Giving a Foster Child Medicine: What You Are Actually Allowed to Do

Somewhere between reading about fostering and picking up the phone, most people arrive at the same small, awkward question. If a child in my care wakes at two in the morning with a temperature, am I allowed to give her a spoonful of Calpol, or do I have to ring somebody first? The answer is more generous than people expect. This is who decides what, and how to give medicine safely once you are the one deciding.

Please note: general information about medicines and the law in England, correct at October 2026. It is not medical or legal advice about one child. Always follow the prescriber’s instructions, your fostering service’s policy and the child’s placement plan. For doses and ages, start with the NHS guidance on medicines for babies and children.

You will not have parental responsibility, and it matters less than it sounds

A foster carer does not hold parental responsibility. Where a care order is in force, section 33(3) of the Children Act 1989 says the local authority named in the order “shall have parental responsibility for the child”, and the child’s parents usually keep theirs too. You are not on that list. Read cold, that sounds like asking permission to buy a tube of toothpaste, and people decide against fostering on exactly that misreading.

What happens instead is that authority gets handed down to the person doing the caring. Fosterline, the advice service funded by the Department for Education, puts the purpose plainly: “Delegated authority is all about giving children in care as normal lives as possible.” So the real question is not whether you will be allowed to parent. It is which two or three decisions somebody else has reserved, and whether you know what they are before the first Saturday night.

What should be written down before the child arrives

The document that answers this is the placement plan, not the care plan. Schedule 2 of the Care Planning, Placement and Case Review (England) Regulations 2010 says what goes in it, and paragraph 1(3) requires the child’s registered medical and dental practitioners, plus “any arrangements for the giving or withholding of consent to medical or dental examination or treatment”. That last clause decides whether your Sunday night involves a phone call.

The separate statutory guidance on delegating authority to carers was withdrawn on 3 July 2015 and folded into volume 2 of the Children Act 1989 guidance, which still carries an annex on it. Every local authority should also have its own published policy. In practice the detail is agreed at the placement planning meeting, which is where to ask about:

• whether you can give over-the-counter medicine without checking first, and which ones
• who signs for a dental check-up, a vaccination or a routine appointment
• what to do out of hours, and which number to ring
• who holds an inhaler or an adrenaline pen at school, and who is trained to use it
• whether a sleepover or a school trip needs a call, or is simply yours to decide

Ask on day one, while everyone is in the room and feeling helpful. A blank line in a placement plan is not neutral. It becomes a ten o’clock call to an out of hours duty worker who has never met the child, about a dose of paracetamol.

Calpol, inhalers and the most under-used professional in fostering

Once you have the authority, the medicine cupboard runs on the same rules as any other household with children. The NHS says liquid paracetamol can be given to children aged two months or older. Ibuprofen is for children aged three months or older who weigh more than 5kg, and if the child has asthma you should get advice from a GP or pharmacist first. Aspirin should not be given to anyone under 16 unless a doctor has prescribed it, because of the risk of Reye’s syndrome. Never use a kitchen teaspoon, since they vary in size. Never give a child medicine bought or prescribed for someone else, even for the same symptoms on the same day.

And then there is the pharmacist. No appointment, no referral, no fee, usually a ten-minute walk away, and expert on which over-the-counter product suits a six-year-old with a cough. Foster carers ring the duty social worker about things a pharmacist would have settled in four minutes at the counter. For anything more specific, Medicines for Children publishes about 240 free leaflets, written with the Royal College of Paediatrics and Child Health.

Giving it, storing it, writing it down

Fostering services teach a checklist called the six Rs. It belongs in your head, not on a laminated card:

• right person
• right medicine
• right route
• right dose
• right time
• right to refuse

Storage surprises people. Medicine lives in a lockable box, in its original packaging, with the child’s name on anything prescribed. If it needs refrigerating, it goes in a locked box in the fridge. That can feel clinical in a family kitchen. It is the same instinct as the high shelf your own mother used, written down and audited.

Then you record it: what it was, why you gave it, how much, when, how it went in, and anything you noticed afterwards. Your fostering service will have a form. The habit quietly protects you, because a note made at the time beats a confident memory six months later.

If you make a mistake, say so immediately. Ring 111 for advice, or 999 if the child is unwell, and tell your supervising social worker the same day. Never tidy it away. A dosing error you report is an incident that gets managed, and nobody will be shocked by it. One somebody else finds on a chart is a very different conversation. Suspected side effects can also go to the Medicines and Healthcare products Regulatory Agency through the Yellow Card scheme at yellowcard.mhra.gov.uk.

When the child says no

The right to refuse sits inside the six Rs. It is one of the rules, not an awkward exception to them. You do not hold a child down and you do not hide tablets in a yoghurt. If a child refuses and the situation is not urgent, write down what happened and why, then talk it through with your supervising social worker and the child’s social worker.

Older children can decide for themselves. Section 8 of the Family Law Reform Act 1969 makes a 16-year-old’s consent to treatment “as effective as it would be if he were of full age”, and the NHS treats 16 and 17 year olds as able to decide unless there is strong evidence otherwise. Below 16, a child with enough understanding of what is proposed can consent in their own right, which is what people mean by Gillick competence. Refusal works differently: where a young person turns down treatment that might lead to death or severe permanent injury, the NHS says a court can overrule that decision. It is rare, and it will not be you making the call.

Have the conversation early. If the child needs life-saving medicine, agree with your supervising social worker in advance what happens if they refuse it one evening. If that has not happened and you are facing it now, ring 999.

When they are somewhere else

Children spend a lot of their week out of your sight, and medicine travels with them. A school nurse may need to give a lunchtime dose. A football coach needs to know where the inhaler is kept, and that it is the child’s own and in date. Make the arrangement, write it down, and check the school has a copy rather than assuming the social worker sent one.

Trips abroad catch people out. Taking a child in care out of the country needs the responsible local authority’s written consent, and that letter has to be with you at passport control, not in a drawer at home. Book the holiday, then ask for the letter, early.

You won’t have to do this alone

None of this is knowledge you are expected to arrive with. You do not need a medical background to foster, and nobody hands a new carer a child with complex health needs and leaves them to it. Your supervising social worker visits regularly and knows the child’s plan. Someone is on the phone at any hour, including the hour when a child is unwell and you want a second opinion before reaching for the bottle. Training covers safe handling and recording, plus paediatric first aid, and it is refreshed rather than done once.

GLF pays one weekly fee covering allowance and reward: currently 479.50 pounds a week for a child under 11 and 507.50 pounds a week for a child aged 11 or over, with an enhanced fee of roughly 100 to 200 pounds a week more where a child’s needs are higher. You can read more about how fostering pay works, the support carers receive from us, and preparing to welcome a child. If a child has longer-term health needs, our guide to fostering a child with a disability or additional needs goes further. Ofsted inspected us between 21 and 25 July 2025 and rated us Outstanding in all three judgements, which is largely a verdict on how well carers are supported at two in the morning.

Frequently asked questions

Can a foster carer give a child Calpol without asking the social worker first?

Usually yes, where over-the-counter medicine has been delegated to you in the placement plan. That is the sort of everyday decision delegated authority exists to cover. Check the plan at the placement planning meeting, and ask your supervising social worker if it is silent.

Do I need medical training to foster a child with a health condition?

No. You need to be willing to learn the specifics for that child. If a child uses an inhaler or insulin, the training is arranged around them and the people who prescribe it will show you.

What happens if I give the wrong dose by mistake?

Ring 111 straight away, or 999 if the child seems unwell, then tell your supervising social worker the same day and write down what happened. Reporting it is the correct response. The serious problem is a mistake that gets hidden.

Who gives consent for a vaccination or a dental check-up?

It depends on the placement plan and the child’s age. Consent may sit with a parent, with the local authority, or with you where it has been delegated.