Medication policy in health and social care

Medication in care homes policy

Medication in care homes policies typically cover more areas than settings like domiciliary care, given the extra requirements on residential care settings to manage, store and order medications for residents.

Care homes medication policy should adhere to NICE Social Care Guideline SC1 (Managing medicines in care homes). Your medication policy and procedures will likely span several separate pieces of documentation. For example, you will probably need a policy and procedure to cover each of these areas:

• Medicines requiring fridge storage
• Management of medicines
• Safe handling and administration
• Topical medications
• Transdermal patch application
• MAR chart management
• Home remedies policy
• Other medicines (not oral or topical)

At a minimum, as per NICE guidance, all care homes should have a written medication policy that gives staff information about how the care home should:

• share information about medicines
• keep records about medicines
• deal with any mistakes that might happen when people who are living in a care home are given their medicines
• review and accurately list the medicines someone is taking
• order, receive, store and dispose (or get rid) of medicines
• give medicines to people in their care.

Under each of these areas there are further sub-areas. For example, under the area of how to give medicines to people in the care home, there may be sections concerning giving residents medicines without them  knowing, how to handle when a person is away from the care home, the process for ensuring medicines are used safely and effectively, how to record this all correctly and so on.

As with any policy, it must be checked regularly to make sure that it is up to date with regulations, legislation and best practice guidance.

For obvious reasons of resident safety and wellbeing, medication management is at the top of the list of care home/nursing home managers, other stakeholder and regulators like the CQC, Care Inspectorates and RQIA. Medication management software reduces medication errors enormously (often completely as this case study from Erskine Care shows) and make the process of managing medicines, prescriptions, stock levels and more, much easier and more efficient. 

Medication policy and procedure for home care staff

Medication policy and procedures for home care staff should adhere to NICE Guidance NG67. Some of the key points for home care providers from the NICE guidance has been made available by the CQC Your medication policy and procedures will likely span several separate pieces of documentation. For example, you will probably need a policy and procedure for home care staff on:

• Management of medicines
• Safe handling and administration
• Topical medications
• Transdermal patch application
• MAR chart management
• Home remedies policy
• Other medicines (not oral or topical)

Each medication policy and procedure for home care staff should - like all policies and procedures – include the scope of the policy, your equality statement, a policy statement and then the policy itself. The scope of the policy should refer to which regulations, standards and legislation the policy is affected by.

Policies and procedures on MAR charts are arguably the most frequently flouted by care staff. While staff will prioritise the handling and administering of medicines, perhaps understandably there is less focus on the importance of using MAR charts properly.

The CQC and other national regulators like Care Inspectorate/Scotland have identified poor record keeping in MAR charts (including being difficult to read or understand, having gaps or errors) as a leading cause of medication errors. Some care management systems come ready equipped with eMAR, that can reduce errors, as the CQC found when inspecting Bay Care Group (rated Outstanding), who use Access Care Planning:

“People were supported safely with their medicines and told us they were happy with the support they received. Staff completed electronic medication administration sheets (eMAR). The computer system alerted staff if all parts of the eMAR had not been completed before the care staff left a visit. This reduced the risk of missed medicines.”