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07th June 2013

Medications in Home Care

Medication has become an increasing and significant aspect of care currently being delivered and requested by Domiciliary care organisations across the UK.

According to the CQC regulations, Outcome 9 Management of Medicines states that the registered person must protect Service users against the risks associated with unsafe use and management of medicines.

However, the CQC Care Report 2011/12 highlights that “poor performance in respect of Medicines management continued across all types of social care setting”.

The demand for home care is increasing year upon year, and the demographic changing from the historic view of “tea and toast” tasks undertaken by care workers, to a need for complex nursing care.  The changes to our industry are happening quickly, and the pressure is on for every provider to recruit in order to meet the demand for our service.  It is a well-known fact that home care has a high staff turnover rate, and this can lead to pressures around comprehensive staff training and robust competency checks.

The nature of the industry is that care workers are often alone in service user’s homes when administering or prompting medication and therefore the margin for error can be high.

It is in the interest of every Registered Provider to ensure their paperwork is as simple as possible, with clear instructions. We must take into account literacy levels and ensure that each individual has had their literacy level checked before competency is assessed. With recruitment being an ongoing, time-consuming and costly process, we do not want to alienate potential recruits who may have the ability to care, but not completely understand a complex MAR sheet.

MAR sheets can be complicated to Care staff that are not familiar and who lack experience in social care, so you must ensure your training covers your paperwork, and an explanation of the importance of such paperwork.

Ensuring care staff are competent before they visit any service user is absolutely critical. As a manager, you are responsible for deciding upon and checking competency, and confirming that individual care staff are comfortable with administering or prompting medication.

A simple ‘How to Guide’ can be beneficial in educating staff and provide an effective reminder should they need to go back and check they are completing paperwork correctly.

During the induction process, you may find it helpful to provide new recruits with a sample MAR sheet which details a number of different scenarios; such as - what if a service user refuses? Or what if a family member has prompted medication before you have arrived?

Work through the sample sheet and ask the recruit how they would document this on the MAR sheet. This process will be an effective tool in reassuring Managers that you have robustly checked individual competency levels.

If all Registered Providers take responsibility for adhering to effective procedures around medicines handling, ensuring risk is managed in a safe and responsible way and that staff are trained and competent, then surely next year’s State of Care report might record something different.


Rosie Robinson

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