Illness and Medication Policy

The purpose of this policy is to ensure we provide a healthy and safe environment for all children and staff and administer any medicines in the correct manner.

ILLNESS

1. We ask that in line with our Terms and Conditions, children who are unwell are not brought to nursery. It is our ethos that an unwell child should not be at nursery and that will always be our guiding principle.
2. If staff have concerns that a child arriving at nursery does not seem well, they will discuss with the parents why it may not be appropriate for the child to attend nursery.
3. Parents must inform staff if they have given their child any medication 12 hours prior to arriving at nursery. Staff will then discuss the reason for medication with the parents to determine if it’s suitable for the child to be at nursery – eg if they are well or not.

IF A CHILD BECOMES UNWELL AT NURSERY

4. Staff will take the child’s temperature using a thermometer. If their temperature is 38C or above and the child is obviously unwell or in distress we will contact the parents to collect immediately. Otherwise, we will attempt to reduce the child’s temperature by environmental control eg removing some clothing. We will also begin to monitor their temperature to see if it continues to rise, using a temperature chart (Appendix 1). This will be given to parents or carers on collection.
5. If the child’s temperature does not lower, or they become distressed due to illness, or start to show other signs of being unwell alongside their temperature, parents will be informed and asked to collect their child. We will also offer to administer liquid paracetamol.
6. If a child has a high temperature, following advice from the UK South West Health Protection Team, they must not return to nursery until they have been 24 hours clear of any fever (the NHS website defines high temperature (fever) as “38C or more”.
7. If a child has sickness, diarrhoea or is suspected to have any other infectious disease, parents will be informed and asked to collect the child as soon as possible. The child’s return to nursery will depend on the government guidance for the specific illness – see link in clause 10 below.
8. In exceptional circumstances professional medical assistance will be sought.

PREVENTING SPREAD OF ILLNESSES/CONDITIONS

9. If a child has any infectious disease they will only be allowed to return to nursery as per the guidance below, or when they are well.
10. The return time for infectious diseases shall be in accordance with the latest UK Health Security Agency (HSA) information which can be found at:

    https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/chapter-3-public-health-management-of-specific-infectious-diseases

11. If a child is on a course of antibiotics for an infectious disease, their return to nursery will be dependent on the advice given in the UK HSA document mentioned above, together with the child’s general health.
12. Should a child be able to return to nursery while on antibiotics, they must have had at least 48 hours on the medicine to ensure there are no reactions and they must be well enough in themselves.
13. For long-term prescription of antibiotics, see Clauses 20 onwards.

NOTIFIABLE DISEASES

14. If a child is suffering from a Notifiable Disease as listed at this link:

https://www.gov.uk/government/publications/health-protection-in-schools-and-other-childcare-facilities/managing-specific-infectious-diseases-a-to-z we will contact our local health protection team (HPT) who will advise us on the correct procedure.

15. We will contact UK HSA who will advise us on the correct procedure. Parents will be notified by a sign put up in nursery. Managers will use a prescribed government format for this.

ACTION PLAN FROM GP OR HOSPITAL

16. If a child has an Action Plan from their GP or hospital, a copy must be provided to nursery and kept in the Medicine Folder.
17. If a child has complex medical needs, an epi-pen (or an inhaler for a life-threatening condition) then a Medication Agreement must be completed, an Action Plan provided by the GP or hospital and a BCC Care Plan created, all to be kept in the Medicine Folder.

ADMINISTERING MEDICINES

18. In accordance with paragraph 3.61 of the EYFS, any medicine, prescription or non-prescription, will only be administered with prior written permission from a parent. Any prescribed medication must be in the original packaging or have the child’s prescription label on it. 
19. Staff will administer medicine/cream/drops if the child has been taking or using it for at least 48 hours at home. Parents will give prior written consent for this by (1) completing a Medication Agreement (Appendix 3) and (2) by signing a Medicine Permission Form (Appendix 2) which will be printed from Connect Childcare. This must be signed BEFORE the parent leaves the child. The Medicine Permission Form will be filled in and signed by staff when they give the medicine, and parents will sign again when they collect the child.
20. If a child has more than one medicine, there must be a Medication Agreement for each medicine. Agreements are filed in each room in a Medicine Folder and move with the children. An additional Care Plan (Appendix 5) will be created with parents if required and filed with the Medication Agreement(s).
21. Staff will administer medication in accordance with the appropriate Medication Agreement. If a child has more than one medicine, staff must ensure they administer the correct medicine for the child’s needs and situation. Each need/requirement is set out on a separate line of the A3 Medical Requirements chart displayed in each room. Medication that has very serious implications, such as a need to call an ambulance, must be highlighted in red on the chart, and a red triangle marked at the top of the Medication Agreement.
22. Only Senior members of staff will administer medicines, with another member of staff present checking the whole process. Both must sign a Medicine Permission Form, which can be signed digitally or printed from Connect Childcare. The form details time and dosage and parents will be asked to sign this when they collect their child. If a child has medication that needs more than one dose a day, the same Medicine Permission Form will be used with each of the times noted on it. If a child has long-term ongoing medication then the Weekly Medicine Permission Form can be used (Appendix 2). These forms are filed and kept centrally at nursery in the nursery Medicines folder.
23. Inhalers and epi-pens can be administered by Room Leaders in an emergency, with the manager informed immediately. A Medicine Permission Form must be filled in as per Clause 22.
24. A parent or medical practitioner must show relevant staff how to administer specialist medication as required and ensure staff understand instructions. It is recognised that staff are not medically trained so in the case of serious medical conditions or a medicine that a child has not had before, managers and senior managers must make a decision as to whether staff can safely care for the needs of that child.
25. An A3 Medical Requirements chart detailing medicines and instructions for each child is displayed in each room. This must be updated by the manager by hand as soon as the information is provided, eg after the Parent Induction Meeting, or at least by the first settling in session. Each month the manager must review each chart and check the information is correct, initialling and dating when this is done. The charts are reprinted at Head Office when required.
26. All staff must understand all information on the Medical Requirements charts and in the Medication Agreement for each child in the room where they work. Managers, deputies and Assistant Deputy Managers (ADMs), in whose care the nursery is left, must know and understand this information for all children. Managers must ensure that they talk through the details of all Medication Agreements and Care Plans with deputies and ADMs.
27. Managers must check all Medication Agreements every month and a new agreement will be required every six months. Parents must also notify the manager immediately if the child’s condition changes or the medication changes such as type or dose. Managers must ensure all Medical Requirements charts are updated and senior and room staff are made aware.
28. If staff have any doubts about the medicine that they are about to administer, or how to administer it, they should call the child’s parents or dial 999 in an emergency.
29. Each nursery will have a bottle of liquid child paracetamol and Piriton, clearly marked and kept in the medicine cupboard for emergency use only. Only Senior staff will administer these medicines, after consultation with a parent. This paracetamol will only be used to bring down a child’s temperature if it is 38°C or over. The Piriton will only be used in an emergency situation where a child is having an allergic reaction. Parents will sign a Medicine Permission Form as per Clause 22.
30. Any mis-medication is taken very seriously by the Company. Any incident will be investigated and may result in disciplinary action.

STORING MEDICINES

31. Medicines must be provided in their original containers. They must be stored in accordance with instructions and out of reach of children. Medicines that do not need to be refrigerated must be kept in the medicine cupboard. Inhalers and epi-pens must be stored in the room with the child (and in the gardens if they need to be carried with the child) but out of reach of the children. Children’s names must be clearly marked on external packaging and all staff must know where they are kept.
32. Medicines stored in nursery, including those in the medicine cupboard, the fridge and inhalers/epi-pens in each room, are checked once a month, by the manager, to ensure all medicines are logged and that they are all in date. The Children’s Medication Monthly Checklist (Appendix 4) is completed each month and secured to the front of the medicine cupboard, with the date it was completed clearly marked. Any out of date medicines, or medicines no longer required, are returned to the parents.

CREAMS AND OINTMENTS

33. If a child has a need for a cream or an ointment which has not been prescribed, this can be discussed with the manager and booked into nursery using the Long-Term Prescribed Medication Agreement with a note that it’s not prescribed. The cream can be kept in a nappy change area or in the room with the child as long as it is out of child reach and must be clearly marked. The manager must know where all such creams and ointments are and must check them once a month as per Clause 32 above. Parents do not need to sign a Medicine Permission form each time the cream is applied as it’s not a prescribed medication. 

HYGIENE

34. To help prevent spread of illnesses, we teach children hygiene routines e.g. using tissues, putting hand to mouth when coughing, washing hands. These are reinforced by using songs, rhymes, stories and pictures in the bathroom. Copies of songs and rhyme words are often shared with parents or available on request.
35. All toys and equipment are sterilised regularly with a cleaning rota in each room. This is recorded in a Room Sterilisation Book or a Sterilisation Checklist.
36. Dummies are sterilised when dropped.

WORKING WITH PARENTS

37. We will work closely with parents to ensure their child’s needs are met. We will also ensure that we involve professionals where required. If a Care Plan is provided to us by the parents we will need written confirmation by a health visitor or doctor that the care set out is appropriate.
38. If required, we will have meetings with parents and professionals to create a care plan that is appropriate for the child’s needs, at home and at Nursery.
39. If required, we will work with parents to organise staff training for particular medical needs.

Appendix 1 – Temperature Chart
Appendix 2 – Medicine Permission Form and Weekly Medicine Permission Form
Appendix 3 – Medication Agreement
Appendix 4 – Medication Monthly Checklist
Appendix 5 – Care Plan