Policy on the Storage of Medicine and Administration of Medicine or Treatment
This chapter was added to the manual in January 2019, it is originally from the Northumberland Fostering and Adoption Services Manual and has been updated.
1. Principles of Safe and Appropriate Handling of Medicines
The 6 Rights Principle should be followed in the administration of prescribed medication:
- Right Person;
- Right Medication;
- Right dose;
- Right time;
- Right route;
- Right documentation.
According to the Medicines Act 1968, medicines can be given by a third party. E.g. a suitably trained carer, to the person that they were intended for in strict accordance with the directions the prescriber has given.
Medicines that have been prescribed and dispensed for an identified child should not, under any circumstances, be given to another person or used for a purpose that is different from the one they were prescribed for.
2. Administration of Medicine or Treatments
Foster carers may be required to give regular or periodic medicine to children / young people.
The prescription must be followed precisely. If a carer is in any doubt, they have a duty to check with the medical practitioner who prescribed the treatment or the child's GP and to inform the Fostering Supervising Social Worker and child's Social Worker.
Foster carers should only give medicines with the young person's consent, and if appropriate include the young person in decisions about their own treatment. Some young people may be able to look after and take their own medicines with the help and support of the foster carer.
All social and cultural preferences should be accommodated.
If the child refuses medication this must be recorded on the administration of medical treatment log sheet. The foster carer must seek immediate advice from a relevant health professional or NHS Direct if the child refuses to take prescribed medication and report this information to the child's Social Worker / Fostering Supervising Social Worker or EDT if after hours.3. Storage of Medicines
When a young person is placed in your care there are two quick checks that you can make immediately:
- The label attached to the medicine should have the young person's name on it and a date when the medicine was prepared. If this is more than 6 months ago, check with the young person's GP whether they should still take it;
- Check the expiry date - do not give medicines that have expired.
Foster Carers should have a designated place for storing medicines. This will be identified in your Safer Care Policy. It should be secure and out of reach of children. It is good practice to ensure that nothing else is stored in the cupboard where you store the medicine.
It is not appropriate to store them in the following as they can be too damp, too warm or unhygienic:
- Filing cabinets;
- Kitchens;
- Bathrooms, toilets, sluices;
- Windowsills or areas next to heaters;
- Child's bedroom.
If temperature is above 25 degrees Celsius it is too hot.
Medicines which need to be stored in a refrigerator should be stored in a secure container separate from other food stuffs at a temperature advised as per instructions. Medicines must be stored in the original packaging and not separate from the label or patient information leaflet. If needed to be stored in the fridge an appropriate lockable unit will be provided.
The carer must read the label thoroughly and strictly adhere to the directions given.
No alterations should be made to the dispensing label provided by the Pharmacist under any circumstances.
Medicines should not be decanted into another container or put out for the child or young person to take at a later time.
Return the medication to its original storage space after use.
Medication for an identified child should be only given to that child.4. Safe Medicine Administration
Safe administration of medicines means that medicines are given to maximise benefit and avoid causing harm.
Any reaction to medication must be reported by the foster carer to the appropriate medical practitioner or GP, NHS Direct or A&E Department or taking the child or young person for immediate advice.
To Administer Medication Safely you must be able to:
- Identify the medicine correctly - the medicine must have a label attached by the Pharmacist or GP;
- Ensure you are giving the medicine to the correct young person;
- Know what the medicine is intended to do, e.g. Inhalers help the young person breathe more easily;
- Be aware of any special precautions e.g. some medicines must be given with food.
Foster Carers can give or assist the young person to take:
- Tablets, capsules or oral mixtures (e.g. Antibiotics for young children in liquid form);
- Applying a medicated cream or ointment;
- Inserting drops to ears, nose or eyes;
- Administer inhaled medication e.g. Inhalers for asthma.
Foster carers SHOULD NOT undertake the following unless they have satisfactorily completed additional training and be certified as competent to do so:
- Rectal administration e.g. Diazepam suppositories for epilepsy;
- Injectable drugs e.g. Insulin;
- PEG feeding;
- Giving oxygen.
Some medicines need to be given at specific times e.g:
- As specified on the pharmacy label;
- Before, with or after food - if not given correctly it can affect how the medicine works;
- Some medicines are given to control seizures and need to be taken at specific times.
What to do it a young person refuses to take the medicine:
- Try waiting a short while then offer it again - never force them to take the medicine NEVER try to hide medication e.g. in food or drink;
- It may be necessary to contact the child's GP to discuss the problem.
What if there is a mistake or incident e.g:
- Wrong dose is given, too much, or too little;
- Medication is given to the wrong child.
The foster carer must:
- Seek medical advice - e.g. Ring either GP, Walk-in Centre, A&E or ring 111;
- Record the incident;
- Inform the Social Worker;
- Inform the Fostering Service via the Supervising Social Worker or Duty worker;
- Closely observe the child for any changes in their condition.
What if the child has a reaction to the medication?
- Contact medical help immediately.
5. Self Administration of Medication
If a young person requests to self-administer, discussion needs to be undertaken to involve the young person, relevant health, other professionals and child's Social Worker to assess the management and appropriateness of self-administration. An agreement about any further action or support for the young person to self-administer must be clearly outlined.
Clear expectations about self-administration of medication, which a young person controls themselves, must be recorded and agreed on the 'Self-administration of Medication Agreement Form'. The exception to this will be oral contraception.
Self-administration medication arrangements must be reviewed and recorded and updated as agreed. The agreement could be reviewed more frequently if required.
If there are any immediate concerns, the agreement will not prevent the foster carer taking urgent action by consulting the young person's GP or NHS Direct. A review of arrangement should be considered to include the young person, relevant health professional, foster carer, the child's Social Worker and relevant others if there is any significant change in medication.
Failure to inform the above or to properly record the maladministration of medication may be investigated as a safeguarding or standards of care matter. (see Allegations Against Foster Carers Procedure.)
6. Record Keeping
An Administration of Medication form must be completed for each child to log the medication administered.
From your records anyone should be able to understand exactly what you have given and you must be able to account for all the medicines you have managed for the child. On receipt of medicines you must record:
- What medicines you received, including the name, strength and amount of medicines;
- When you received it;
- If returned to pharmacy the date it was returned and the name of the pharmacy.
7. Covert Medication
It is illegal to disguise medication in food or drink.
Requests to crush tablets from parents or carers must be subject to medical and pharmacy advice. A specific directive must be in place before any medication is administered in this way. If tablets are to be crushed a pill crusher should be used.
Record medication and route given as per policy.
Failure to follow policy, guidance or best practice can lead to disciplinary measures being taken.8. Disposal of Medicines
The young person and their relative / carers should be encouraged to return any unwanted or out of date medicines to their community pharmacist.
Pharmacists are responsible for the disposal of unwanted medication.
Medicines remain the property of the patient and cannot be removed without consent.
A record must be made stating what medicine has been removed, to which community pharmacy and the date returned.
Where a death occurs medication must be kept for 7 days before being returned to the pharmacist.
9. Homeopathic Remedies
No homeopathic remedy may be applied or administered without the express permission of the child's Social Worker and having received guidance from the Dedicated LAC Health Team.
The Health Team LAC
The Health Team LAC are available to discuss any issues with medication.
Contact / Link Details:
Debbie Rice - Designated Nurse LAC
Tel: 01670 593 643
Email: Debbie.Rice@northumbria-healthcare.nhs.uk
Kate Moody - Lead Nurse LAC
Tel: 01670 593 601
Email: kate.moody@northumberlandcaretrust.nhs.uk
Clare Gates - Administrative Assistant
Tel: 01670 593 630
Email: Clare.Gates@northumberland.gov.uk
Sandra Hedley - Administrative Assistant
Tel: 01670 593 631
Email: Sandra.Hedley@northumberland.gov.uk
Dr Anna Redfearn - Designated Doctor LAC
Tel: 01670 396 467
Email: Anna.Redfearn@northumberlandcaretrust.nhs.uk
Blyth Health Centre
Thoroton Street
Blyth
NE24 1DX
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