1. Wendy Bagnall Medicines Management Technician Walsall tPCT

2. Outcome 9: Management of Medicines The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, safe keeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity.

3.  People who use services receive care, treatment and support from staff who:  Ensure they make a record of any medication taken or reminded by the person using the service where this is part of the plan of care.  Follow clear procedures, that are monitored and reviewed, that explain: ◦ their role with regards to helping people take their medicines ◦ what staff should do if the person using services is unable, or refuses, to take their medicines

4.  A clear comprehensive written medication policy must be available to support care workers. It should include: ◦ When the care worker may prompt medication or administer medication ◦ The limitations of assistance with prescribed and non prescribed medication and which tasks the care worker may not undertake without specialist training

5. ◦ Requesting repeat prescriptions. ◦ Collecting prescriptions and dispensed medication. ◦ Procedure for administration. ◦ Records of procurement, administration & disposal. ◦ Procedure for removal of unwanted medication. ◦ Procedure to deal with medication error.

6.  The following should be documented in the persons care plan ◦ The nature and extent of help that the person needs. ◦ A current list of prescribed medicines for the person including the dose and frequency of administration; method of assistance; and arrangements about the filling of compliance aids if these are used

7. ◦ Details of arrangements for medication storage in the persons home and access by the person, relatives or friends ◦ A statement of the persons consent to care worker support with medication.

8.  Three levels ◦ Level 1- General Support or Assisting with Medicine ◦ Level 2- Administering Medication ◦ Level 3- Administering Medication by specialised techniques.

9.  Person takes responsibility for their own medication  Support MAY include ◦ Requesting repeat prescriptions ◦ Collecting medicines ◦ Disposing of unwanted medicines ◦ Occasional reminder or prompt to an adult to take their medicines ◦ Manipulation of a container. E.g. opening a bottle or popping tablets out of a blister pack.

10.  The person is assessed and is identified as being unable to take responsibility for their medicines  The need for medication to be administered should be recorded in the persons plan  The person must agree to have the care worker administer medication and the consent must be documented

11.  When the care worker selects and prepares medicines for immediate administration, including selection from a monitored dosage system or compliance aid.  When the care worker selects and measures a dose of liquid medicine for the person to take  When the care worker applies a medicated cream/ ointment; inserts drops to ear, nose or eye and administers inhaled medication

12.  When the care worker puts out medication for the person to take themselves at a later (prescribed) time to enable their independence  Only competent and confident staff should be assigned to people who require help with their medicines.  Care workers should only administer medication from the original container. This includes MDS and compliance aids

13.  Care workers can administer medication by a specialist technique in exceptional circumstances but only if they have been trained and assessed by a healthcare professional.  The agency’s procedures must include that care workers can refuse to assist with the administration of medication by specialist techniques if they do not feel competent to do so.

14.  There is no requirement for patients receiving support through a Care Agency in their own home or in Extra Care Housing to have their medication dispensed into a MDS  Use of the MDS system should be decided by an assessment of the patients needs through DDA (Disability Discrimination Act 1995)

15.  Although domiciliary staff may be asked to ‘select and prepare medicines for administration from a monitored dosage system or compliance aid’ this does not mean that they are not allowed to administer medication from original containers. As long as the care worker has been fully trained in medicines administration and feels themselves competent to do so then they are able to administer medication from the original packs

16.  Training for domiciliary care staff must be at least to the same standard as for care workers in a care home  The domiciliary care agency should provide a training package that will meet both the needs of care workers and service users,

17.  How to prepare the correct dose of medication for ingestion or application  How to administer medication that is not given by invasive techniques, including tablets, capsules and liquid medicines given by mouth; ear, eye and nasal drops; inhalers; and external applications

18.  The responsibility of the care worker to ensure that medicines are only administered to the person for whom they were prescribed ◦ Right dose ◦ Right time ◦ Right method/ route  Checking the medication use by date has not expired

19.  Checking the person has not already been given the medication by anyone else, including a relative or care worker from another agency  Recognising and reporting possible side effects

20.  Reporting refusals and medication errors  How a care worker should administer medicines prescribed ‘as required’ e.g. pain killers or laxatives  What care workers should do when people request non- prescribed medicines  Understanding the service providers policy for record keeping.

21.  It is the Care Providers responsibility to ensure that staff have the correct training and are confident and competent to assist with or administer medication.  Guidance on training can be found on the Skills For Care website www.skillsforcare.org.uk

22.  Bharat Patel Head of Medicines Management Walsall tPCT ◦ bharat.patel@walsall.nhs.uk bharat.patel@walsall.nhs.uk ◦ Tel. 01922619908  Wendy Bagnall Medicines Management Technician ◦ Wendy.bagnall@walsall.nhs.uk Wendy.bagnall@walsall.nhs.uk