Is it a generic policy, bought or copied from somewhere, that you don’t really pay attention to or did you write it years ago and haven’t bothered with it much since? Or is your policy a working document which is regularly updated … and does your policy exactly reflect your practice? If you have staff, can they explain your policy verbally to an Ofsted inspector and do they follow it, to the letter, if you are out or concentrating on something else?
Is your Medication Record Form robust – does it include all the information you need to gather from parents to keep children safe? Does it include, for example, the reason why you are giving the medication, the dosage taken from the medication bottle or box, the date it was prescribed (if it was prescribed) or handed to you (if parents bought it off the shelf)? Does it have space for parents to sign before the medication is given (after you have filled it in) and afterwards to confirm they know what you have done?
**THINGS TO DO – go through your Medication Administration Forms and check them against the EYFS for accuracy and completeness.
Have you risk assessed the medication – do you know and record if you need to, for example, wear gloves, keep it in the fridge or apply it with a tissue? Do you record where it needs to be stored – and how long should you use it before handing it back to parents? Part of the risk assessment process is to ensure permission is regularly updated – does your form include an update date?
**THINGS TO DO – add a section to your Medication Administration Form to ensure you risk assess.
Did you read the EYFS before writing your Medication Policy and Procedures and use the exact wording in the EYFS to frame it? If it’s not been updated for a while, your policy might share the wrong information with parents – for example, it might reflect the out-of-date EYFS 2014 rather than EYFS 2017 in some of its wording.
**THINGS TO DO – go back to the EYFS 2017, requirements 3.44 – 3.46 and review your policy to make sure it accurately reflects what the EYFS says about prescribed and non-prescribed medication administration. If a problem arises during inspection, Ofsted will look at this section of the EYFS when making their judgement.
FOR EXAMPLE, doctors no longer prescribe medication such as Calpol so if your policy says you only give prescribed medication to children, you might not be able to meet a child’s needs effectively if they fall ill while in your care – or a staff member might give Calpol in contravention to your policy because they haven’t read or understood it fully and a parent asked them to give it to their child.
Taking this scenario one step further, what would you do if a parent asked you to do something medication related that was completely against your policy? For example, if a parent said ‘give my child cough medicine’ and your policy says you don’t give non-prescribed / over-the-counter medication?
**THINGS TO DO – train your staff during staff meetings or plan a training session to go through your updated Medication Policy so they know exactly what to do and say to parents in different scenarios.
If you have a general medication form for things like Calpol and, say, hay fever medicine or bum cream, do you update it with parents regularly - do you know parents current wishes? With a general medication form in place, do you still contact parents every time you need to give medication to check when it was last given – to ensure you are not overdosing the child? How do you record this conversation, bearing in mind that the EYFS says permission must be given in writing?
**THINGS TO DO - get parents into a routine where they send you a WhatsApp, email or text to confirm last dosage amount, time given and permission to administer. You can then print it out and pop it in the child’s file alongside the completed Medication Administration Form.
If a parent asks you to overdose their child what would you say? Would you follow their wishes – or refuse? FOR EXAMPLE, if a box says 5ml for a certain age child and you ring the parent and they say ‘the doctor said the child can have 7.5ml’ what would you do - what would staff do? Would you / staff give the medication – what does your policy say you will do in this situation?
**THINGS TO DO – don’t ever overdose a child – explain to parents that you are only allowed to give the dose stated on the box, once you know when it was last administered (and how much in this sort of scenario) and have written permission in place from them. You are not currently working as a medical professional - regardless of your background - and your childminder insurance does not cover you for this so you cannot make medical decisions about how much medication to administer.
It is really important you get medication administration right and think through the things that might go wrong so you can tackle them in advance, especially if you have staff.
THINGS TO DO NEXT include:
- Read through and, if necessary, update your Medication Policy and Procedures using the EYFS as a starting point.
- Read through and, if necessary, update your Medication Administration Form(s) thinking about the information I have shared above.
- Train your staff (if you have them) so they know what to do in different scenarios
- Share the updated information with parents so they understand the importance of, for example, giving you written permission before you administer anything to their child.
I hope this helps, Sarah