Medication Administration & Records

JLK staff administer four broadly different types of medication, and each has different rules:

1. Prescription medication (antibiotics, eczema creams, asthma inhalers, etc.)

• Must be prescribed for this child by name.
• Must be in the original packaging with the pharmacy label showing dosage, frequency and child name.
• Requires the JLK Medication Consent Form completed and signed by the parent before first dose.
• Written record per dose given, witnessed by two staff.

2. Non-prescription medication (Calpol, teething gel, sun cream, etc.)

• Must have written parental consent on the JLK Medication Consent Form — specifying brand, dose, conditions.
• Cannot be given just because "Mum said it'd be fine" verbally — we need the form.
• The same two-staff witness rule applies.
• Some — like Calpol — are typically given only if temperature exceeds [CUSTOMISE: e.g. 38.5°C]; check the consent form for the specific trigger.

3. Emergency / life-saving medication (epi-pens, salbutamol inhalers, anti-seizure meds)

• Lives in a labelled bag at the room exit — accessible to all staff in that room.
• Detailed individual healthcare plan from the family's medical team, on file.
• All staff on the room rota trained on use of this child's specific device before they're on shift with them.
• Goes with the room leader on any evacuation.

4. Controlled drugs (rare in early years — e.g. some ADHD medication).

• Separate locked storage, separate controlled-drugs register.
• Manager or DSL is the only staff member who administers.
• Requires specific written consent and prescription documentation.

⚠️ If you're ever unsure which category something falls into, ask the manager BEFORE administering. Not after.

• I can name the four medication categories and the rules for each
• I know prescription medication must be in original packaging with the child's name on the pharmacy label
• I will never give non-prescription medication on verbal say-so — only with the written consent form
• I know emergency medication lives at the room exit and goes with the room leader on evacuation

Every dose follows the same 5 steps. Same shape for paracetamol as for an inhaler. The shape is what catches errors.

Step 1: Check the consent form is in place and current.

• Pull the file. Confirm parent signature within 6 months. Confirm dosage matches what you're about to give.
• For prescription meds, confirm the pharmacy label matches the child's name and the prescribed dose.

Step 2: Two-staff verification.

• Two staff members — together — check: the child's name, the medication, the dose, the time, the route (oral / topical / inhaled).
• One reads aloud, the other confirms. "Eli, paracetamol suspension, 5ml, 14:20, oral." Out loud. Every time.
• If only one staff member is in the room, wait until a colleague is free. Never administer alone unless it's an emergency (epi-pen / inhaler in a crisis).

Step 3: Administer.

• The child is told what's happening in age-appropriate language. "Eli, time for your medicine — one spoon, then a sip of water."
• Never disguise medication in food without explicit consent on the form.
• If a child refuses, don't force. Try once, then stop and tell the room leader; parent is then notified.

Step 4: Record immediately.

• On the JLK Medication Record — child name, medication, dose, time, route, two staff signatures, any notes.
• Recorded before you start the next task. Never "I'll write it up at the end of the day".

Step 5: Tell the parent at pickup.

• Verbally at the door + the parent counter-signs the Medication Record. Same day, every time. No exceptions.
• If the parent isn't doing pickup, manager calls them.

🎯 The five steps in order: Consent · Two-staff check · Administer · Record · Tell parent. Memorise the sequence; it'll save you.

• I can list the 5 administration steps in order
• I will always do the two-staff verbal check before administering
• I will record the dose immediately, not at the end of the day
• I will get the parent's counter-signature at pickup, every time

Medication errors are rare at JLK but they happen in every setting eventually. What separates a good response from a bad one is speed and honesty.

If you gave the wrong dose (too much / too little):

1. Tell the manager immediately — the second you realise.
2. Manager calls NHS 111 (or 999 if symptoms are present) for advice on what to monitor and whether to seek further care.
3. Manager calls the parent immediately — while it's happening, not at end of day. They get the choice about collecting / next steps.
4. Incident form filled in same day. Includes time of error, time of report, time of parent call, action taken.
5. Ofsted is notified within 14 days if the child needed medical attention.
6. Team debrief: what happened, what would prevent it next time. Updated process if relevant.

If you gave the wrong medication (e.g. another child's): same as above, but call 999 if the medication wasn't on this child's consent form — you don't know the interaction risk.

If the child has an allergic reaction:

1. Hives / mild rash only: stop the medication. Tell manager. Manager calls parent and NHS 111. Monitor.
2. Swelling of face / throat / difficulty breathing: this is anaphylaxis. If the child has an epi-pen, administer it (you're trained — this is what the training is for). Call 999. Call parent. The dose order is: epi-pen first, then call, then parent.

If a child refuses the medication:

• Try once gently. If they refuse, stop.
• Tell room leader; they'll call the parent for guidance — sometimes parents will come in to give it, sometimes the dose is skipped, sometimes there's a tip ("hide it in yoghurt" — only with consent).
• Record the refusal on the Medication Record with reason.

If you find medication unsecured (left on a counter, dropped on the floor):

• Pick it up. Lock it in the storage immediately.
• Tell the manager. The "who left it out" conversation happens after the medication is secured.

🚨 The JLK no-blame rule for medication errors: if you make a mistake, telling immediately is the only thing that matters. We have never disciplined a staff member for an honest, immediately-reported error. We have disciplined for cover-ups. Always tell.

• I know the order for a medication error: tell manager → 111/999 → parent → incident form
• I know to administer the epi-pen first, then call 999, then parent, for anaphylaxis
• I will not force medication if a child refuses
• I understand the JLK no-blame rule for immediately-reported errors

Scenario: It's 14:15 in the toddler room. Practitioner Aisha needs to give 4-year-old Maya her 14:30 dose of antibiotics (prescription, on consent form, original pharmacy bottle — ceftriaxone, 5ml).

Step 1 (Consent): Aisha pulls Maya's medication file. Parent signature dated 3 days ago. Dose on consent form: 5ml at 14:30. Pharmacy label confirms Maya's name and 5ml dose. Match.

Step 2 (Two-staff check): Aisha calls room leader Bisi over. Bisi pulls the bottle out. Aisha reads aloud: "Maya. Ceftriaxone suspension. 5ml. 14:30. Oral." Bisi confirms each: "Correct, correct, correct, correct, correct."

Step 3 (Administer): Aisha kneels: "Maya, time for your medicine — one spoonful, then you can have a drink of water if you'd like." Maya takes it. No refusal.

Step 4 (Record): Aisha walks straight to the medication record book on the office shelf, writes the entry, signs. Bisi countersigns next to her.

Step 5 (Parent at pickup): At 17:40 when Mum collects Maya, Aisha is at the door: "Hi Sara — Maya had her 14:30 antibiotic dose at 14:32, all fine, she took it without fuss. Just need your signature on the medication book." Sara signs. Done.

Total time: ~3 minutes across all 5 steps including parent handover. Not a hassle. A routine.

The same scenario gone wrong: Aisha is alone in the room, in a rush, decides to give the dose without finding a second staff member. Reads the bottle quickly, gives 7.5ml instead of 5ml. Notices the mistake immediately when entering it on the record.

What Aisha does: tells Bisi within 30 seconds. Bisi tells the manager. Manager calls NHS 111 — advice: monitor for 4 hours, no medical intervention needed for that overdose level. Manager calls Mum — Mum is grateful for the immediate honesty. Maya is fine. Incident form filled in. Staff debrief that evening: solution is to never administer alone in the toddler room (already the rule, but reinforced).

The error was the wrong dose. The save was the immediate report. No one was disciplined.

Reflection prompt: When was the last time you administered medication and skipped a step ("I didn't bother with the verbal two-staff check — we were busy")? What would happen if you'd misread the dose that day?

• I've reflected on whether I've ever skipped a medication step under time pressure