0115 949 5421

Monitored Dosage System

104628 12/05

email: mds@boots.co.uk

Trust

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Boots MonitoredDosage ServiceGroup home service offer

Trust

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contents

Summary of offer 3

Monitored Dosage System 5

The Boots service 6

Provision of the MDS system 7

Distribution 8

Storage 9

Training requirements 10

Pharmacist advice 12

Communication and support 13

Agreement review process 14

Policies and procedures 15

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•Unrivalled nationwide coverage of the

UK – Boots The Chemists has over

370 stores able to provide a specialised

service to care homes. Each of these

separate units operates with its own

dedicated pharmacy team ensuring

a local, personal service tailored to

the individual requirements of each

care home.

•Our experience – we were the first

major pharmacy chain in the UK to

provide the Monitored Dosage System

to care homes and ours is widely

accepted as the standard system.

We currently service over 30% of the

total care home market. We have an

excellent internal structure of store, area,

regional and national staff to support the

business, giving you peace of mind.

•Recognised system – the MDS is the

system of choice for over 50% of all

care homes. We own and operate the

Manrex system, which we also sell to

independent pharmacies and other

multiple pharmacies nationwide.

The system is approved by the Royal

Pharmaceutical Society of Great

Britain, and meets the requirements

of CSCI and the NMC, giving your

staff confidence.

•An unrivalled market–leading training

package – fulfiling the training need

at every stage.

- Comprehensive systems training,

including certification and a

competency assessment tool for

the home manager.

- On-going and refresher training

for new and existing staff,

ensuring continuity.

- In-house topical training folder

for carers self development.

- Accredited (to national minimum

standards), Care of Medicines

training, helping you to meet

standard 9.7.

summary of offer

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4

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5

The Boots Monitored Dosage

System is a compliance aid system

introduced in 1989 to help care

homes better manage service

users’ medication.

The system follows the current

guidelines set by the Royal

Pharmaceutical Society of Great

Britain (RPSGB) and the National

Association of Health Authorities

and Trusts. The National Care

Standards Commission (CSCI)

also approve the system.

The Boots MDS System is a unit dose system, which means that

we do not mix medication, making identification of medicines

easier at the time of offering. The system also incorporates

the “five rights” of medication offering, i.e. right person, right

medication offering, ie. right person, right medication, right dose,

right time and right route. It is organised on a regular 28-day cycle

making it easier to plan for the re-ordering of new drugs, without

the worry that you might run out.

In addition our Regional Dispensing Services Advisors provide

support to our new and existing homes and oversee the

operating procedures within our MDS stores to ensure a high

quality service is maintained. The Dispensing Service Advisor

would also be involved in any issues that the MDS store and the

home were unable to resolve.

The MDS system reduces the time taken in drug rounds as

medication is specifically packed for the relevant time of day, in

the order you require them. We also provide each home with a

full set of computer-generated Medication Administration Records

(MARR sheets) every 28 days.

The MARR sheets facilitate a robust auditing procedure for

record keeping, ordering and receiving repeat prescriptions and

stock control.

MDS – Boots Monitored Dosage System

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The Boots service was introduced

in 1989. We offer a high quality,

professional service that our

customers compliment us on,

and the fully trained teams in each

of our MDS stores are always

ready to provide help and advice.

The Boots Monitored Dosage System is available nationally

through approximately 370 of our stores. Each store has a

member of the pharmacy team known as a “Key Contact” who is

dedicated to ensuring all of their homes receive the best service

and attention at all times.

In most cases the service that we offer can be adapted to

suit each individual home. Every effort will be made to produce

a tailor made package to incorporate the preferences of the

Home Manager (this would be done at a local level) at the time

of implementation.

Our Regional Dispensing Service Advisors provide support to both

our new and existing homes and oversee the operating

procedures within our MDS stores to ensure a high - quality

service is maintained.

the Boots service

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Boots will provide each home

with the following equipment

to ensure the system runs

effectively and efficiently.

• Pharmafiles, with pillpacks already racked in the order required

by the home, making it easy to work in a logical order.

• Pillpacks in the appropriate colour for the time of day:

pink (morning), yellow (lunchtime), orange (teatime), blue

(bedtime) and white for PRN medication, so you only

need to pick the relevant file/s for that medication round.

• Medtime cards to identify the correct pharmafile for that time

of day and incorporating any extra details such as unit number

or name.

• Divider cards to identify the correct person and reduce the risk

of error.

• Reminder cards for non-blistered items, incorporating all

medications into the system.

• Alert strips which give you greater flexibility within the

drug round.

• Computer-generated MARR sheets to record drug

administration. The MARR sheets also provide an audit trail and

a Review and Request of the next supply cycle, making sure all

aspects of legislation are complied with.

• MARR sheet folders.

• MARR sheet divider cards.

• Security system for deliveries of medication to the home and

returns from the home to the pharmacy.

• Returned/disposed medication book for recording of

refused medication.

• Returned/disposed medication bags.

• Fridge line labels to identify items that need to be stored in

the refrigerator.

• Controlled drug delivery book. These items need to be checked

at the time of delivery and a signature obtained.

• MDS procedures manual, for on-going reference and

training purposes.

• Quick reference guide, acting as a prompt for staff unfamiliar

with the system.

• Spare equipment.

• Wall planner, which acts as an aid for drug re-ordering.

provision of the Boots Monitored Dosage System (MDS)

7

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In accordance with the guidelines

set by the Royal Pharmaceutical

Society of Great Britain (RPSGB),

all prescriptions should be ordered

by the home from the surgery.

Once the prescriptions have been generated and received by the

home, they should be checked and signed ready for collection by

Boots no later than 10 days prior to the next start date. This

procedure ensures that the home has full control of its own

ordering process and demonstrates compliance to best practices.

Boots will deliver the next 28-day supply of medication in the

MDS system to the home no later than 3 days before the next

cycle is due to commence. This gives the person checking the

medication in enough time to intervene should it be necessary to

do so, and gives the home flexibility for staff planning.

The monthly medication will be supplied in security sealed bags

and a representative at the home will be required to sign for each

bag and hand a portion of the tag back to the driver as proof of

delivery.

All controlled drugs will need to be checked and signed for

separately upon receipt. Boots provides each home with its

own controlled drug delivery book to make this process quick

and easy.

All fridge lines will be clearly marked so that they can be easily

identified by the home staff and quickly checked and stored away

in the refrigerator.

The Pharmafiles will be delivered to each home in the order

requested, making the drug round as smooth as possible.

The MARR sheets will also be in the same order, to facilitate

the checking in process.

Collection of empty files

On a monthly basis, Boots will arrange with each home a

mutually convenient time to collect the empty files. This would

usually happen a few days after the start of the new cycle,

giving the home time to complete the audit trail for the previous

28 day cycle.

Returns and disposal of medicines will be made available for

Care Homes to return to the Pharmacy (Residential Homes only)

or Pharmaceutical Waste Carrier for Homes with Nursing.

Mid Cycle Prescriptions

Any prescriptions for interim medication should be faxed to

Boots by an agreed cut-off time, for delivery the same day.

The original prescription must be handed over upon receipt of

the medication, so that the faxed copy can be checked against

the hard copy, to ensure that the item/s are correct. A separate

MARR sheet for the new item/s will be issued, for ease of

record keeping.

distribution of the MDS system

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9

Boots will undertake an initial

assessment of the storage

available in the home.

If the home has a suitable trolley that could be adapted to hold

the MDS system, Boots may be able to provide the equipment for

doing this. The home would need to carry out the fitting of the

adapting panel.

In the event of a home having no storage of their own, Boots may

be able to provide a trolley/s on loan to accommodate the MDS

system whilst the home continues to receive their medication

supply from us.

An equipment agreement would need to be signed at this time

by the home, and it would remain the responsibility of the home

to ensure that any medication trolleys on loan from Boots were

maintained and fit for their purpose.

storage of the MDS system

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Boots is able to offer a unique

6–tier training system to homes

using our MDS service.

Tier 1 – Initial set-up system training

Training will be provided to all relevant home staff prior to starting

the Monitored Dosage System.

This training covers all aspects of operating the system accurately

within the home and in accordance with current legislation.

The trainer, usually the Dispensing Services Advisor, will provide

a certificate of attendance for each member of staff who has

participated in the session.

The session normally takes about 1 hour to complete and

comprises of safe administration of medication and accurate

and meaningful record keeping. Audit trails, including receipt

and the returning of medicines are also covered.

There will be time to discuss the comprehensive service that

you will receive from the supplying MDS store and details of

the Key Contact and support staff will be given at the session.

We usually train all staff involved with medication administration

at the same time, at a time to suit the home, to minimise

disruption.

A Systems Training Package encompassing the above will be

left at the home for the use of the Home for any staff unable

to attend the initial training session.

Tier 2 – On-going training

For the purpose of refresher training or new members of staff, the

training package provides comprehensive instructions on how to

use the MDS system effectively. In addition, Boots can provide

each home with a copy of our training video.

There is a workbook to complete after viewing the video,

consisting of a question and answer type document. There is

also a competency assessment sheet for homes to use.

As further back up each home will each receive a manual to use

as an on-going source of reference, and a quick reference guide

inserted into the front of the MARR sheet folder, which acts as

a prompt when adjusting to using the MDS system.

training requirements

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Tier 3 – Further training

Each home that uses Boots MDS automatically receives a copy

of our ‘Care to Train’ folder and related inserts. The Care to Train

folder consists of six single modules:

Pain and its management

Depression

Dementia

Heart Disease

Continence

Sleep

This is a topical, relevant information pack used for the

continuation of education within the care home environment.

The package can be used for self-study and there is an

assessment to complete at the end of each module.

Tiers 4, 5 and 6 – Care of Medicines Training

We can also offer our homes additional training packages for both

nurses and care staff.

These packages are called ‘Care of Medicines’ and include

foundation courses aimed at care staff and advanced for nurses

or senior carers.

The courses last half a day and are run by a suitably trained

pharmacist. There is also a workbook and certificate provided

following the assessment.

The courses are usually chargeable but for large numbers of

delegates or for group homes, we may be able to negotiate

a preferential rate.

The Care of Medicines Foundation Module is accredited to

National Care Standards by ASET (an affiliated body to the

National Curriculum Authority and partners with The Learning

Skills Council).

safe handling of medicine

answer book

monitored

dosage system

Carer name

Home name

safe handling of medicine

work book

monitored

dosage system

medication handling

system training

Trust us to help you handle medicines safely

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Boots The Chemists will provide

access to pharmacist advice for

all group homes. This would be

carried out regularly, in either

a visit to the home or during a

telephone conversation.

It is routine practice for the advising pharmacist to give feedback

on all procedures associated with medication management within

the home.

They make recommendations in order to assist homes with

preparation for visits from the National Care Standards

Commission, ensuring that homes comply with all legal and

good practice aspects of storage, handling and administration

of medicines.

All visits would be documented and a copy sent to the home.

In addition Boots can provide a pharmacist to deliver

topic–specific training.

pharmacist advice

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In addition to our store

pharmacists, a number of key

personnel will be available to

all homes during provision of

our services.

Each home will be allocated a Key Contact whose role is to

ensure the smooth running of the system on a day–to–day basis.

The Key Contact will be the main person dealing with the

everyday issues involved with the medication management of

a home, and will be an expert in operating the system.

At a regional level a Dispensing Services Advisor (DSA), will be

responsible for the initial contact and implementation of the

system. The role of the DSA is to ensure

a smooth transition of service and continued maintenance

throughout. The DSA can also be contacted should there be any

concerns relating to the service provision.

In the unlikely event of the home not being satisfied with the

service they receive from our store team, the DSA will intervene

to reach a solution.

communication and support

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Regular reviews will be held with

both parties at either a national

or regional level to ensure the

continued success of these

arrangements.

The DSAs are available at all times should any issues arise

outside these meetings.

agreement review process

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Boots may be able to advise

homes when developing a

medication policy across the chain.

This would include advice on all current legislation and guidance,

ensuring compliance with the National Minimum Care Standards.

The above forms the core of service that care homes

can expect from Boots The Chemists in the provision of the

MDS service.

Should you like any further information please

contact me at the address below:

Lisa Hallam

National Accounts Manager

The Boots Company PLC

Dispensing Operations

D90 West F17

Nottingham NG90 1BS

Tel: 07734 056 710

Fax: 01691 670 322

Email: lisa.hallam@boots.co.uk

policies and

procedures

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