Managing medicines summer 2012

Reinwood Infant & Nursery School
Supporting Children with Medical Needs and Managing Medicines Policy
Summer 2013

Introduction
The purpose of this Policy is to provide clear information on how Reinwood Infant & Nursery
School support children with medical needs and how medicines are managed and
administered in our school. We ensure that the document is shared within our school so that
al staff, Governors, parents, children, volunteers and others working in schools are aware of
its existence and content. All parents receive a copy of the School Prospectus, where there is
guidance on arrangements for administering medicines in school. Parents can request a copy
of this policy.
Close co-operation between schools, parents/carers, health professionals and other agencies
wil provide a supportive environment for our pupils with medical needs. This wil enable our
children to maximise their access to education within Reinwood School. The governors,
Headteacher and staff of Reinwood Infant & Nursery School wish to ensure that children with
medical needs receive care and support in school. Children should not be denied access to a
broad and balanced curriculum simply because they are on medication or need medical
support, nor should they be denied access to such activities as school trips.
The Headteacher wil accept responsibility for members of staff giving or supervising children
taking prescribed medication or carrying out prescribed procedures during the school day
where those members of staff have volunteered to do so. She wil ensure that members of
staff receive adequate information, instruction and training to ensure their competency to
carry out their roles safely and effectively.
Kirklees Council ful y indemnifies al its staff against claims for al eged negligence providing
they are acting within the remit of their employment. As the administration of medicines is
considered to be an act of “taking reasonable care” of the pupil, staff agreeing to administer
medication can be reassured about the protection their employer would provide (provided
they fol ow ChYPS policy and procedures). In practice, this means that Kirklees Council, not
the employee, would meet the cost of damages should a claim for al eged negligence be
successful. At Reinwood we wil take the same care that a reasonable, responsible and
careful parent would take in similar circumstances, whilst we are responsible for the care and
control of our pupils. In al circumstances, particularly in emergencies, teachers and other
staff are expected to use their best endeavours. The consequences of taking no action are
likely to be more serious than those of trying to assist in an emergency.(Quoted from the
Kirklees Children & Young People Service Guidelines on supporting children and young
people with medical needs, including managing medicines in schools and early years’
settings. January 2007 page 18)
The acceptance of this responsibility is within the context of this policy. The headteacher wil
consider, in each case, the nature of the medication to be administered, any potential risks
and al other relevant information before deciding in a particular case that medicine can be
administered. Where there is concern that the child’s needs cannot be met, the headteacher
wil seek further advice from medical professionals and appropriate LA Officers.
Through their PSHCE curriculum, al our children are taught about medicines & drugs, what a
medicine is, safety regarding medicines, the importance of not talking other people’s
medicines (e.g. inhalers), the difference between medicines & drugs, in particular that al
medicines are drugs, but not al drugs are medicines. (see PSHCE policy for further detail).
As soon as a child is diagnosed, it is the responsibility of the parents to alert the school of
the child’s needs.

Development
This policy was developed by al staff, School Nurse, Governors & LA consultants using the
Kirklees Children & Young People Service (CHYPS) guidance January 2007. Reference has
also been made to the DCSF guidance – Managing Medicines in Schools & Early Years
Settings document March 2005 and The 5 Outcomes of the Every Child Matters document, in
particular Being Safe, Staying Healthy.
At our school we aim to maximise the inclusion of pupils with medical needs in as ful a range
of educational opportunities as possible. We wil assist parents/cares and health
professionals by cooperating in agreed procedures to administer medicines where necessary
and reasonably practical. We have effective and robust management systems for this.
We have adopted the ChYPS policy and guidance Supporting Children and Young People
with Medical Needs and outline below the detailed arrangements for implementing the policy
in our school.
The Headteacher wil ensure that appropriate aspects of this policy & guidance are
communicated to al relevant parties including staff, parents, children and others.
1.
Roles and responsibilities
Roles and responsibilities wil be in accordance with the previously mentioned policy (ChYPS policy and guidance Supporting Children and Young People with Medical Needs ). We have set out school / specific roles / duties briefly below: The designated teacher with responsibility for children with medical needs is our
Inclusion Manager
to compile, update & disseminate the inclusion register for the whole to make relevant staff aware of the medical needs of children. to update the training log regarding children with medical needs. Other staff members with specific duties are outlined below: Headteacher – liaising with parents/carers, Health Care Plans,
Administrator – administering medication, pupil records, parent consent forms
Breakfast Club Co-ordinator –parent consent forms(for children arriving early)
Inclusion Manager – liaising with parents/carers, Health Care Plans
Class teachers – transferring medical information, liaising with parents
Support Staff – passing on information to supply teachers
Lunchtime supervisors – aware of dietary needs, liaising with class teachers
& kitchen staff
Kitchen Staff – ensuring children get the correct dietary requirements
Health & Safety Co-ordinator – ensure blood waste is ready for col ection,
analyse accident forms and maintain medical cupboards
Detailed organisation/arrangements
School staff wil only administer medication in accordance with school policy. We have detailed the specific school arrangements briefly below.

Non prescription medicines:
We will not administer medication until the appropriate forms have been completed &
signed by parent/carer and school.
For non prescription medicines-
Annexe B form 2 - page 68 (Parental and School agreement to administer medicines)
&
Form 6 page 55 – (Record of medicines administered to all children)

1. Only prescribed medicines wil be administered (that is, only if it would be detrimental to a child’s health if it were not administered), therefore medicines such as ‘Calpol’ wil not normal y be given. 2. Non prescription medicines should not normal y be administered in school time. 3. In exceptional and/or occasional circumstances the school may agree with the parent/carer to administer non prescription medicines, (after appropriate forms have been signed) .
Prescription medicines:
We will not administer medication until the appropriate forms have been completed &
signed by parent/carer and school. –
Annexe B form 2 page 68 (Parental and School agreement to administer medicines)
&
Form 3 page 69 (Record of medicine administered to an individual child)
For prescription medicines

1. It would be helpful, where clinical y appropriate, if medicines are prescribed so that they can be taken out of school hours. We encourage parents/carers to ask the prescriber about this. Medicines to be taken 3 times a day should normal y be given in the morning before school, afternoon at home and bedtime. 2. Staff wil only accept medicines prescribed by a doctor, dentist, nurse prescriber or 3. Children with long term conditions or returning to school after il ness whilst medication is stil being taken can continue as usual in school, however it is important that a child’s teacher and administrator is provided with ful information by the parent/carer regarding their child’s medical needs. Long term medical needs:
We will not administer medication until the appropriate forms have been completed &
signed by parent/carer and school. –
Annexe A form 2- page 48 (Individual Health Care Plan PLUS a photograph)
Annexe B form 2 -page 68 (Parental and School agreement to administer medicines)
When a child first enters school medical details are recorded on their admission forms. If
medical conditions arise later, forms are updated. Health Care Plans are written for any child
with sever or mild medical needs, such as food al ergies, diabetes, asthma, anaphylaxis.
(examples of forms are at the end of this policy). Health Care Plans are written by the
Headteacher, Inclusion Manager or relevant Health Professional as appropriate.
Authority for administering medicine:
We will not administer medication until the appropriate forms have been completed &
signed by parent/carer and school. –
Annexe B form 2- page 68 (Parental and School agreement to administer medicines)
&
Form 3 page 69 (Record of medicine administered to an individual child)

1. All prescribed medicines to be administered in school has to be accompanied by instructions from the parent &/or doctor, specifying: Carriage of medicines:
1. Children must not carry medicine into school. The only exception to this may be
inhalers for asthmatics, adrenalin in cases of anaphylaxis and insulin for diabetics where
the child has been deemed competent to self administer. Where the Council has
responsibility for transporting children then the health care plan must include the
management arrangements required to transport the child safely(if they are at risk).
2. Medicines should be brought into school by the parent/carer or other responsible adult

Emergency procedures:
If a child has an accident at school:
1. 1st aid is given as appropriate 2. A note given to parents at the end of the day (if minor) 3. If considered necessary, parent informed to come to school to take child home, to the 4. If the injury is severe, an ambulance wil be cal ed for 5. Pupil record cards, Individual Health Care Plans & medical notes wil be taken to the 6. Al injuries are recorded on the accident form, severe accidents are recorded on the LA form and sent to the LA 7. Staff should never take children to hospital in their own car (LA guidance page 21) 8. At Reinwood we currently have 8 trained 1st aiders (3 of whom are LTS) When a child becomes unwel at school we will look after the child safely, comfortably & with dignity and contact their parents/cares or named contact person to col ect them. It is then the responsibility of the parent to accompany the child to their GP surgery or to hospital.
Arrangements for administering medicines:
We will not administer medication until the appropriate forms have been completed &
signed by parent/carer and school. –
Annexe B form 2 page 68 (Parental and School agreement to administer medicines) &
Form 3 page 69 (Record of medicine administered to an individual child)
1. The medicine should be handed into the office to the administrator
2. The medicine must be in its original container
3. The medicine container must be clearly named
4. The dose must be clear
5. The type of medicine must be clearly labeled
6. In some cases we may encourage parents to visit school to administer medication
7. If a child refuses their medication, they will not be forced to take it. We will talk to them,
then if unsuccessful, record the reason, then we wil inform parents/carers immediately
9. Complete the form– Form 3 page 69 (Record of medicine administered to an
individual child)
10. Al inhalers MUST BE CLEARLY NAMED


Self administration by pupils:
Children may be al owed to take responsibility for self –administration of medicines e.g
inhalers; however an adult needs to be present. If this is the case it must be part of a written
agreement with the child’s parents/carers & school.
Administration by school staff:
Most medication is given by the administrator. Volunteers may indicate their wil ingness to
administer medication though it is clear that they are not required to do this.
We keep a record of the names of persons who administer medication.
Practice, Procedure & record keeping:

Before administering medication consult the appropriate forms – Annexe B form 2
page 68 (Parental and School agreement to administer medicines)
&
Form 6 page 55 –(Record of medicines administered to all children)
1. check the details on the label (see above) 2. check the expiry date of the medicine 3. check the record of the timing of the last dose on the form 4. measure out the exact dose 5. check the child’s name on the medicine container again 6. complete written record of the dosage given, including date, time, & signature on Form 6 page 55 –(Record of medicines administered to all children)
7. unless it is an emergency, the child’s privacy & confidentiality wil be considered In cases where there is doubt about the correct dosage, the parent should seek advice and clear instruction from the prescribing doctor/ dispensing pharmacy before the medication is given. Al children requiring long term prescribed medication (asthma, diabetes, food al ergies,
epilepsy etc) will have a Health Care Plan (Annexe A form 2- page 48 Individual Health
Care Plan PLUS a photograph)
Children with chronic or complex medical needs:
Some children suffer from chronic medical conditions, which may require urgent action to prevent a possible life-threatening situation from developing. The fol owing chronic or potential y life threatening medical conditions are commonly found amongst the school age population: • Anaphylaxis ( a severe al ergic reaction) – training for al staff is provided by the school nurse & the IHCP completed by the hospital doctor/school nurse • Epilepsy (IHCP drawn up with the help of a specialist nurse)
• Asthma – asthmatics wil have an Individual Health Care Plan – see form 2
• Diabetes (IHCP drawn up with the help of a specialist nurse) In these cases the children wil have an Individual Health Care Plan • All staff, including lunchtime supervisors & catering staff, are made aware of the children who have severe medical needs • Photographs of children with food al ergies are made available to the kitchen
Employees training and record keeping- the Inclusion Manager wil record training details
& update the training log on the child’s Individual Health Care Plan, record & update
appropriate details on the training log.
Emergency procedures - detailed arrangements, roles and responsibilities:
In a case of a fire/fire practice the teacher & administrator wil take out with them essential
medication eg medication for a diabetic, asthmatic, Epipen
Food management - re food allergies and intolerances:
As with asthma when a child first enters school medical details are recorded on their
admission forms. Health Care Plans are written by the Headteacher, Inclusion Manager or
relevant Health Professional as appropriate.

All children with a severe or life threatening allergy must have an Individual Health
Care Plan. Children with less serious allergies and intolerances should also have an
IHP. Children with minor food intolerances will be recorded on the class list which
goes in the class register.
Where parents wish their children to be provided with school meals, a meeting must take
place with the parents, catering representative and headteacher so al parties are ful y
informed. The school is responsible for arranging this meeting. At the meeting, the parents
must be given a copy of the catering providers food al ergies/al ergens policies and
procedures (see Annexe A Form 11 for DSO information) and made ful y aware of them.
They can use this information to make an informed choice about whether or not they wish
their child to receive meals. If the decision is made to provide meals, then the health care
plan must clearly set out what the arrangements are. The parents must agree to the terms
and conditions my signing their child’s health care plan.
The arrangements must be in line with the providers’ policy and al paperwork completed and
shared with the head of the kitchen. The written summary of arrangements with the catering
provider and a brief outline of the controls that have been put in place should be displayed in
the kitchen including a photo of the child so al staff are aware e.g. class teachers, lunchtime
supervisors and catering staff.

Day to day measures
Day to day measures are needed for food management , awareness of the child’s needs in relation
to the lunch menu, individual meal requirements, snacks in schools and some curriculum activities.
These will be collated into a class list each September by the admin staff and a copy put in each class
register, given to the all LTS staff and a copy also place in the Food Technology files.

Safe storage of medicines:
Written using guidance set out in the Control of Substances Hazardous to Health regulations 2002 (COSHH) a. Medicines wil be stored in accordance with product instructions b. Medicines wil be stored in their original container in which dispensed c. Medicines must be named, with dosage, instructions of administration, date of dispensing, cautionary advise & with a clear expiry date d. Instruction regarding any specific requirements for the disposal of equipment/waste product eg syringes, gloves, should be kept with the medication & equipment e. Under no circumstances should any medication be transferred into another f. Medicines wil be locked away in the office, with the key readily available in case of emergency, except for inhalers, gel for diabetes and Epipens g. Inhalers wil be kept in the same place in every classroom at child height h. Exceptions to f – medicines for asthma, anaphylaxis, diabetes & epilepsy. These medicines might be needed in emergency situations i. Some medicines might need refrigeration (in the office fridge) – refrigeration used for medication wil be secured in the office, inaccessible to unsupervised pupils. The temperature of the fridge should be maintained by using a digital thermometer and a system in place to record regular inspections.
Record keeping - consent, health care plans etc
Annexe A form 2 page 48 Individual Health Care Plan
1. Not al our children with medical needs require an Individual Health Care Plan 2. Children who have asthma will have an IHCP - for guidance we can refer to 3. Al children who have severe medical needs wil have an IHCP – food al ergies, 4. Parents should confirm al the medical information, in writing (in serious forms, 5. IHCP include details of symptoms, daily care requirements, detailed emergency procedures & family/medical contact details 6. The IHCP should be developed in consultation with parents, the GP & school health service & others as appropriate (eg catering provider for food al ergy children) 7. We review each IHCP annual y or as and when the school is notified of
Off site activities and home to school transport & sports day:

In cases of doubt we wil consult with The Educational Visits Advisor (based at
Oldgate House tel: 8602742) for advice. We can also refer to ChYPS (Children &
Young People Service) & BAALPE publication – Safe Practice in Physical Education &
School Sport
1. Al children with medical needs wil take part in Educational Visits
2. The staff wil take with them the medication of al children with medical needs
3. Children with medical needs wil be encouraged to take part in Sports Day.
4. Medication such as inhalers, epipens wil be taken with the child
Disposal, hygiene and infection control:

1. Staff wil not dispose of medicines 2. Parents/carers are responsible for ensuring that date expired medicines are returned to the pharmacy for safe disposal 3. Parents should col ect medicines at the end of each term 4. ‘Sharps’ boxes should always be used for the disposal of needles 5. Al staff are familiar with precautions for avoiding infection 6. Al staff fol ow basic hygiene procedures 7. Staff have access to protective disposable gloves 8. Al staff take care when dealing with spil ages of blood & other bodily fluids & 9. Blood waste is disposed of in yel ow bin bags, which are located in the Y1 toilet medical area, Reception disabled toilet area and the Year 2 disabled toilet area.
Risk assessment and risk management procedures:
The Inclusion Manager and Headteacher wil be responsible for completing risk assessments
where needed concerning pupils with medical needs.
Class teachers wil ensure that the requirements for children with medical needs are recorded
on their risk assessments when planning for a school trip.

Asthma

Introduction
Research shows that one in seven children have asthma and numbers are increasing,
making it the most common long-term medical condition in schools. ALL CASES OF
ASTHMA NEED TO HAVE AN INDIVIDUAL HEALTH CARE PLAN.
At Reinwood we:
• Welcome al pupils with asthma
• Recognise that asthma is an important condition affecting many children
• Encourage and support pupils with asthma to participate as ful y as possible in al
• Encourage children to be independent in taking their treatment • Recognise that immediate access to inhalers is vital • Have a clear understanding of what to do in the event of a child having an asthma attack • keep up to date records of children with asthma Annexe B form 2 page 68 (Parental
and School agreement to administer medicines)
• Do all we can to make sure that the school environment is favourable to children with
Recognition/ Symptons
Signs and symptoms of worsening asthma or the onset of an attack can include:
• increased coughing. • wheezing. • Wheezing is NOT ALWAYS PRESENT IN A SEVERE CASE • feeling of tightness in the chest. • breathlessness- indrawing of ribcage. • blueness of lips (caution this can be a very late sign!) Relievers Longer acting – e.g. Serevent relievers are not suitable for an acute asthma attack. There are various devices that simply deliver the same drugs in different ways (e.g. ‘spacers’, dry powder devices, aerosols and nebulizers). These devices should only be used by trained persons). Implementation
1. Identification
• The Admin staff, named first aider and Inclusion Manager wil screen al administrative
• A letter, Annexe B form 2 page 68 (Parental and School agreement to administer medicines) and asthma letter wil be sent home to parents to complete and return • A completed record sheet and IHP Annexe B form 2 page 68 (Parental and School
agreement to administer medicines & wil be stored, readily accessible, in the office
2. Information
• A notice cal ed ‘asthma in our classroom’ with information on triggers and treatments wil
be kept in the register as information for teachers. • The teacher wil add details to this notice of where inhalers are kept in the classroom. 3. Administration of treatment • Pupils should be able to take their inhalers independently. • The teacher should make an opportunity for pupils to use their inhaler before sport or playtimes if necessary. The inhaler should be taken into P.E. lessons if needed. • Inhalers should always be readily accessible to pupils and staff at al times. All inhalers wil be kept in a similar place in every classroom, accessible to children • A pupil should have a spare inhaler, which can be left at school. All inhalers should be 4. Education on site • Pupils with asthma can join in al normal classroom activities. • They should join in P.E. unless a medical note is provided. • Staff need to be aware that exercise may induce asthma and take any necessary action. 5. Education off site • Inhalers must accompany pupils on school trips. • Inhalers must accompany the pupil on any occasion where the premises are left, e.g. 6. Updating records • In September the administrator wil distribute an asthma list to staff and check that records from the previous teacher have been exchanged. Annexe B form 2 page 68 (Parental and School agreement to administer medicines)to be completed • The teacher wil check with parents if treatment has changed. • Asthma records wil be changed accordingly, signed and dated. Register copies wil also • At point of transfer to the junior school, the Inclusion Manager wil forward the relevant asthma records and information for the year group. 7. Staff training • All staff can access this policy from the staff board on the server. • Lunchtime staff are informed of procedures and places for inhalers, to use as required. • The school nurse offers periodic training for staff in relation to the care of asthmatic
Allergy & Anaphylaxis (severe allergic reaction):
All forms must be completed
Anaphylaxis is a severe al ergic reaction needing immediate medical attention. It usual y
occurs within seconds or minutes (occasional y hours) of exposure to a certain food or
substance.
The most severe form of anaphylaxis is anaphylactic shock, when the blood pressure fal s
dramatical y & the patient looses consciousness.
Procedures for food allergy children: Treatment is urgent & essential to prevent
progression of a severe anaphylactic reaction.
1. If pupil develops asthma –like symptoms such as shortness of breath, wheeziness, hives, tingling, general flushing of the skin ADMINISTER THEIR ADRENALIN
WITHOUT DELAY
2. CALL AN AMBULANCE
3. SEE INDIVIDUAL HEALTH CARE PLANS - Annexe A form 2 page 48 Individual
Health Care Plan
4. Anaphylactic shock – the school wil maintain pre-loaded Epipens of the correct dose of adrenalin for a child in the event of a serious al ergic reaction as arranged with the parents of such children. 5. These must be stored in specific first aid boxes out of pupils reach in both the 6. Named staff on the Health Care Plan only administers them.
Diabetes:
Annexe B form 2 page 68 (Parental and School agreement to administer medicines)&
Annexe A form 2- page 48 (Individual Health Care Plan PLUS a photograph)

1. Arrangements for children with diabetes wil be made between the parent and the class
teacher and wil be subject to regular reviews, including input from the diabetic nurse.
2. Any child with diabetes wil have an Individual Health Care plan- Plan (Annexe A form
2- page 48 Individual Health Care Plan PLUS a photograph)

Hypoglycaemia
Urgent treatment required. CONTACT 999 IMMEDIATELY and then tel the parents. All
diabetics should have either Dextrosol or jel y beans or glucose gel(hypostop) within east
access. Alternatives are Lucozade, coke, pepsi etc(not diet drinks) chocolate, honey jam and
fresh fruit. Syptoms are gradual and you should have plenty of warning. Allow the child to
drink as much water as the child wishes.
Attention Deficit Hyperactivity Disorder (ADHD):
Annexe B form 2 page 68 (Parental and School agreement to administer medicines)
&
Annexe A form 2- page 48 (Individual Health Care Plan PLUS a photograph)
1. Where children require medication for ADHD this again must be administered by named staff. The tablets wil be stored in a locked cupboard in the school office. 1. All staff wil take the same care that a reasonable, responsible and careful parent
would take in similar circumstances, while they are responsible for the care and control of
children.
2. Before any medication is administered to any child the parents/carers & school must
have signed the relevant forms - Annexe B form 2 page 68 (Parental and School
agreement to administer medicines)
3. If children have long term/severe medical needs they must have an Individual Health
Care Plan - Annexe A form 2- page 48 (Individual Health Care Plan PLUS a
photograph & Annexe B form 2 page 68 (Parental and School agreement to
administer medicines)

4. Clear procedures are in place, known & fol owed by al staff. 6. Do not take children to hospital in staff cars in an emergency situation(see LA This policy wil be reviewed every year. Signed ……………………………………………… Date ………………………. Chair governing body Signed ………………………………………………. Date………………………. Headteacher Review date: ……………………………………………………………

Source: http://www.reinwoodinfantschool.co.uk/_files/policies/managing_medicines_summer_2013.pdf