Posts Tagged ‘outcome 9’

Essential Standards Outcome 9 pt 5

January 17, 2012

9e People who use services detained under the Mental Health act 1983

●●  Receive medicines that are duly authorised and administered in line with the Mental Health act 1983 Code of Practice.


9f People who use services receive care, treatment and support that:

  • follows clear procedures in practice, which are monitored and reviewed and that explain how staff may be permitted to administer homely remedies.

Homely remedies are those medicines that can be purchased by the client or a relative over the counter from a pharmacy, general store of health food shop. Guidance says that carers may support clients with over the counter medicines in the course of their care. And after all, who are we to take away their choice o use these things?

If our care teams are to support our clients with this group of medicines there are certain criteria that need to be met and it is these criteria that you need to be clear on and give clear guidance in your procedures and training for.

If the client purchases the medication themselves (or a relative buys it on their behalf) they should let the care agency know, especially if they require assistance with it from a member of the care team. The care organisation then has a responsibility to check with a pharmacist that that medication is appropriate and safe for that client to take with any other medicines they take and the medical conditions that they have. They should make a record of this conversation and the outcome.  The medication belongs to the client and would be kept by the client (in their room in a lockable cupboard or drawer in a care home) and a record of the administration made on the medication administration record.

I n a care home (residential or nursing) you may choose to buy over the counter remedies to keep in stock in case a resident needs something for a minor aliment such as pain relief, indigestion, sore throat, a cough mixture, a laxative etc. In this instance you must keep these medicines locked away centrally in a separate place to the prescribed medication. You must have authorised in advance by the GP which over the counter medicine can be taken by which resident.

You must also have for each over the counter medicine that you choose to keep, a record of the recommended dose i.e. How much can be taken or used at one time?
How long should you wait before it is taken or used again? Is there a set number of doses allowed with in a set time e.g. no more than 8 in 24 hours? How long do you continue to use that medication if the resident is not getting any better before you refer to the GP? What each medicine is to be administered for and in what circumstance may it be administered?

Once again, these medicines if given or used must be recorded on the medicines administration record at the time of administration.

Next time we’re exploring Outcomes 9g and 9h so watch this space!

Meeting Essential Standards – Managing Medicines

December 12, 2011

What do the regulations say?

Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010

Management of medicines
13.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.

What should people who use services experience?
People who use services:

Will have their medicines at the times they need them, and in a safe way.

Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

This is because providers who comply with the regulations will:

Handle medicines safely, securely and appropriately.

Ensure that medicines are prescribed and given by people safely.

Follow published guidance about how to use medicines safely.
My thoughts:-
Unsafe and management of medicines is usually the result of a lack of understanding of the legislation and guidance which governs medicines administration in all care settings.

  • Policies become out-dated as legislation changes and time whizzes by so fast you don’t realise just how out of date they have become.
  • A nervousness around taking responsibility for administering medication often leads to policies which are full of don’t and can’ts where medication administration by carers is concerned. Unfortunately, often this leaves your carers and clients at risk in not being able to fully support the client with their medication when they require it. As a result, companies who think they are protecting themselves from the responsibility of administering medicines often leave themselves inadvertently in a very vulnerable position legally.
  • Policy writers are stuck in the “old ways” of doing things assuming their way is the right way and maybe it’s not!
  • Policies around medication are not detailed enough to give clear guidance to nursing and care teams
  • A lack of quality training updated at least every 2 years if not annually given to all levels of the care and nursing teams.
  • Our nurses may be nurses but they need to be kept up to date too!

Service users should expect to have their medicines at the times they need need them and in a safe way. This becomes even more important as we move forward into the personalisation agenda – does your organisation ask the client how and where they would like to recieve their medication and at what times? (within reason to meet the requirements of the prescription)
Do you have a system in place to ensure that clients are informed about what they take medication for, possible side effects etc.? How will you make this information available to them? Do you have patient information leaflets for all the medication the client takes?

Ensuring that your current training arrangements provide expert knowledge will ensure that you get the policies that you work to right,  and that your teams are trained so that they are competent and confident in their role is essential to meet the new standards. May be now would be a good time to start taking a look at these things.

Next week we’ll take a look at Standard 9a in a little more detail – Providing personalised care through the effective use of medicines to guide you through it.