D338. Childrens Medication in Domiciliary Care

Background

This children’s domiciliary care service provides trained staff to support children and young people in their own homes. Support provided includes help with day-to-day activities including: washing, dressing and eating, support to go to school and relax/socialise, etc. All support is based on an individualised person-centred assessment of needs and a plan of care which is agreed in full collaboration with parents/guardians and families and in partnership with social services and healthcare providers. In all cases the objective of home care arrangements will be the provision of safe, high-quality care which empowers and supports children and young people to be as independent as possible.

Where necessary a care plan might include support for children and young people to take medication.

In most cases parents or guardians will normally be expected to be responsible for a child’s or young persons medication. Where necessary an appropriately trained and supervised home care worker may be able to provide assistance as a result of a request from the health or social care professional in charge of care.

{{org_field_name}} recognises that the correct and effective administration of medication is essential for the safety and wellbeing of children. Families must, therefore, receive the help identified in their care plan for the administration of medication only by trained and competent staff.

Legislation

{{org_field_name}}’s policies and procedures are all in line with relevant legislation relating to the safe and legal use of medicines, including:

The Medicines Act 1968
The Misuse of Drugs Act 1971
The Misuse of Drugs (Safe Custody) Regulations 1973.

In addition, this agency recognises that it must comply fully with all relevant regulatory requirements.

Procedures

The following procedures apply in this agency.

The personal support provided to a child or young person will always be based on a personalised plan of care agreed with the parents/guardians and based on a careful person-centred assessment of needs.
Where it is identified in the needs assessment that support may be needed for a child or young person in taking their own medication, the first step will usually be to ensure that a comprehensive review of their medicines has been completed — such a review would typically be requested by the social care or healthcare team primarily responsible for the care of the child or young person and carried out by a pharmacist or by an appropriate health professional who is part of a multidisciplinary team.
Where a support requirement remains, the involvement and role of {{org_field_name}} should be fully discussed with the parents/guardians and any agreed role specified in the plan of care — in all cases where help with medication is required, the explicit consent of the parents/guardians involved is required.
Assistance with medication should preferably be given by care staff providing prompts or reminders and support to the responsible parent/guardian who will actually carry out the administration — in all cases the parents/guardians will be expected to retain full responsibility for the medication where they have the capability to do so.
The administration of medication by a parent/guardian to their child is considered appropriate whenever the leading health or social care professional involved with a child or family has considered that the parent/guardian is safe and competent to do so and a note to this effect has been entered into the care records.
Any potential need for medication to be actually administered by staff (for instance, in an emergency situation) should be identified at the care assessment stage and recorded in the plan of care — the parents/guardians must agree to having a suitably trained and experienced care worker administer the medication in the specified circumstances and their explicit consent must be documented.
Care staff will use all possible means to provide support and to communicate effectively to the child or young person.
A medicines administration record should be kept with full details of all medication administered, withheld or refused — where the medicine has been administered by a parent/guardian, the record should be initialled and “service user self-administration” documented.
Clear communication and documentation between home care staff, families and healthcare professionals involved in the care of a child or young person is considered of vital importance at all times during any care placement in order to avoid any potential for errors, such as the inadvertent omission of a dose of medicine or administration of an extra dose of any medicine.
Care staff should help parents and families in keeping their medicines in a safe place at home and in storing them where they cannot be accessed by children — again, assistance will usually be provided by prompting and the parents/guardians will retain full responsibility for the medicines at all times.
Care staff must never help with the administration of any medication or prompt a parent/guardian to administer medication, unless they consider it to be fully safe and appropriate to do so.
Any care staff member who is unsure of what to do regarding medication in any given situation should contact their line manager or supervisor immediately.
After taking any medicine, children should be monitored by a care worker who should report any side effects immediately to the parents/guardians and to their supervisor or manager — where possible side effects are identified, a note should be entered in the care records and the parent/guardian prompted to seek appropriate medical advice from their GP or pharmacist.
Where care staff believe a medication error may have occurred, or where they have any concerns for a child’s or young person’s health as a result of helping to administer medication, they should stop the administration immediately and make the parent/guardian aware of their concerns — the parent/guardian should be prompted by care staff to seek appropriate medical advice from their GP or pharmacist or, in the case of a medical emergency, call for an ambulance.
Care workers who have any concerns about the safe administration of medication to a child — including where an error or a “near miss” may have occurred or where another incident may have occurred that might represent a risk — should raise their concerns with their line manager or supervisor and with the leading health or social care professional involved with a child, young person or family.
The safety of any child receiving care is paramount, including safety from any misuse of medicines by any person (such as agency staff, other health or social care professionals or by the child’s parents, guardians or family, etc) — {{org_field_name}} will take all possible action to safeguard children and young people from such risks by training home care staff to report any concerns and by explicitly linking its medicines management safeguards with its wider safeguarding children processes.
Care workers involved in providing support for a child taking medication, while they will be trained to have a competent working knowledge about medicines and their administration, should not be expected to make any clinical judgements or decisions about medicines and must have access to advice from a pharmacy professional or another appropriate health care professional.

This policy applies wherever {{org_field_name}} has agreed to support a family or child in taking medicines, including prescribed medicines, over-the-counter medicines and those to be taken (as required).

Training and Supervision

This agency recognises that assistance with medication administration to a child or young person in their own home requires careful training, supervision, governance and assurance of competency of the care worker. This will ensure that care workers have the necessary skills and knowledge to carry out their role safely and know when to seek advice.

In this agency the following applies.

All new care staff will receive training as part of their induction covering relevant information about common medicines and how to recognise and deal with medication problems or issues.
Those who will be involved in supporting medicines administration for children or young people in a domiciliary home care setting will have additional training to the level required by their roles and responsibilities.
Only staff who have been assessed as sufficiently skilled and competent will be designated to assist with supporting medicines administration for children or young people in a domiciliary home care setting.
All training will reflect up-to-date, evidence-based guidelines.
Where relevant, training will be carried out by healthcare professionals from partner organisations.
Care staff will be expected to attend refresher training and additional training as required in order to keep up to date.
Any care staff member who is involved in supporting parents/guardians in giving medication to their children will be provided with adequate and ongoing supervision.
Records will be kept of all medicines administration training and supervision.

Care staff in this agency should never undertake any duties or roles for which they have not been trained or for which they do not feel competent. Staff must at all times work within the bounds of their role, training and competency. If they have concerns they should talk to their line manager or supervisor. All staff in this agency are trained in children’s safeguarding and have the appropriate checks.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

Next Review Date: {{next_review_date}}

D338. Childrens Medication in Domiciliary Care