Care Homes

Care homes are required to protect service users against the risks associated with the unsafe use and management of medicines.

Risks 

Within Leeds the activities within care homes which we have seen to fail to protect service users include:

• Establishing what medicines a service user is supposed to be taking when that are admitted to the home. 
• Ensuring that services users have received a medication review from a healthcare professional within the right time period (commonly every 6 months).
• Ensuring sufficient personalisation of care is recorded in care plans, in particular around the administration of "when required" medication.
• Failing to check the medication against the medication administration chart prior to administration.
• Lack of infection control measures during the administration of medicines.
• Missing entries on the medication administration chart.

There is also continuing concern nationally that patients with dementia are innaproprately receiving treatment with antiychotic drugs.

Leadership

Strong leadership within care homes and a well developed culture of safety are vital to a homes ability to protect people from the harm that can be caused by medicines. In relation to medicines these attributes are frequently evident as:

• Audits of the completion of medication administration charts.
• Alerts, reminders, posters and facilities which aid people to follow the correct procedures for managing medicines.
• Sufficient staff and procedures that allow the administration of medicines within a short period of time and with minimal distraction.
• A well established procedure for reporting, analysing and learning from incidents (errors and near misses) relating to medicines management. (which is distinct from a disciplinary or performance management procedure) 

Good Practice

Guidance on how to manage medicines in a care home can be found here.

Guidance on how to establish a culture of safety can be found on the National Patient Safety Agency (NPSA) website or by clicking here.

Guidance on how to review incidents can be found here. (this would be appropriate for all incident types see CQC outcome 16 - Regulation 10 of the Health and Social Care Regulations 2009)

Information for care homes in Leeds on how to obtain advice on the management of medicines can be obtained by e-mailing the NHS Leeds Medicines Management Team 

The CQC guidance on regulatory compliance can be found here.