This page should be read alongside the page managing medication in care homes.
Care homes have a duty of care to the people they look after. This includes making sure the home has enough of the correct medication at the right time for all individuals. It is not acceptable to give the GP or pharmacy being closed as a reason for someone you provide care for running out of medication. Out of hours GPs or pharmacies are available.
If you have a problem and need to access prescriptions or pharmacies outside normal working hours you can find out of hours medicines on the
NHS website External link.
A care home must be able to give evidence that they have been proactive in addressing any concerns or issues with medication. The care home should keep copies of what has been done to remedy any issues. For example, you should keep copies of any emails to pharmacies if there are any issues, such as the wrong medication being received.
Supporting people with their medication
A short and useful overview of giving medication from the NHS is available in the
medicines tips for carers
External link page.
- Always follow the doctor's instructions about when and how someone should take medication.
- You must
not provide any medication that has not been prescribed for that individual
- You must
not provide medication in any way other than as described on the prescription
Helping people to take their medication
Before giving medication you must make sure that you have all of the up to date information about how the person wants to receive their medication and any special care that may need to be taken. For example:
- does the medication have to be taken a certain way, for example only with water? Where the prescription allows you should offer the person their preferred drink to take their medication. If you are in doubt about which drinks you can offer with medication with consult with a pharmacist.
- does the person have any temporary swallowing or mouth problems?
- is the person taking any over the counter, as opposed to prescribed, medicines? You should contact the pharmacy and seek advice if giving over the counter medicines when prescribed medication is also being taken
- ongoing issues like diagnosed swallowing problems should inform a personalised medication plan. Remember, you can always ask the pharmacist or GP whether the medications comes in alternative or easy to swallow formats e.g. dispersible/syrups
- PRN (also known as 'as required medication') can cause difficulties. PRN medications should have a personalised medication administration plan in place. Some things to consider are if medication is prescribed as "take for pain" and the individual can't speak, how do you know when to give the medication? You could try to find out how the person expresses pain, for example do they rock, or hold their stomach?
- instructions such as "Give one or two" are unclear and should be clarified with the pharmacist or doctor. You need to know long to wait between doses to see if the medication has worked, what the maximum dose in 24 hours is and if there are any times you should not give the medication
- it is important that wherever possible people are in control of how they receive their medication and have choice about what they take it with e.g. orange juice or milk, if the prescription allows this. If they decide to refuse medication you must follow your organisation's policy and procedure and record this. If the person is refusing medication consistently you should try to find out why this is. Is there a simple answer? If not, does the person have mental capacity or not? You may need to discuss this with the registered manager
- you must never covertly administer medications without due process and best interest process being followed and fully documented. The pharmacist and GP must be consulted on how best to do this
- don't forget, a person may need help to take their medication as they may have difficulty with their mobility, eyesight and memory. It is important to help them to do as much as they can for themselves, for example taking the medication themselves if this is appropriate and safe
- all medication must be recorded and stock checked in line with the home's policies and procedures. No medication,
prescribed or over the counter, should ever be provided that is not recorded
- you should consider infection control when providing medication. Remember, your residents have a lowered immune system. Any dropped tablets should be recorded and destroyed/returned
- when giving controlled drugs requiring two signatures both individuals signing must have witnessed the administration
Other areas to consider when giving medication
Timing
Some medication must be given at certain times. This must be taken into account and clear guidance must be available should the individual refuse, or the time interval be missed. If medication is prescribed to be taken before or after food then this must be adhered too.
Importance of drinking
- Taking medication and not drinking enough during the day is not good for the body. People taking medication need to ensure that they are drinking regularly. Make sure that each person is drinking 6-8 glasses per day using a 250ml mug or glass.
- Remember that foods high in water, like fresh fruits, vegetables and some dairy products can be an important part of a person's fluid intake.
- More information is available on our
helping people to drink enough to stay healthy page.
Sick Days
Something often not considered is what to do with pre-existing medication when someone becomes sick. Sometimes this is referred to as the 'sick day rules'. For example, if someone develops vomiting this can impact on their normal medication. Many health care professionals provide advice to such patients that certain drugs should be temporarily stopped during acute inter-current illnesses, particularly where there is disturbed fluid balance. This advice is commonly described as 'sick day rules' or to take a 'drug holiday'. You should get advice from a GP or pharmacist if the person you care for becomes sick to see if their medication needs to change.
Guidance on medication
