Chapter Contents
- Delegated Authority – Consent to Medical Treatment
- First Aid
- Medication – Information, Rules and Guidance
- Infectious Diseases
- Hospitalisation
- Death of a Child
Delegated Authority – Consent to Medical Treatment
The child’s placement plan will outline decisions that you are able to make as a foster parent. This is called ‘delegated authority’ and includes health and medication. The placement plan will state whether you can, for example:
- Give the child medication
- Sign a consent form for emergency and planned medical procedures
- Consent to the chid receiving routine vaccinations
- Consent to dental treatment
If the child needs medical treatment that you are not allowed to consent to then the doctor will contact the child’s local authority for consent. Hospitals have their own emergency procedures to ensure a child is treated without consent if necessary. Report all incidents to ISP as soon as possible.
If the child is over 16 they will usually be able to make their own medical decisions. A young person under 16 can request to make their own medical decisions and will be assessed for ‘Gillick competency’. This assessment is carried out by the health professional, e.g. the young person’s GP or a registered nurse at a young person’s sexual health service and considers their:
- maturity
- intelligence
- ability to make decisions and manage things like peer pressure, their family’s opinion and their own fears
- ability to consider the implications of their decisions
The child might be considered competent to make some decision but not others, depending on how serious the health problem is.
A young person who consents to their own medical treatment can request that certain aspects of their health be kept confidential between themselves and the health practitioner, and not shared with you or their social worker.
Read about delegated authority in Part 2 of the Foster Parent Handbook.
First Aid
Every fostering household should have a first aid kit for the treatment of minor injuries. Please keep an additional kit in each vehicle that children travel in.
The first aid kit should contain plasters and dressings to deal with minor injuries, for example:
- Alcohol-free cleansing wipes
- Plasters – a variety of sizes
- Micropore tape
- Crepe rolled bandages
- Burn dressings
- Gauze dressings (small, medium and large)
- Disposable gloves
- Safety pins
- Tweezers
The first aid kit should not contain any medication, and it does not need locking away. Store all medication securely, in line with the young person’s risk assessment.
Complete the mandatory training course: First Aid.
Medication – Information, Rules and Guidance
- Always read the information leaflet for details of possible side effects
- If the young person is taking any prescribed medication, check with a pharmacist that it is safe to give them any over-the-counter medicines.
- Prescribed medication is only for the child whose name is on the label. Never give it to another child, even if they have similar symptoms.
- Check expiry dates, especially on over-the-counter medicines.
- Do not crush tablets or open capsules unless a doctor or pharmacist has indicated that it is safe to do so.
- Consult your GP if a child needs over-the-counter medicine for more than 48 hours.
- Do not give aspirin to young people under the age of 12 years unless it has been prescribed
- Give paracetamol or ibuprofen. Don’t give both at the same time, unless a doctor has advised you to.
- Do not give vitamin supplements or homeopathic remedies without consent from the child’s social worker.
- Keep a record of all medication given, on CHARMS (see ‘recording’ section above)
Managing problems
If a young person experiences side effects from medication, seek medical advice straight away. Do not discontinue the medication without instructions from the doctor or pharmacist, unless the child has had a severe reaction. Severe reactions include:
- difficulty breathing
- tingling sensation in the lips or mouth
- swelling to the lips, eyes, hand, face or body
- reddening of skin or blotching
In the event of a severe reaction, dial 999, reassure the child and keep them calm and notify ISP at the earliest opportunity, ensuring that the child is safe first.
In the event of a medication error (e.g. incorrect dose given, or incorrect medication given), contact the pharmacy and/or doctor and follow their instructions. Report the incident to ISP at the earliest opportunity, making sure that the child is safe first.
In an emergency, phone 999 and follow these general guidelines while waiting for help to arrive:
- Put the patient in the recovery position if possible. However, if they have fallen from a height, do not move them
- Try to find out what has happened in order to inform the emergency services
- Do not try to make the patient sick if they have swallowed something
- Observe the patient and keep them calm, warm and quiet
Report any serious accident or illness to ISP without delay. We will inform the Local Authority social worker and complete a significant event form.
Safe storage and disposal
Medication should be stored safety – out of reach of children and most likely in a locked cupboard. Your child’s risk assessment will confirm the expectations.
Always store medication in its original packaging. Some medication needs to be stored in the fridge and you may need a small locked box for this purpose.
Always dispose of medication when it reaches its use-by date. Medication should be returned to the pharmacy and never thrown in the bin, poured down the drain or flushed down the toilet.
Complete the mandatory training course: Medicines in the Foster Home. There is an online course that secondary foster parents may take as an alternative. This can be found on Learnative, and is called Medication and Health Care.
For more information, read our policy: Accidents, Illnesses, Medication & First Aid
Infectious Diseases
Infectious diseases are caused by organisms such as bacteria, viruses, fungi and parasites. Some infectious diseases are passed from person to person – these are called contagious diseases. Many infectious diseases can be controlled through routine vaccination in childhood (e.g. Measles, Rubella) and a fostered child’s first health assessment will look at their vaccination history.
You can see the current UK vaccination schedule here.
Advice on managing infectious diseases, including school exclusion times can be viewed here.
Some contagious diseases are passed from person to person through bodily fluids or pregnancy, and some children will have been infected in this way as a result of a parent being infected. This includes a risk of HIV and Hepatitis B. A young person might be tested if there are concerns about infection.
HIV and AIDS
HIV (Human Immunodeficiency Virus) is a virus which damages the body’s immune system and weakens its ability to fight infections and disease. There is no cure for HIV, but there are treatments which help most people with the virus to live a long and healthy life. AIDS is the final stage of HIV infection, when the immune system has lost the ability to fight illness. Most people with HIV infection today will not go on to develop AIDS.
HIV is transmitted through blood, semen, vaginal and anal fluids, and breast milk. Transmission is therefore possible through unprotected sex, pregnancy and childbirth, breastfeeding and using contaminated needles and syringes. HIV is not transmitted through sweat or urine nor normal contact and activities, e.g. coughing, sneezing, kissing, hugging or sharing bathrooms.
Further information about HIV in childhood can be found at the Chiva website.
Hepatitis B and Hepatitis C
Hepatitis is a term used to refer to inflammation of the liver. There are several different types of hepatitis virus – you can read about them all on the NHS website.
Hepatitis B and Hepatitis C are both contagious and passed from person to person through blood, semen and other bodily fluid. Children may become infected during childbirth if their mother is infected. Hepatitis is not spread by normal daily contact, coughing, sneezing, kissing, hugging, holding hands or sharing a bathroom.
Children with Hepatitis B and C often have no symptoms. Symptoms that can occur include fatigue, aches and pains, jaundice (yellowing of the skin and eyes and dark urine), nausea, vomiting, itching and loss of appetite. Long-term infection can cause liver damage which is more severe with Hepatitis B. For this reason, infected children will need specialist treatment.
Confidentiality
A child’s HIV/Hepatitis status is confidential and should only be disclosed on a need-to-know basis, in the interests of the child.
The child and those with parental responsibility should always consent to disclosure.
Infection control
The following hygiene and infection-control procedures should be used in all homes. We may be aware of some infections and not others, and these procedures can help reduce the risk of any infection begin transferred.
- Do not share towels, face cloths, razors or toothbrushes.
- Cover minor cuts with a waterproof plaster.
- Wrap sanitary products and nappies before placing in a bin.
- Clean kitchen and bathroom surfaces with a general household cleaner. Either use a disposable cloth or wash cloths after every use in hot, soapy water and leave to dry fully.
- Surfaces soiled by body fluids should be cleaned immediately with bleach or disinfectant.
- Crockery and cutlery can be shared. Wash after every use with hot soapy water or in a dishwasher.
- Use disposable gloves if cleaning up body fluids, and cover any cuts or wounds on your hands with a waterproof dressing.
- Wash your hands immediately if they come into contact with body fluids.
Young people with HIV or Hepatitis infection should be informed about the importance of using condoms and never sharing needles if they are using drugs.
Hospitalisation
Tell your supervising social worker, or the out-of-hours service, if a child is admitted to hospital. We will inform the child’s local authority and Ofsted.
Going into hospital is frightening and the child or young person is going to experience separation from people they know. In line with the principles of providing a secure base, you should, if possible, stay with and remain available to them in hospital. ISP may be able to provide assistance, if this means additional costs or the need for extra help.
Death of a Child
In the event of the death of a fostered child in your care, this is a summary of whom you should inform and what action you should take. The following procedures are designed to help at a time when everyone may be confused and distressed:
Who to notify
- Contact the relevant emergency services: doctor, ambulance, and police. Dependent upon the action they take, ensure that you know where the child is being taken.
- Immediately notify your supervising social worker, if possible by speaking to them personally. If they are not available, ask to speak to your registered manager, or another manager in ISP. Do not leave a message – insist on speaking to someone as a matter of urgency. If the death occurs out of normal hours you should immediately contact the ISP out-of-hours service.
- ISP will tell the child’s social worker, and children’s services will take responsibility for informing the child’s parents and anyone with parental responsibility.
- ISP is required to inform Ofsted and the Secretary of State of the death of a fostered child, within 24 hours. We/they may request further information, and it may be necessary to conduct a formal review of events before the child’s death. In the event of a sudden death there is likely to be an inquest, which you may be required to attend.
Funeral arrangements
- The child’s social worker will discuss with the parents the arrangements they wish to make about the funeral. Following the death of a child, any legal order on that child is no longer in place and the responsibility returns to the parents. This is a distressing time and sometimes parents and carers can disagree about funeral arrangements. It is the parents’ right to make decisions on these matters.
- Depending upon the parents’ wishes, you may be involved in the arrangements for the funeral.
- Your supervising social worker and registered manager will offer you and your family support and keep you informed of the procedures and the arrangements.
