Archive for the ‘written’ Category

Top 5 Myths about Compliance Aids in Social Care Dispelled

March 6, 2008

j0390523.jpg  Compliance aids are used extensively in social care and I would like to take this opportunity to clear up a few myths about them if I may.

Myth #1

In order to support a service user with his or her medication it must be in a monitored dosage system (MDS)

This is incorrect. There is absolutely no legal or ethical reason why medication needs to be in a monitored dosage system. It can just as easily and safely be supported from bottles, boxes and original packs as long as the correct checks are made, the dose instructions followed and good records kept. Incidentally these things have to happen for MDS too.

Myth #2

All tablets and capsules can be put into a MDS

This is incorrect. Not all tablets and capsules will remain stable once out of their original packaging and therefore must be dispensed in their original packs.

Myth #3

You can legally support a service user who has their medication put into the MDS by a friend or relative

This is incorrect. All monitored dosage systems must be filled by a pharmacist (or dispensing GP in rural areas). Supporting medication in trays filled by friends or relatives is not legal. If this is happening in your service you should take steps to make changes. Inform relatives or friends that from a certain date (e.g. a month’s time) that you will no longer be able to support the service user if they continue to fill the trays themselves. They should go to the pharmacy and request an assessment under the Disability Discrimination Act in order to have the medication dispensed by the pharmacy into a suitable MDS. If the service user meets the criteria of the Disability Discrimination Act they will be entitled to this service free of charge from the pharmacy.

Myth #4

All MDS systems are appropriate for use in social care.

This is incorrect. Any MDS system used in both care homes and domiciliary care must be dispensed by the pharmacy into a system that is able to be properly labelled to identify it’s contents on the actual pack containing the medication. The system used should also be tamper evident and secure.

Any system that does not meet this requirement should not be dispensed into by the pharmacy for use in social care. This includes the little “finger” type systems that have a different “finger” per day that can be taken separately from the pack. These systems have historically been purchased by the service user and filled by the pharmacy which is fine if they are assessed and unsupported, for you though as care staff supporting service users they are not suitable. If you have clients using these systems please ask the pharmacy to provide a system that meets labelling and security requirements.

Myth #5

The pharmacy dispensed the medication into the tray and therefore it’s nothing to do with me, not my responsibility to make any checks.

This is not correct. You have a legal obligation to check that the right patient receives the right medicine by the right route in the right dose at the right times. So, you then need to check the name on the pack is the right service user. You need to check that the contents of the pack match both what was ordered on the prescription and what is on the medication administration record. You need to check that the strength of the medication is what was expected and that the instructions for use are the same. Do the time slots in the pack match the administration times and do you know exactly how this medication is to taken, used or applied?

I do hope that this has cleared up many common misperceptions about monitored dosage systems and that as a result you will check your policies and procedures and update where necessary.

If you have any further questions about compliance aids or would like support in writing or reviewing polices please contact:-

Tracey Dowe

Email training@momentumpeople.co.uk

Tel 01793 700929

http://www.momentumpeople.co.uk

Consent and Medicines Management

March 6, 2008


Forms Before any support with medication can happen in care the service user must give their consent. In order to give informed consent they must first be given all of the information they require to make a decision about their level of care. It is important that information is shared freely with the service user, this will include providing patient information leaflets to your service users, and if necessary reading and explaining these to them if they are not able to do this themselves.

A service user can agree to treatment and care verbally, in writing or by implying (by co-operating) that they agree. Even though verbal consent or consent by implication would be enough evidence in most cases written consent is always preferable and probably expected in most care agency policies.

Service user consent should be obtained and recorded in the care plan during the care assessment. Both the service user and the assessor should sign and date the document. Written consent stands as a record that discussions have taken place and of the service users choice. however, the service user had the right to refuse consent and may do so at any time during his or her care. This may be detrimental to their care and you must provide them with the information they require to be fully informed I making their decision but if they still refuse to consent then you must respect that decision. You should make a record of the refusal and document what information was given and who else you involved such as your line manager or GP in the service users records.

What you should never do is hide the medication in food or beverages for the service user to take without knowing that it is there. This is covert administration of medicines and is considered to be abuse.

In an emergency situation were treatment is necessary to preserve life and the service user cannot make a decision (for example because they are unconscious), the law allows you to provide treatment without their consent, providing you are sure you are always acting in their best interest.

You should also know that if the service user is an adult, consent from relatives is not sufficient on its own to protect you in the event of a challenge, as nobody has the right to give consent on behalf of another adult unless the service user has passed over the power of attorney to another person. In this case the other person can give their consent for you to administer medication

As you can see gaining consent may not be as straightforward as it first appears. Nonetheless, it is a vital part of caring for people. The reason it is so important is that it is assumed that the service user is the best person to be in control of their care. So any procedure that may affect them can only be given once they have consented to the care and this includes medication.

 

For further information Contact

Tracey Dowe

email training@momentumpeople.co.uk

Tel 01793 700929

http://www.momentumpeople.co.uk