Supporting Pupils at School with Medical Conditions

Policy details

• Date created - September 2023
• Date reviewed - September 2023
• Date approved - October 2023
• Next review date - September 2024
• Policy owner - Charlotte Millea

Supporting Pupils at School with Medical Conditions Policy

Rationale

Co-op Academy Delius will ensure that pupils can all participate in ‘Safe, Happy, Learning’. Many of our pupils are likely to have medical needs which mean that additional measures are required to ensure that they have full access to the curriculum. As a school Co-op Academy Delius’ priority is to provide each child with the best possible outcomes including for those pupils who remain at home because of implications due to their pre-existing health conditions.

Aims

Our school aims to:

• Provide a safe and secure environment for all students
• Assist parents in providing medical care for their children
• Educate staff in respect of special medical needs
• Adopt and implement any national or LA policies in relation to medication in schools
• Ensure training is up to date for providing medical support
• Liaise as necessary with medical services, parent/carers, in support of the pupil
• Keep medicines and drugs in appropriate locations relative to their purpose ( e.g inhalers with the pupil and Buccolam upstairs/downstairs)
• Accurately record all medications taken into and out of school
• Ensure that we are up to date with any guidance linked to COVID-19

Safeguarding Procedures

Safeguarding Procedures are supported by rigorous selection and recruitment procedures including DBS checks. If a staff member notices any unexplained marks during close contact or have any safeguarding concerns these must be reported to the designated person in school responsible for Safeguarding. These concerns should be reported without delay. The Designated Safeguarding Lead and a team of Designated Safeguarding Deputies can be identified via the flowchart which is visible around school and on the website.

No staff member will be permitted to work alone with a child until they have undergone a Disclosure and Barring Service (DBS) check

Medical/health care plans

When a child has a medical condition, this is discussed with the school nurse as part of the admissions process and the initial health care assessment. If a child develops a new condition, the school nurse would be alerted. They would inform the care team and instigate a care plan, if required. These are written and monitored by health professionals and reviewed when required (usually annually). School staff will raise queries if needed to ensure the safety of pupils. Care plans are carried around school in a ‘care plan bag’ to ensure quick access to the documents if required.

When a new care plan is received into school, they will be given to Charlotte Millea (Deputy Head Teacher) to sign. The information regarding this care plan will be entered into the care plan spreadsheet by Elizabeth Shields. Elizabeth then makes copies of the care plans which are put into the class care plan file, the office file and the swimming pool. If the new care plan is a replacement to an old care plan, Elizabeth will shred the old versions.  Staff are not permitted to make copies of the care plans.

Training

Staff at  Co-op Academy Delius have  First  Aid  Qualifications.  First Aid  kits  are  in  in  every classroom and other main areas e.g. Reception office, kitchen , pool etc

Staff are also trained in procedures relevant to the pupils’ needs in their class and across school, wherever possible and within agreed guidelines. There will always be staff members present in school who can attend to individual medical needs, within these guidelines. Sarah Kelly as cover lead will ensure that pupils' medical needs are supported if there are staff absences. Staff in classes are all ‘care plan aware’, and any supply staff will be briefed accordingly.

The recording of training is kept on a spreadsheet. This training information is kept up to date by Elizabeth Shields. Staff will be alerted via email when their training is due to run out. Training is arranged by Caroline Hellewell and most training is facilitated or sourced by School Nursing Special Needs.

The care team and SLT will make every possible effort to match staff with pupils at the beginning of the academic year. However, due to changes to pupil need, additional training can be requested via the SNSN training request form. See appendix 1.

Medicines policy

Schools should only accept medicines that have been prescribed by a doctor, dentist,nurse prescriber or pharmacist prescriber. Medicines should always be provided in the unopened original container as dispensed by a pharmacist and include the prescriber's instructions for administration with the pupils’ name clearly marked. The only exception to this rule is for pupils who receive ongoing, daily antibiotics, as their medicine will come to school in an unopened container.

Delius staff should never accept medicines that have been taken out of the container as originally dispensed nor make changes to dosages on parental instructions.

Consent Forms

Consent forms provide the first aider with all necessary information which is required before any medicine is administered. The consent form must be read each time a medicine is given. The only exception to this rule is buccolam/diazepam which is an emergency rescue medicine. The care plan and seizure charts contain all of the information that is required in order to administer this medicine.

When administering medicines the trained person MUST ensure that the 4 elements are in place:

• Child
• Consent form (to make sure that correct dosage and route are adhered to)
• Medicine
• Sign to say it has been given

THE CHILD MAY BE TAKEN TO THE CONSENT FORM OR THE ORIGINAL CONSENT FORM MAY BE BROUGHT WITH THE MEDICINE TO THE CHILD.

IF ORIGINAL CONSENT IS TAKEN TO THE CHILD IT MUST BE RETURNED TO THE NURSE’S FILING CABINET. It is the responsibility of the nursing team to give updated versions of the consent forms (via Delius Care Team) to classes when this occurs.

Staff must ensure that they sign to say that they have given medicine after they have done so. This will be completed in the ‘as required medicine book’ kept in the nursing filing cabinet. This is essential to ensure that the school nurse can keep consultants informed about any changes to pupils’ needs.

Controlled Drugs (buccal midazolam, diazepam)

• The supply, possession and administration of some medicines are controlled by the Misuse of Drugs Act and its associated regulations.
• Only staff who have the relevant training may administer a controlled drug to the child for whom it has been prescribed. Staff administering medicine should do so in accordance with the pupil’s care plan
• Delius school keeps controlled drugs in a double locked cupboard and only named staff have access Key people are to sign medication in and out of the book these people are; Elizabeth Shields, Sarah Kelly , Cathy Alred, Caroline Hellewell.
• When taking controlled drugs out on a trip, this medicine will be signed out by the first aider who is carrying the medicine, but to be co-signed by one of these key people
• A record is kept for audit and safety purposes
• A controlled drug, as with all medicines, should be returned to the parent when no longer required to arrange for safe disposal
• Misuse of a controlled drug, such as passing it to another child for use, is an offence
• Whoever signs out the controlled drugs on trips etc. is responsible for these medicines and needs to keep them on their person/with them at all times
• Delius will ask that parents inform school if they have given buccolam/diazepam in the previous 12 hours.

Inhalers

 Can be kept in close proximity to the child in order for them to be accessed quickly

• Should be taken to areas around school with the child
• Should be kept with the spacer, if one is required
• Inhalers will be administered according to the care plan and by trained persons
• Inhalers can be only be given to a child if they have a care plan
• Once an inhaler has been administered it is crucial that staff sign to say that it has been given (in the ‘As required book in the Nurse’s office)

Epipens

• Should always be kept near by the child – out of reach of children
• Should be carried around school
• Epipens should be in labelled container with name and photo of the child

Non-prescription medicines

Staff should never give a non-prescribed medicine to a child.

Short term medical Needs

Any medications administered must have had a consent form filled in by the parents as provided by the school nursing team.

Antibiotics  can  and will  be  administered  by  a  trained  person when a consent form is signed by parents and only when they require the medicine four times daily

Receiving medicine into school

• It is the responsibility of the class team to check bags each day for any medication which parents may send into school
• All rescue medication must be signed in by the designated staff (see above)
• Medication can not be given unless there is a consent form in place, which has been signed by a parent
• All regular medication is logged on the spreadsheet by Elizabeth Shields
• Elizabeth Shields will also alert the cover team to any changes to pupils’ conditions to ensure that pupils' needs continue to be catered for

Storing Medicines 

Large volumes of medicines should not be stored. Staff should only store, supervise and administer medicine that has been prescribed for an individual child. Medicines should be stored strictly in accordance with product instructions (paying particular note to temperature) and in the original container in which dispensed. Staff should ensure that the supplied container is clearly labelled with the name of the child, the name and dose of the medicine and the frequency of administration. Medicines are only accepted in the original container as dispensed by a pharmacist in accordance with the prescriber's instructions. Where a child needs two or more prescribed medicines, each should be in a separate container. Non- healthcare staff should never transfer medicines from their original containers.

The head is responsible for making sure that medicines are stored safely. Emergency medicines, such as asthma inhalers and adrenaline pens, should be readily available to children and should not be locked away. Emergency medicines to be kept in a secure place not accessible to children. A few medicines need to be refrigerated. They should be kept in the locked refrigerator in the nurse’s room.

Access to Medicines

Children need to have immediate access to their medicines when required.

Disposal of Medicines

Staff are not to dispose of medicines. Parents or the school nurse are responsible for ensuring that date-expired medicines are returned to a pharmacy for safe disposal.

Sharps boxes should always be used for the disposal of needles. Collection and disposal of the boxes should be arranged with the Local Authority's environmental services.

Pupils who are fed via gastrostomy or jejunostomy

Dietician plans must be followed at all times. The ‘feeding records’ are to record the feeds, not to inform of dosage and rate (always look at the feeding plan). If staff have any queries whatsoever, they should see Cathy Alred, Caroline Hellewell or Liz Shields; these are the only staff who are permitted to call dieticians regarding a feeding plan query.

Hygiene And  Infection Control

All staff should be familiar with normal precautions for avoiding infection and follow basic hygiene procedures (see Hygiene and Close Personal Contact Policy). Staff should use protective disposable gloves and aprons and take care when dealing with spillages of blood or other body fluids and disposing of dressings or equipment. In the event of CPR, the first aider will use a face shield.  

General Data Protection Regulations

The safety of our pupils with care plans and other medical records is paramount. However, we have systems in place to ensure that General Data Protection Regulations (GDPR) are adhered to. All classes have a copy of their pupils’ care plans which are stored within a red file in a locked cupboard. During school hours, class teams must keep the care plans close to hand. If the care plans need to travel with the child or group, they will travel in a designated bag. Each class has a care plan checking sheet which is checked at the end of each day to ensure that all care plans are present. Elizabeth Shields or Caroline Hellewell. checks that all care plans are in place each Friday and records her findings via a google form.

Key First Aiders Protocol (Updated 2023)

Emergency Procedures - Key First Aid

We have introduced Key First Aiders in school. These people are:

• Sarah Kelly
• Liz Shields
• Caroline Hellewell
• Lorraine Sanderson
• Cathy Alred
• Carla Illingworth

Key first Aiders must liaise with each other if they are leaving the building

These people MUST be called when a child becomes seriously unwell – for example, at the beginning of a seizure for a non epileptic, allergic reaction, if they stop breathing, or administration of buccolam.

How to call upon a Key First Aider  

If there is an emergency, you need to summon help immediately using a radio. There is a script that will be followed.

 ‘Could a Key First Aider Come to Room X, could a key first aider come to room X’.

It is essential that you radio immediately and repeat the message clearly.

The Key First Aider should respond using a radio by saying ‘xxxx is on their way’

The office staff will listen out, if they notice that the request has been made twice without response, they will use the Tannoy to request help.

This process will trigger the involvement of a member of the Senior Leadership who will say  ‘Let xxx if you need SLT’.

Nurses may be called to observe where appropriate.

What happens when the Key First Aider arrives?

The Key First Aider may ask people to leave or may ask for assistance to move the child to somewhere more discrete

The Key First Aider may request a second (specific) first aider to come to support

What is the role of a Regular First Aider?

The introduction of Key First Aiders is to support all first aiders when medical situations become more serious. Regular first aiders should help with minor incidents. They can also administer rescue medication but only with the support of the Key First Aiders. First aiders may be asked to collect consent forms and medicine or rescue medicine whilst the Key First aiders wait with the child.

The rest of the team in class have an essential role in class

It is appreciated by the Key First Aiders, that some class team members may have close working relationships with pupils and that it can be distressing for everybody involved when there is a medical emergency. However, it is essential that the Leader of Learning supports the rest of the children by continuing with teaching. This may need to happen elsewhere and  this may require more help to change location around school.

When should a member of SLT be called?

A member of SLT should be requested when:

• Rescue medication will be administered
• A child is seriously unwell
• The staff need support

What is the role of the Head Teacher or (other member of SLT)

The head teacher (other member of SLT) will attend the incident when requested  to act as a support and a witness.

What is the role of the Head Teacher or (other member of SLT) in the event of a child requiring rescue medicine

The SLT member will ask the following questions as a script for administering medicines:

• Do you have the medicine for the correct CHILD?
• Do you have the CONSENT form or care plan for administering buccal midazolam?
• Do you have the correct medicine and is it out of date?
• Please can you tell me the dose you are going to administer?
• What route are you going to administer the medicine?
• If the situation becomes better, the head teacher will leave, ensuring that the class is safe (for example more staff may be required in class, if the child is in need of closer monitoring

What is the role of the Head Teacher or (other member of SLT) in the event of an ambulance being required

• If an ambulance is required, they may be the most appropriate person to talk to the operator
• If this call takes place, the severity of the child’s needs (i.e Profoundly disabled child) must be relayed
• The head teacher will ensure that the office know if an ambulance has been called and for what child, they will also request that parents are informed
• The head teacher may, where appropriate, look at the care plans and ask questions of the treatment/first aid given
• If parents are coming to school and the situation is very serious, the head teacher may feel that it is appropriate to meet the parents at the reception
• Decide who will go in the ambulance with the child and ensure that cover arrangements have been considered
• If a child goes to hospital in an ambulance, the Serious Incident Book will be filled in by the member of SLT in charge
• If a child is gravely ill and parents are being met at the hospital the head teacher may decide to make arrangements for extra Delius presence at the hospital (for example a member of SLT to travel in their car separately)
• Extra consideration would be given in this case as to which member of staff would travel with the child in the ambulance
• The head teacher will ensure that all parts of this plan are delivered effectively by overseeing or directing staff as required (not medically)

What is the role of the business support team if an ambulance is called

• If there have been unanswered radio calls for a Key First Aider, they must use the tannoy to convey the message
• If an ambulance is called, the office will ask if parents need to be contacted
• The medical information will be photocopied and stamped for GDPR purposes and taken
• to the child when the paramedics arrive
• One member of office staff will man the main barrier and another will await the
• ambulance arriving
• The paramedics will be signed into school
• The paramedics will be escorted to the child
• Ensure staff accompanying children are given the school taxi phone number to call to return to work/home
• Complete the serious incident book

Defibrillator

A de-fib which is kept in the central office. If it is required at the scene of an emergency a radio call will be made saying:

‘Please could the orange box be brought to (location), please could the orange box be brought to (location). Someone from the office will then bring the de-fib to the location.

Before and after school clubs, activities and educational visits

It is good practice for schools to encourage children with medical needs to participate in safely managed visits. In situations where the group may be separated, such as transition visits, pupils must travel with a familiar member of staff. Sometimes additional safety measures may need to be taken for outside visits. It may be that an additional support assistant might  be needed to accompany a  particular child.

Arrangements for taking any necessary medicines  will also need to be taken into consideration. Staff supervising excursions should always be aware of any medical needs, and relevant emergency procedures. Health care plans should be taken on visits in the event of the information being needed in an emergency. These care plans should be the class copy and should be signed in and out of school using the class tracking sheet. Staff must take into consideration any pupils who have daily medication and ensure that a person trained in administration of medicines attends the trip.

Medications should be kept with a trained member of staff at all times. Children should not be taken far away from their medication (for example, to the other end of a supermarket). There is not an expectation that Key First Aiders go on trips. Risk assessments should include medical conditions.

Inclusion Visits  

Pupils who visit co-located schools and require emergency medication must travel with a trained member of staff who carries the care plan along with the medicine in a safe bag (for example a bum bag).

Unacceptable Practice:

Governing bodies should ensure that the school’s policy is explicit about what practice is not acceptable.

Further advice: Although school staff should use their discretion and judge each case on its merits with reference to the child’s individual healthcare plan, it is not generally acceptable practice to:

• prevent children from easily accessing their inhalers and medication and administering their medication when and where necessary;
• assume that every child with the same condition requires the same treatment;
• ignore the views of the child or their parents; or 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 school activities, including lunch, unless this is specified in their individual healthcare plans;
• if the child becomes ill, send them to the school office or medical room unaccompanied or with someone unsuitable;
• penalise children for their attendance record if their absences are related to their medical condition, e.g. hospital appointments;
• prevent pupils 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 school to administer medication or provide medical support to their child, including with toileting issues. No parent should have to give up working because the school is failing to support their child’s medical needs; or
• prevent children from participating, or create unnecessary barriers to children participating in any aspect of school life, including school trips, e.g. by requiring parents to accompany the child.

Reference to Government Legislation: Supporting Pupils at School with Medical Conditions

Appendix 1

Training Request Form