The proper and safe management of medicines is one of the requirements of Regulation 12 (2)(g) of the new Fundamental Standards introduced recently. In Regulation 9, there is also an expectation that service users’ needs and preferences are assessed, which will include helping them to maintain their independence for as long as possible. However, a report by the National Care Forum (2013) found that often when service users enter a care home, the staff ‘take over’ the responsibility of medication administration, often leading to a loss in the independence of the person.
This prompted the National Institute for Health and Care Excellence (NICE) to publish a new quality standard – QS85 Managing medicines in care homes (2015) – to assist care homes in ensuring that they have a person-centred approach to medication administration. The aim is to support service users to take an active role in decisions about their medication and, where possible, to self‑administer this. Read on to find out more.
Quality standards consist of a set of statements designed to promote quality improvement. You can use this to adjust your practice and demonstrate how effective and responsive your service is to making positive changes.
The Managing medicines in care homes quality standard consists of 6 statements as follows:
Statement 1. People who transfer into a care home have their medicines listed by the care home on the day that they transfer.
Statement 2. Providers of health or social care services send a discharge summary, including details of the person’s current medicines, with a person who transfers to or from a care home.
Statement 3. People who live in care homes are supported to self‑administer their medicines if they wish to and if it does not put them, or others, at risk.
Statement 4. Prescribers responsible for people who live in care homes provide comprehensive instructions for using and monitoring all newly prescribed medicines.
Statement 5. People who live in care homes have medication reviews undertaken by a multidisciplinary team.
Statement 6. Adults who live in care homes and have been assessed as lacking capacity, are only administered medicine covertly if a management plan is agreed after a best interests meeting.
Each of these statements has a rationale, quality measures (structure, process and outcome measures) and includes information about what this will mean for staff, providers and service users.
What You Should Do Next
- Go to the NICE website and view the information for each statement.
- Use the information to measure your service to see how you compare with each statement and to help you identify where you could improve your practice.
- Complete an action plan, if needed, to assist you to make the changes required.
- Although the standard is specifically for care homes, the principles could help to improve home care practice too. Particularly for service users transferred to the service from other providers, or from out of the area.