Duty of Care for First Aiders and Staff Administering Medication

The Duty of Care of school staff to pupils and students is a fundamental aspect of best practice. The people who undertake these important roles, often do so voluntarily and provide an essential service to the school community with is much valued. These roles come with a high degree of responsibility, so understanding the associated duty of care needs to be carefully considered.

It is essential for school staff taking on responsibility as first aiders and administering medicine to pupils to understand that they have a duty of care to ensure that children’s health and safety needs are met. By undertaking these roles they are committing to undertaking the responsibility to make sure that they provide quick and effective actions to medical emergencies, have up-to-date training, including first aid certification, and make sure that medicines and equipment are correctly managed, stored and recorded.

To fulfil this role, it is also imperative staff understand the importance of effective and regular communication with parents and carers, as well as the maintenance of confidentiality and diligently follow policies and procedures to ensure the prevention of harm. An example of this is providing parents with ‘bumped head’ letter which clearly informs parents that their child has received first aid and what they need to be mindful of when the child goes home.

Here are my top tips to help guide everyone working in educational settings:

Key Responsibilities of First Aiders

1. Responding quickly: In the event of a medical emergency, first aiders must respond quickly and efficiently in providing immediate care, preventing any further injury or complications.
2. Training: Training must be fully compliant and certificated to the role, including the use of interventions e.g. CPR and how to use any needed medical equipment.
3. Maintaining and Storing Supplies: Ensuring that first aid kits and medical supplies are well-stocked and regularly checked for expiry dates and that all medicines are correctly stored in a secure location, including refrigeration where required.
4. Record keeping: All incidents and treatments performed must always be documented. These records should include; the date, time and location of the incident, the nature of the injury, the treatment provided and any further actions that were taken.
5. Communication: All relevant people should be informed following the administering of any first aid- parents/ carers, the school admin and any other named people as per your school policy and procedures.
6. Confidentiality: Maintaining the confidentiality of the individual receiving first aid, only sharing information with those who need to know.

Key responsibilities for Staff Administering Medicines in Schools

1. Authorisation: All medicines that are administered must have signed authorisation from the pupil’s parent or carer. For medicines which are only available on prescription, these will only be administered if prescribed by a medical professional e.g. hospital consultant, GP, nurse practitioner and clearly labelled for the intention of the pupil.
2. Ensure Correct Dosage: The correct dosage of medication should always be given at the correct times and always follow the instructions provided by the medical professional or as indicated on the medication.
3. Secure Storage: Make sure that all medicines are stored securely and in a safe place to ensure any misuse or accidental use by any other persons. This includes refrigeration where necessary. Safely storing medicines in a secure, appropriate environment to prevent misuse or accidental ingestion by other students.
4. Record keeping and monitoring: make sure all records of medicines administered are fully recorded, including the time administered, dosage given and any observations of the pupil’s response to the medication.
5. Training and Proficiency: Make sure that all persons administering medications are fully trained and proficient. They must also understand the potential side effects and what to do in the case of an adverse reaction.
6. Prepared for Emergencies: Ensure that there is an emergency action plan in place that all staff understand and can follow in any case where there is an adverse reaction or medical emergency.
7. Consent: Schools must always have parental consent before dispensing any medication. This ensures safety and gives legal protection to the school and staff. This should be reviewed regularly, at least annually, but will depend on the specific needs of the child. It is important for schools to work closely with parents to make sure a child’s healthcare plan is up to date and still reflects their needs. Consent should include the child’s information (name, date of birth, class), medication details (name of medication, dosage, time to be administered and method), medical condition (including any known allergies or adverse reactions) and the parental information (full name, contact information and emergency contact details) This must be documented and kept.
8. Confidentiality and Privacy: Ensure that pupil’s medical information is treated with privacy and confidentiality, and only share such details with those who need to know.

Legal and Moral Responsibilities

Further to the practical steps, it is also important to understand the legal and moral responsibilities associated with Duty of Care.

Legal Responsibilities

1. Following the Law: Ensure compliance with all the relevant laws and regulations with regard to first aid and medicine administration, including health and safety regulations.
2. Follow Policy: Ensure that all school policies and procedures are followed and all actions are in line with these policy and procedural guidelines.
3. Proper Authorisation: Ensure that all medicines administered are authorised by a parent or carer and, where appropriate, prescribed by a medical professional.
4. Record Keeping: To ensure legal protection and continuity of care, keep detailed and accurate records of all incidents, treatments, and medications administered. Well-kept records help to ensure precise dosage and monitoring for potential side effects and help to avoid ‘near miss’ administration ( A near miss in medicine administration refers to an event that could have resulted in patient harm but did not, either by chance or through timely intervention)
5. Secure Storage: Ensure all medicines are stored in a secure environment to prevent misuse or accidental use and maintain the integrity of the medication for use.

Moral Responsibilities

1. Integrity and Honesty: Ensure that all interactions are conducted with honesty and integrity, helping to ensure transparency and build trust with pupils, parents/carers and other staff.
2. Respect and Fairness: Ensure that everyone is treated with fairness and respect, and without any discrimination or bias
3. Confidentiality and Privacy: Ensure all medical information is treated as private and maintain confidentiality, only sharing information to those who need to know.
4. Proficiency: Ensure correct training is given, including regular refresher training, to ensure proficiency in the role. Seek additional help if or when necessary.
5. Emergency Readiness: Ensure an emergency action plan is in place and be ready to effectively implement in the case of a medical emergency.

What are the Consequences of a Breach?

A breach of duty of care is a failure and to avoid to take reasonable care to prevent harm or loss to another person. For first aiders and those administering medicines any failure not to meet their duty of care could lead to serious consequences, such as legal, professional or even personal consequences. Such consequences could include lawsuits and fines in a legal context, whilst professional consequences could include loss of certification and reputational damage. Personal consequences could include emotional and financial stress.

Breaches can also lead to increased scrutiny of the school by authorities such as Health and Safety Executive (HSE) and / or the local authority, leading to a review of all policies and procedures. For pupils and students, a breach involving medical care could be extremely severe, even leading to death. By having and adhering to effective policies and procedures, with regular comprehensive training and diligent record keeping, then the risk of any breach is minimised.

Monitoring and Evaluation

As with any area of practice, it is essential to monitor and evaluate duty of care practice. This should include:

• Regular Audits and Inspections:
• Perform routine checks of first aid supplies and medication storage.
• Conduct regular safety inspections.

• Record-Keeping:
• Keep detailed records of incidents and medication administration.
• Keep updated training records for all relevant staff.

• Feedback:
• Conduct surveys and/or feedback forms from pupils, parents/ carers, and other relevant staff.
• Conduct regular reviews to address any feedback or concerns.

• Training:
• Ensure there is regular ongoing training and refresher courses.
• Assess staff proficiency regularly through evaluations.

• Policy and Procedure Reviews:
• Conduct annual reviews of policies and procedures.
• Analyse incident records and identify any trends, updating practices accordingly.

• Monitor Practice:
• Perform unscheduled observations to review competency and include first aid duties in any performance management system.

• Emergency Response Drills:
• Organise regular emergency drills, followed by debriefing sessions to improve response times and effectiveness where necessary.

First Aiders and administrators of medicines play a crucial role in safeguarding pupil and staff health and safety. Their Duty of Care is essential to maintaining a safe and healthy environment. By upholding this Duty of Care by quickly and effectively responding to medical emergencies and incidents, being properly trained with regular refreshers, and ensuring comprehensive record keeping, as well as ensuring correct authorisation and communication is in place, they will effectively meet all their legal and moral responsibilities.

Sara Spinks

SSS Author & Former Headteacher