CARE

WITH

MEDICATION

Prescribed medicine is the most frequent treatment provided for patients in the NHS.GPs in England issue more than 660 million prescriptions every year = (1.8 million a day)There are estimated 200 million prescriptions in hospitals.Standards of prescribing in this country are high and the majority of drug treatment is provided safely.

Care Homes Regulations 2001

Regulation 13(2) requires the registered person

‘to make arrangements for the…safe administration..of medicines’ prescribed for the people they care for.

Domiciliary Care Agencies Regulations 2002

The registered person shall : ‘… specify circumstances in which domiciliary care workers may administer or assist in the administration of medication… and the procedures to be adopted…’ Regulation 14(6)(a)

• ‘…make arrangements for recording, handling, safe keeping, administration & disposal of medicines…’ Regulation 14(7)

Care Homes Reports 2004 NCSC report :-

Medication Management• incorrect medication give• poor recording of administration• medicines inappropriately handled, sometimes

by untrained staff• inappropriate storage conditions

follow-up study commissioned by CSCI‘Handled with Care?’ (February 2006)

‘Handled with Care?’

• Slight overall improvement in performance with exception of nursing homes for older people

• Nearly half the care homes for older people and younger adults, providing 210,000 places, are still not meeting the minimum standard

• Similar proportion of children’s homes failed – nearly 6000 places

• Wide variation of performance from area to area

‘One third of homes do not meet the standards relating to managing medication safely and operating safe working practices’

‘Homes themselves need to put their house in order and place medication management at the top of their agendas’

Actions required by Care Homes

• Review policies and practices in managing medication

• Make use of existing good practice guidance and demonstrate progress

• Support and closely monitor the practices of care workers in relation to this standard

• Develop policies and practices which are culturally sensitive

Domiciliary Care‘TIME TO CARE’

• Report published Oct 2006

• 58% of agencies achieved the medication standard in 2005-06

• Similar findings & concerns to those in care homes

Why does it go wrong?

• Weak/bad management• Poor procedures• Poor records• Staff not following procedures• Inadequate training• Staff not assessed as competent• Complacency

Three Essential Safeguards• Written procedures, reviewed and

monitored to make sure safe practice is followed

• Correct level of training before giving medicines, followed by competency assessments, supervision and updates

• Only give medicines from containers filled, labelled and provided from a pharmacy (or from a dispensing doctor)

Durham and Tees Valley

Social Care

Medication Strategy

Group

Middlesbrough Primary Care TrustMiddlesbrough Borough CouncilRedcar and Cleveland CouncilRedcar and Cleveland Primary Care TrustDurham County Council Commission for Social Care InspectionDarlington Borough CouncilIndependent Providers Durham Darlington TeessideHartlepool Borough CouncilDurham Employer Care and Health AllianceStockton Borough CouncilCentre of Vocational Excellence for Social CareCELSCity &GuildsSkills for careAnd…….

 

A substantial number of home care services are failing standards relating to medication’

There have also been high profile cases of corporate manslaughter associated with medication brought against care home managers and carers.

A common finding of enquiries is poor quality training as a fundamental cause.

 

NORTH EAST

LEADS THE WAY

ON MEDICATION

READ ALL ABOUT IT

• Have the care workers had sufficient and appropriate training to meet the needs of the people they care for?

• Is there a formal means to assess & record staff competence in medication handling & administration?

• Do the policies and procedures support staff to manage all aspects of medication handling?

The indications are that there is a serious deficit in the competence of carers to administer medication safely.

The training to date has been knowledge based and often distance learning.

Estimates indicate that there are 89,000 – 123,000 carers who require assessment of this competence in the Northern East Region. 

The aim of the group was to develop a regional strategy and policy for the safe administration of medication. Produced in consultation with the Commission for Social Care Inspection. (CSCI).

SAFE

HANDLING

OF

MEDICINES

A training plan was devised that closely follows the NVQ Code of Practice especially around the competence of the assessors

and expert witnesses.

A Strategy for the Safe Handling, Management and Administration of Medication by Carers across the North East of England 

Model of Good Practice for the Development of those involved in Handling, Management and Administration of Medication across the North East of England…………….

Outcome

Two significant documents have been produced:

The documents are freely available to all employers to adopt or amend to suit their needs.

WORKBOOKS

INTERMEDIATE CERTIFICATE IN SAFE HANDLING OF MEDICINES

OPEN COLLEGE NETWORK LEVEL 1 - MEDICATION

NATIONAL VOCATIONAL QUALIFICATIONS

• The level 2 units – HSC221 – Assist in the administration of

medication – HSC236 – Receive and Store medication and

products• Are suitable for health and social care

staff who are assisting health care professionals

NATIONAL VOCATIONAL QUALIFICATIONS

• The most appropriate accredited knowledge and competency assessment is the NVQ level 3 Optional Unit

– HSC375 – Administer Medication to Individuals

Assessment Process

• Initial Assessment carried out by appropriate assessor

who will ensure that the candidate meets:– Requirements of the award– Skills for Life development if

appropriate

Assessor

• Hold assessor award A1 or achieve it within 12 months of commencing the role

• Be occupationally competent– Clinically updated– Currently competent

• Be familiar with the award body requirements for documentation

LSC estimate that it costs £145

• More– Tailored & unique– No knowledge or skills– Already have NVQ 3– Fragmented assessment– Peripatetic assessor– Tutor assesses

• Less– Several learners together– Prior knowledge and skills– Does not have NVQ level 3– Holistic assessment– Work based assessor– Assessor assesses

CLEMENT O’DONOVAN

WORKFORCE DEVELOPMENT MANAGER

MIDDLESBROUGH

DEPARTMENT OF SOCIAL CARE