HSC 3047 : Part 4 Support the use of medication in social care settings Receive, store and dispose of medication supplies safely. Sheena Helyer 01.2013 Photo supplied by:- supporttheadams.com

Medication policy and job description Local medication policies will outline how much a community carer may assist with ordering medication, receipt of medication, delivering medication and recording the arrival of medication in the home. The package of care and care plan will outline exactly what care should be provided. All care staff administering medication must read their local policy. The job description of the member of staff should reflect the responsibilities they have in administering medicine Ask the learners to find out where their policy is and ensure that they read it. Photo supplied by:- westcoastdhb.org.uk Receive, store and dispose of medication

Delivering medicine Most medication given by care staff will be long term medication. Repeat prescriptions will need to be sent to the pharmacy at least a week before the end of each 4 week cycle as it may take several days before the tablets are delivered to the home. Occasionally the service user may have an acute illness and need urgent medication and efforts will have to be made to start the medicine the same day it is prescribed. Care staff should only collect medicine if this is allowed by the local policy. The learners should discuss how they get service users medication to the home. It will vary depending on the GP surgery, the pharmacy and the involvement of family and friends. Some may use the nomad system for repeat prescribing. photos supplied by:- pulsetoday.co.uk and applbypharmacy.com Receive, store and dispose of medication

Information for the service user Many people are completely capable of managing their own medicine, they just need a bit of help and information to make that possible. Care staff should ensure that the person knows:- Why they are having the medicine What time of day they should take it If they should take it before, during or after meals Any side effects they should expect Education of service users is a very important aspect of community work. The more they understand about their medicine, the more compliance will improve and fewer errors will occur. There will also be benefits in terms of improved health, independence and self respect. Photo supplied by:- en.wikepedia.org Receive, store and dispose of medication

Information for the service user Information about medication can be accessed from many sources:- The product information supplied with the medication The person’s pharmacist or GP The British National Formulary: BNF (an up to date version should be available in the office) The internet or local library Receive, store and dispose of medication

Documenting medication If care workers are responsible for administering medication, it must be recorded when it arrives in the home. Some pharmacies will send an accompanying MAR (medication administration record) sheet with the medicine where the care worker can record the number of tablets sent and the date of arrival. If no MAR chart has been sent then a hand written record must be kept using the local form and all care recorded in the care plan. There are risks in hand writing instructions for medication administration. It is generally safer if hand written instructions are signed by 2 people. Photo supplied by:- churchmutual.com Receive, store and dispose of medication

Daily record of medication administration Every dose of medication which is administered must be recorded Any medicine which is NOT given must be explained, for example:- Service user had been vomiting Service user refused the medication Service user was in hospital If medication is being given ‘as required’ it must be made clear in the plan of care what the medication is to be given for e.g. Movicol to be given if the service user has not had a bowel movement for 2 days. Some medicines can be given for a variety of different problems for example codeine phosphate may be given for diarrhoea or pain Photo supplied by digplant.com Receive, store and dispose of medication

What medicine can the care worker give? Only medicine which is on the recording sheet and labelled correctly by the pharmacy can be given. Other homely remedies, over the counter medicine and vitamins cannot be given. Tablets left in pots and unlabelled containers cannot be given. Photo supplied:- wepl.co.in 8

Safe storage Medication should be kept in a clean dry place which is not exposed to extremes of temperature. Medication should not be stored over 25c. Aerosols and oxygen must be kept away from heat sources. Medication should be kept in a neat orderly manner and expired medication should be returned to the pharmacy with the permission of the service user. Medication must be kept out of reach of pets and children who may be visiting. How many of you have expired medicine at your home? Have you ever used expired medication? Photo supplied by lexleeskids.org Receive, store and dispose of medication

Keeping medicine in the fridge Some medicines such as antibiotics, insulin or eye drops may need to be kept between 2-8c in the fridge. These should be kept in a separate container from the food and away from children and vulnerable adults. Plastic air tight labelled boxes are good for keeping medicine in the fridge Photo supplied by type1tootsie.com Receive, store and dispose of medication

What if the service starts to lose mental capacity? Care staff must be alert for signs that a service is becoming more confused or may be taking medication inappropriately. Any behaviour which causes concern must be recorded and fed back to the service manager. The person’s GP will need to establish the cause of the confusion If necessary there should be a ‘best interest’ meeting of all involved to decide on the best way forward. A plan should be drawn up which is minimally restrictive. Medicine might need to be put in a place where the service user does not have access to it. Remind the learners of the principles of assessing mental capacity Photo supplied by conversation.which.co.uk Receive, store and dispose of medication

Teamwork There may be a number of different people and agencies involved in supporting a vulnerable person at home so there needs to be a high level of coordination and liaison to prevent misunderstandings and mistakes with medication. The following may be helpful:- Regular meetings Plan for shared care which clarifies the responsibilities of all involved Shared documentation and message book Keeping all contact numbers on mobile phone Regular phone contact / text messages Encourage discussion at this point of how well their teams share information. Photo supplied by thefuneralconsultancy.co.uk Receive, store and dispose of medication

Controlled drugs There are no laws about how controlled drugs in the home should be kept. They are now the property of the service user but can only legally be used by the person for whom they have been prescribed. If care staff are administering CDs it is good practice to keep an exact record of the number of tablets/patches on the premises. If any go missing the service manager must be informed immediately. If staff are involved in collecting or returning CDs they should carry ID and sign the pharmacy records. It is good practice to ask for a receipt for CDs which can be given to the service manager. There are risks in the home that CDs may be used inappropriately by the service user, or a family member or member of staff may be tempted to take the CDs themselves. If there are good procedures in place any irregularities will quickly be spotted and reported. Receive, store and dispose of medication

Disposal of medication Any unused, unwanted or expired medication should be returned to the local pharmacy for disposal. Medicines should not be put into household waste containers or flushed down the toilet as they may cause environmental contamination or danger to others. It is best if medicine can be returned by the family. If they are not available the care workers may be required to take them to the pharmacy. Photo supplied by homecarepharmacy.co.uk Receive, store and dispose of medication

Medication Errors Good systems of work and good training will help to eliminate errors but if they do occur there must be complete honesty and transparency about what has happened. Local policies must be followed but will usually involve the following:- Reporting the error to the service user, the service manager, the GP and close family members. Careful monitoring of the service user’s medical condition Review of what went wrong to prevent reoccurrence. Encourage a discussion about how errors might occur in the situations the learners are involved in… photo supplied by brainfoggles.com Receive, store and dispose of medication

What happens now? Learner attends all the taught sessions for the unit Learner completes the work book and hands to their assessor. Learner makes an appointment to meet their assessor in the work place. Practical procedures and skills are observed in the work place by the assessor and assessed. The evidence is reviewed by the internal verifier. A certificate of completion is issued. The learner is now considered competent to administer medication All the learners need to know who will be assessing them and have dates booked for their practical assessments Receive, store and dispose of medication