I have an acquaintance who is looking for respite care for his wife who has Dementia. She has been taking vitamin supplements for over 10 years and her condition has not declined. Her husband believes this is because of the supplements he has given. When he was recently ill his wife had to go into a care home but they were reluctant to administer the vitamins.
He wants to have a plan in place should he become ill again and plans to do this via testing out respite care. Whilst looking for respite, care homes are advising him that they cannot administer homely medicines. What is the CQC stance on this in order that I can advise him?

Answered by Sheila Scott

Dear J,

Thank you for your question.

The CQC’s approach to the handling of medication in a care home is the same whether the service user is admitted as a permanent resident or for respite care and the care home is required to demonstrate:

KLOE S4.2 – How does the service make sure that people receive their medicines (both prescribed and non-prescribed) as intended (including controlled drugs and ‘as required’ medicines), and that this is recorded appropriately?

The care home should have a policy on the handling of medication and this should include the handling of homely remedies as well as prescribed medication. Homely remedies are often called ‘Over-the-Counter Medication’. NICE Guidelines Managing medicines in care homes Social care guideline [SC1] Published date: March 2014 state:

‘Care home providers offering non-prescription medicines or other over-the-counter-products (homely remedies) for treating minor ailments should consider having a homely remedies process, which includes the following:

• The name of the medicine or product and what it is for
• Which residents should not be given certain medicines or products (for example, paracetamol should not be given as a homely remedy if a resident is already receiving prescribed paracetamol)
• The dose and frequency
• The maximum daily dose
• Where any administration should be recorded, such as on the medicines administration record
• How long the medicine or product should be used before referring the resident to a GP

Care home staff who give non-prescription medicines or other over-the-counter products (homely remedies) to residents should be named in the homely remedies process. They should sign the process to confirm that they have the skills to administer the homely remedy and acknowledge that they will be accountable for their actions.’

Homely remedies should be only administered following discussion with the GP/Pharmacist and the Home will need to undertake a risk assessment and then the vitamins should be administered as requested by the next of kin.

For the service user’s husband, if he wants to have a plan in place in case he is ill again I would suggest that he speaks to care homes in the area to see if this is possible.

I hope this is helpful,

Sheila