </li>
283 <li>
283 For the use of Buccal Midalozam;
283 </li>
284 <li>
284 For the use of Rectal Diazepam.
284 </li>
285 </ul>
286 <p>
286 If a child requires a skilled health task to be undertaken, this will only be carried out by
trained staff, with the written authorisation of the prescribing Doctor in relation to the child
concerned, and as set out in a Placement Plan or other written
286 <a href="http://trixresources.proceduresonline.com/nat_key/keywords/health_care_plan.html"
target="_blank">
286 Health Care Plan
286 </a>
286 .
286 </p>
287 <p>
287 Appropriate training will be provided, together with written guidance, as to how the skilled
tasks will be performed and recorded.
287 </p>
288 <h2 class="h2_underlined">
288 <br />
289 Appendix 5:
289 <a name="app_five" id="app_five">
289 </a>
289 Guidance: Intentional Overdose
289 </h2>
290 <p>
290 If an overdose is suspected, hospital treatment should be sought without delay. Staff should try
to find out what the child/young person has taken and if possible take a sample to give to a
medical practitioner.
290 </p>
291 <h3 class="h3">
291 Possible signs of an overdose:
291 </h3>
292 <ul>
293 <li>
293 Mild nausea/vomiting;
293 </li>
294 <li>
294 Paler skin;
294 </li>
295 <li>
295 Blue lips or fingernails;
295 </li>
296 <li>
296 Not waking up or reacting to a loud noise;
296 </li>
297 <li>
297 Shallow or disrupted breathing;
297 </li>
298 <li>
298 Gurgling, snorting or snoring/choking sounds;
298 </li>
299 <li>
299 Slow or very faint pulse.
299 </li>
300 </ul>
301 <p>
301 It can take a long time between taking the substance and the first signs of
an overdose; children/young people may verbally 'boast' about having taken an overdose: even
when there are no signs, but staff must consider that there is a chance an overdose has been
taken and they must act in caution and seek medical attention.
301 </p>
302 <h3 class="h3">
302 What to do if someone is reacting to an overdose
302 </h3>
303 <ul>
304 <li>
304 Lie them on the floor;
304 </li>
305 <li>
305 Put them in the recovery position;
305 </li>
306 <li>
306 Call the ambulance - 999 - inform the operator of the overdose;
306 </li>
307 <li>
307 Do not leave the child/young person alone, make sure they don't roll onto their back;
307 </li>
308 <li>
308 Inform the ambulance team what the person has taken; try to gather all the packaging you can
find;
308 </li>
309 <li>
309 Get some help, keep other children and young people away (but don't dismiss any valuable
information that they may be trying to pass it on to you).
309 </li>
310 </ul>
311 <p class="bold">
311 DON'T
311 </p>
312 <ul>
313 <li>
313 Walk the child/young person around;
313 </li>
314 <li>
314 Put the child/young person in a cold bath/layer them up to heavily to generate warmth;
314 </li>
315 <li>
315 Give them a drink.
315 </li>
316 </ul>
317 <h3 class="h3">
317 Recording and Review
317 </h3>
318 <p>
318 See also:
318 <a href="p_self_harm.html">
318 Self Harming and Suicidal Behaviour Procedure
318 </a>
318 .
319 </p>
320 <p>
320 <br />
321 <br />
322 </p>
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