Supporting Children With Medical Conditions Policy

Aims

This policy aims to ensure that:
• Children, parents and I, understand how the setting will support children who require medicines in nursery.
• A framework is in place to administer medicine as part of maintaining children’s health and wellbeing or when they are recovering from an illness.

I will implement this policy by:
• Making sure that I am suitably trained
• Being aware of children’s conditions
• Ensuring that I am always available to support children with medical conditions, who require medication
• Developing and monitoring individual health and/or care plans

Legislation and statutory responsibilities
This policy meets the requirements under
https://www.legislation.gov.uk/ukpga/2014/6/part/5/crossheading/pupils-with-medical-conditions
which places a duty on settings to make arrangements for supporting children with medical conditions.
It is also based on the Department for Education’s
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/803956/supporting-pupils-at-school-with-medical-conditions.pdf

Roles and responsibilities
As the Early Years Lead and SENCo, I will:
• understand my role in the implementation of this Policy
• Ensure that I am sufficiently trained and available to implement this policy and deliver against all individual health and/or care plans, including in contingency and emergency situations
• Take responsibility for the development of individual health and/or care plans
• Ensure that I am appropriately insured
• Contact the health visiting team, in the case of any child who has a medical condition that may require support or medicines at nursery, but who has not yet been brought to the attention of the health visiting team
• Ensure that systems are in place for obtaining information about a child’s medical needs and that this information is kept up to date.

Parents

Parents will:
• Provide me with sufficient and up-to-date information about their child’s medical needs
• Be involved in the development and review of their child’s individual health and/or care plan and may be involved in its drafting
• Carry out any action they have agreed to as part of the implementation of the individual health and/or care plan, e.g. provide medicines and equipment, and ensure they or another nominated adult are contactable at all times

Children

In setting, the parent /carer will be the person who is best placed to provide information about how the condition affects their child. They will be fully involved in discussions about their child’s medical support needs and contribute as much as is possible to the development of their individual health and/or care plans. Where the child is able to, they will be encouraged to talk about how their condition affects them, and ideally their feelings and understanding should be reflected in the plan.

Health Visitors and other healthcare professionals

With parental permission I will liaise with Healthcare professionals, such as Health Visitors, GPs and Paediatricians, on children’s medical conditions, so information for health care planning is correct and appropriate for the child. They may also provide advice on developing individual health and/or care plans.

Equal opportunities

I am clear about the need to actively support children with medical conditions to participate in nursery trips and visits, or in sporting activities, and not prevent them from doing so.
I will consider what reasonable adjustments need to be made to enable children to participate fully and safely in nursery trips, visits and sporting activities.
Risk assessments will be carried out, so that planning arrangements take account of any steps needed to ensure that children with medical conditions are included. In doing so, children, their parents and any relevant healthcare professionals will be consulted.

Being notified that a child has a medical condition

When I am notified that a child has a medical condition, I will decide whether the child requires an IHP.
I will make every effort to ensure that arrangements are put in place within 2 weeks.

Individual healthcare plans

As the early years lead and SENCo, I am responsible for the development of individual health and/or care plans for children with medical conditions.
Plans will be reviewed at least annually, or earlier if there is evidence that the child’s needs have changed.
Plans will be developed with the child’s best interests in mind and will set out:
• What needs to be done
• When
• By whom
Not all children with a medical condition will require an individual health and/or care plan. It will be agreed with a healthcare professional and the parents when an individual health and/or care plan would be inappropriate or disproportionate. This will be based on evidence. If there is no consensus, I will make the final decision.
Plans will be drawn up in partnership with parents and a relevant healthcare professional, such as the Health Visitor, Specialist, Consultant or Paediatrician, who can best advise on the child’s specific needs. Where appropriate the child will be involved.
Individual health and/or care plans will be linked to, or become part of, any Education, Health and Care Plan (EHCP). If a child has SEN but does not have an EHCP, the SEN will be mentioned in the individual health and/or care plan.
The level of detail in the plan will depend on the complexity of the child’s condition and how much support is needed. I will consider the following when deciding what information to record on individual health and/or care plans:
• The medical condition, its triggers, signs, symptoms and treatments
• The child’s resulting needs, including medication (dose, side effects and storage) and other treatments, time, facilities, equipment, testing, access to food and drink where this is used to manage their condition, dietary requirements and environmental issues – e.g. outside environment, space, noise
• Specific support for the child’s educational, social and emotional needs.
• The level of support needed, including in emergencies.
• Who will provide this support, their training needs, expectations of their role and confirmation of proficiency to provide support for the child’s medical condition, from a healthcare professional.
• Arrangements for written permission from parents for medication to be administered by me, or self-administered by the child during setting hours
• Separate arrangements or procedures required for trips or other nursery activities outside of the normal timetable, that will ensure the child can participate, e.g. risk assessments
• Where confidentiality issues are raised by the parent/child, the designated individuals to be entrusted with information about the child’s condition
• What to do in an emergency, including who to contact, and contingency arrangements

Managing medicines

Children taking prescribed medication must be well enough to attend the setting. In many cases, it is possible for children’s GP’s to prescribe medicine that can be taken at home in the morning and evening. As far as possible, administering medicines will only be done where it would be detrimental to the child’s health if not given in the nursery. If a child has not had a medication before, it is advised that the parent keeps the child at home for the first 48 hours, to ensure no adverse effect, as well as give time for the medication to take effect.
Only prescribed medication is administered. It must be in date and prescribed for the current condition and in the original labelled container.
EYFS Statutory Framework states: Prescription medicines must not be administered unless they have been prescribed for a child by a doctor, dentist, nurse or pharmacist (medicines containing aspirin should only be given if prescribed by a doctor).
EYFS Statutory Framework 3.46. Medicine (both prescription and non-prescription) must only be administered to a child where written permission for that particular medicine has been obtained from the child’s parent and/or carer. Providers must keep a written record each time a medicine is administered to a child, and inform the child’s parents and/or carers on the same day, or as soon as reasonably practicable
NB – Children’s Paracetamol (non-prescription) is only administered in the case of high temperature, with previously written consent, and at the time of administering, (phone call to ascertain permission and when last dose administered) with verbal consent of the parent/carer.
Prescription and non-prescription medicines will only be administered at Nursery:
• When it would be detrimental to the child’s ’s health or nursery attendance not to do so and •Where we have parents’ written consent
Children will not be given medicine containing aspirin unless prescribed by a doctor.
When I give a child any medication (for example, for pain relief) I will first check maximum dosages and when the previous dosage was taken. Parents will always be informed.
I will only accept prescribed medicines that are:
• In-date
• To be administered 4 times a day or where a child is in from 7.30am – 5pm
• Labelled
• Provided in the original container, as dispensed by the pharmacist, and include instructions for administration, dosage and storage

The Nursery will accept insulin that is inside an insulin pen or pump, rather than its original container, but it must be in date.
All medicines will be stored safely. If they need to be refrigerated, they are stored in the fridge in the kitchen, any other medication is kept in a box on a high shelf, out of sight and out of reach.
Medicines and devices such as asthma inhalers, blood glucose testing meters and adrenaline pens, will always be readily available to use with the child and are not locked away.
Medicines will be returned to parents to arrange for safe disposal, when no longer required.

Controlled drugs
https://www.gov.uk/government/publications/controlled-drugs-list–2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation
are prescription medicines that are controlled under the
https://www.legislation.gov.uk/uksi/2001/3998/schedule/1/made
and subsequent amendments, such as morphine or methadone.
In Nursery, all controlled drugs are kept in a secure place in the playroom, out of sight and out of reach.
Controlled drugs will be easily accessible in an emergency and a record of any doses used and the amount held will be kept.

Children managing their own needs
Children who are competent, will be encouraged to learn to take responsibility for managing their own medicines and procedures. All children will be encouraged to be positive about taking their medicine, and learn that it helps to keep them well. This will be discussed with parents and it will be reflected in their individual health and/or care plans.

Unacceptable practice
I will use my discretion and judge each case individually, with reference to the child’s individual health and/or care plan, but it is generally not acceptable to:
• Assume that every child with the same condition requires the same treatment
• Ignore the views of the child or their parents
• Ignore medical evidence or opinion (although this may be challenged)
• Send children with medical conditions home frequently for reasons associated with their medical condition or prevent them from staying for normal activities, unless this is specified in their individual health and/or care plans
• Penalise children for their attendance record if their absences are related to their medical condition, e.g. hospital appointments
• Prevent children from drinking, eating or taking toilet or other breaks whenever they need to in order to manage their medical condition effectively
• Require parents, or otherwise make them feel obliged, to attend nursery to administer medication or provide medical support to their child, including with toileting issues. No parent should have to give up working because I am failing to support their child’s medical needs
• Prevent children from participating, or create unnecessary barriers to children participating in any aspect of nursery life, including nursery trips, e.g. by requiring parents to accompany their child

Emergency procedures
I will follow my Nursery’s normal emergency procedures (for example, calling 999). All children’s individual health and/or care plans will clearly set out what constitutes an emergency and will explain what to do.
If a child needs to be taken to hospital, I will stay with the child until the parent arrives, or accompany the child to hospital by ambulance.

Training
As the person responsible for supporting children with medical needs, I will receive suitable and sufficient training to do so.
The training will be identified during the development or review of individual health and/or care plans.
The relevant healthcare professionals will lead on identifying the type and level of training required and will agree this with me. Training will be kept up to date.
Training will:
• Be sufficient to ensure that I am competent and have confidence in my ability to support the children
• Fulfil the requirements in the individual health and/or care plans
• Help me to have an understanding of the specific medical conditions that I am being asked to deal with, their implications and preventative measures
Healthcare professionals will provide confirmation of my proficiency in a medical procedure, or in providing medication.
The training I receive with preventative and emergency measures will help me to recognise and act quickly when a problem occurs.

Record keeping
I will ensure that written records are kept of all medicines administered to children, for as long as these children are at the nursery. Parents will be informed if their child has been unwell in Nursery.
individual health and/or care plans are kept in a readily accessible place.

Liability and indemnity
I will ensure that the appropriate level of insurance is in place and that it appropriately reflects setting’s level of risk.

Complaints
Parents with a complaint about their child’s medical condition, should discuss these directly with me. If I cannot resolve the matter, I will direct parents to my setting’s complaints procedure.