The safe handling of medicines in social care settings

Welcome to our webpages which aim to support care providers in managing medicines safely in all social care settings. The information will assist managers to meet the fundamental standards in relation to medicines management. 

If you require information or support on medicines management in social care setting please contact the Medicines Management Team at nyccg.rxline@nhs.net

Did you know?

Guidance has been published to allow the safe re use of medicines between residents living in the same care home or staying at the same hospice in exceptional circumstances. This is includes where a supply cannot be obtained for a person who needs it in a timely manner and the medication is no longer needed by the person it was prescribed for. 

The guidance including the process to be followed is available here https://www.gov.uk/government/publications/coronavirus-covid-19-reuse-of-medicines-in-a-care-home-or-hospice (The guidance may change so always check the website for the latest version.)

Please read this guidance fully to be able to recognise when medication can be used in this way, the records you need to keep and the consents that should be obtained wherever possible.

                   

Management of Medicines

Medicines Administration Record (MAR) Chart.

It is essential in any care setting where medication is administered by staff that a MAR chart is used. The provision of the MAR chart is the responsibility of the care provider (although pharmacies often supply them as a complimentary service).

Example MAR chart for care homes (1)  

Example MAR chart for care homes (2)

Example MAR chart for domiciliary care

Signature list for staff involved in the administration of medicines

Controlled Drugs 

Care homes in North Yorkshire and York should report incidents involving controlled drugs to the Controlled Drugs Accountable Officer (CDAO) at NHS England using the online reporting tool.

Care homes should register and login to the reporting tool at https://www.cdreporting.co.uk/

This does not change the requirement to report incidents to CQC/safeguarding/police as appropriate which should still be done.

Pregabalin and gabapentin became schedule 3 controlled drugs on 1st April 2019. There is no change to storage and recording requirements. Storage in a controlled drug cabinet is not required. Records are not required in a controlled drugs register. For care homes with nursing (nursing homes) only: As pregabalin and gabapentin are schedule 3 controlled drugs it is recommended they should be disposed of in a CD denaturing kit before transfer to the waste company. Residential homes and domiciliary care providers should return them to the pharmacy for safe disposal as previously.

Safe recording templates

Clear and accurate documentation is a fundamental part of safe medication practice. The following forms can be downloaded and used by care providers. Click on the title to download the document.

Supplementary information (Protocol) about when required and variable dose medication – It is essential that staff administering medication prescribed to be taken ‛when required’ know what the medication is for and under what circumstances it may be appropriate to administer a dose. The supplementary information document can also be used for variable dose medication to indicate when a higher or lower dose should be given. The supplementary information document should be reviewed on a regular basis and/or if the person’s circumstances change.

Supplementary information about creams and ointments - It can be helpful to provide extra information about creams and ointments including the use of a body map.

Transdermal Patch record - when administering patches it is important to remove the old patch before applying a new one and to rotate the sites where the patch is applied. This form will support safe recording.

Supplementary Medication Administration Record – As the space on traditional MAR charts is quite limited care providers may find this supplementary record sheet useful as it allows staff to record the time the medicine was administered, the dose and the quantity remaining. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Supplementary sheet for the recording of creams and ointments – Administration of prescribed creams/ointments must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. In care homes this may be kept in the person’s room. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Supplementary sheet for the recording of nutritional supplements – The administration of nutritional supplements such as Fortisip and Ensure must be recorded. In some circumstances it may be appropriate to use separate documentation to record the administration. If using a supplementary record staff must annotate the main MAR chart with ‛see supplementary sheet’ so all staff record the administration in the same place.

Medicines Refrigerator –  Temperature Recording Chart – In care homes the maximum and minimum temperature of the fridge should be recorded daily. Staff must ensure that they always reset the thermometer once the reading has been taken. If the fridge temperature is outside of the required range then action must be taken.

Recording of medicines taken on short periods away from the home – Care homes must be able to account for all the medication for which they are responsible. This form can be used to document medication which the person takes with them for periods away from the home, for example, weekend visits to family.

Staff Competency

It is the responsibility of managers to assess the competency of staff before they are allowed to administer medication – competency assessment tools to support this are available below.

1.• Competency assessment tool for staff working in care homes

          

2.• Competency assessment tool for domiciliary care staff

Information is also available through your local Clincal Commisioning Group websites.

Scarborough and Ryedale CCG has Resources for care homes and domiciliary care providers.   Includes information on nutrition, fortified foods and weight monitoring 

Vale of York CCG Includes a section specific to care homes in the Vale of York area 

Hambleton Richmondshire and Whitby CCG

Harrogate and Rural District CCG

National Resources

For further information or queries please email

nyccg.rxline@nhs.net