What is the Best Way to Manage Medicines in Your Care Home?

You may just be looking to ensure you’ve got the best method to manage medicines in your care home to prevent risk before any incidents occur. 

In this blog we will take a look at some key guidelines to manage medicines properly, and then we will examine the most popular methods of managing medicines in care homes, comparing each, so that you can better determine which is best for your care home.  

The Access Group is the UK’s largest provider of social care software and we’ve guided thousands of different providers to improve their medicine management processes, with advice and guides, and with our own eMAR System. That’s why we understand the different methods of managing medicines and the pros and cons of each and can help you too.

Why is Managing Medicines in Care Homes Important?  

If someone has multiple prescriptions, having a process in place is key to keeping them safe and avoiding medication errors, which potentially harm or injure a resident. Proper medicine management can:  

• Reduce medication errors 
• Provide targeted care 
• Achieve the best outcome for residents 
• Lead to cost-effective care 
• Give family and friends peace of mind
• Make medication administration easier and safer for carers  

How to Manage Medicines in Care Homes  

To avoid preventable medical mistakes, you should streamline the medication administration process. With so much to remember, it can be hard to know where to begin, but here is how you can start managing medicines in your care home:  

1. Put a Plan in Place 

Efficient and accurate medication policies and procedures can help ensure that medicines are administered correctly and safely. All care staff must be aware of the 5 rights of medication administration and should check over these points when administrating medicines. Caregivers should also be aware of changes they need to make to adapt to certain situations, for example, what to do if a resident is sleeping or experiences side effects.

2. Avoid Disruption During Administration  

Avoiding disruption during the medicine round will make it easier for carers to concentrate on this important task and reduce the risk of errors creeping in. Even though there is often a tight schedule to stick to, caregivers should be given the right amount of training and time administer medications correctly. Miscommunication and lack of time can result in errors.

3. Record Medication Given  

When medicines are administered, they should be recorded and updated in real time. This should be done in a way that other staff can easily understand if the shift changes. For example, it should state the date and time of the last administration, who administered the medication, and if a dose was missed or changed, it should explain why. Or if a medicine has been stopped, the caregiver must explain why.

4. Keep in Touch with the Pharmacy  

Integration with the pharmacy is vital, as it allows the pharmacy and home to share information on stock and medication profile changes. This ensures that staff do no run out of stock for PRN medication and guarantees that accurate information is available to all staff at the point of medication administration.

Ways of Managing Medicines in Care Homes 

There are two aspects of managing medications – storing and recording. There are various ways to manage medicines in care homes and every option comes with its pros and cons. From paper-based systems to electronic records, here are 3 ways medicines are managed in care homes.  

1. Traditional Paper Administration + MDS  

This is the use of multi-dose systems (MDS) and paper. MDS consist of big plastic containers where the pharmacy unpackages and repackages medication into plastic trays. This is sent to the care home, where it’s taken out of the trays and given to residents. Any medication administered will be recorded on a paper-based MAR (medication administration record).

The pharmacy is responsible for putting the medication from the packaging into the container. This means it can be difficult to know if you’re getting the right medication from the right pod, as none of the medications are labelled. The sector is phasing out the use of multi-dose pods due to the lack of traceability.

Pros – it’s a fast and simple way to administer medicines in care homes, carers don’t usually check or dose medication as they just pop the pod and give it to the resident.

Cons – medication errors, cross-contamination and the expiry date is shorter due to medicines being unpackaged. Care homes have no real understanding of what the medication is, they’re just relying on the pharmacy. The responsibility lies with the nurse if the medication is incorrect and harms a patient.

2. Traditional Paper Administration + OPD  

Original packet dispensing (OPD) is when medication is sent out in its original packaging e.g. packs of pills in small tin blister packaging. The sector is moving in the direction of care homes getting their medication in its original packaging from the pharmacy. Once received by the care home, the carers will be responsible for organizing the patient’s medication and will be able to see exactly what is what.

Pros – This method is far safer as the nurse or carer knows that the medication is what it says on the box, it can eliminate dispensing errors if a mistake is made and reduces the risk of medication errors as the medicine hasn’t been tampered with.

Cons – It takes a lot of time for the nurses to organise the medication, nurses need to be responsible for all the medication. Care home staff will need to know if they have enough stock and if there’s enough PRN (pro re nata) in stock for residents when they need it.

Why are paper-based systems bad? 

A MAR chart has tons of information but it’s static. It won’t tell you if medication is late or if it needs to be signed. It doesn’t tell you to write medication down and human errors aren’t picked up. It can also be hard to get information off a MAR chart. For example, if you want to know how long someone has been taking a medicine, you will need to count pills and signatures to find this out.

Another issue staff face is messy handwriting messing up the records, as it’s difficult to read. Paper-based systems can be expensive as the care home will need to restock regularly and the waste is bad for the environment. Finally, calculation stock is a pain that’s made worse by paper, due to the fact it’s hard to get the information you need from it.

3. eMAR Administration + OPD 

Using an eMAR (electronic medication administration record) tool alongside OPD is one of the best ways to manage medicines. Using eMAR allows care staff to manage the end-to-end process of medication. This includes stock management (the system tells you when stock is low), auditing and reporting.

Before implementing an eMAR system, providers need to look at what they need from their software. For example, in domiciliary care, the stock doesn’t need to be managed so these businesses can get away with using a simple eMAR tool that tells you what to administer, when and record those administrations of medicine.

However, care homes need a tool that will help the care team manage the full process.

So, what do full medication management tools do? These systems give you automated alerts and alarms, which inform staff about missed doses, double doses, late doses, etc. This drastically reduces the risk of medication errors, especially when it’s combined with mandatory visual and general nurse checks and automatic background checks.

If you have a MAR chart and the GP says that they’re changing the dose of medication, this will need to be written out on the MAR which may be misread due to handwriting or not seen by staff. With eMAR, the data from the pharmacy will be linked to the management system and updated automatically.

How “eMAR” systems vary

It is really important to note that there are lots of different systems available for residential care providers that are described as eMAR. 

Some are complete electronic medication management systems, while others do little more than the term ‘eMAR’ suggests, they’re basically just electronic, digital versions of a MAR chart. Often these are hastily created ‘bolt ons’ to an existing electronic care planning system, where the software provider is trying to fill a gap in their product with something pretty lightweight and limited.  

A basic eMAR system still offers some benefits in terms of recording data electronically, which makes it easier to read, export, analyse and so on. But you will usually miss out on the important safety features that prevent errors, for example by warning carers if they try to give medicines too closely together. 

These more simplistic eMAR tools usually don’t have other key functionality, such as stock control and pharmacy ordering features or detailed medicine information to ensure proper administration. 

So while any eMAR will be an improvement on paper MAR, some systems are very basic, while others are a holistic system to manage and improve all the processes involved with medicines in a care home or nursing home. 

EMAR Pros

eMAR systems reduce medication errors and improve resident safety greatly.  

They increase efficiency, improve the quality of life for residents as the care staff will be able to spend more time with them rather than going through paperwork, are better for the environment, cost-effective, records are updated automatically, alerts and alarms to notify staff about stock and missed dosages, etc.  

EMAR Cons

If not properly rolled out, it can take time for staff to adapt, and continuous training is required to keep up with software updates if the system goes down or requires maintenance it can cause problems.  

Like most software, it requires an initial investment, sometimes for setup and then ongoing monthly costs. Paper MAR does not of course. However, most vendors should be able to explain how the software gives you a decent ROI.  

For best results your eMAR, or medication management system should be integrated with both your electronic care plan or care management system. It should also be able to interface with the software used by your pharmacy. This may restrict your choices of system and ROI/overall benefits can be compromised by opting for a basic eMAR system over a full medication management system. 

Managing medicines in care homes – what’ll your choice be? 

Now you should have a clearer understanding of the main methods used to manage medicines in care homes in the UK and hopefully which is better for you.

Providers are generally moving away from mutli-dose systems to original pack dispensing, largely due to safety concerns. This leaves most providers with a decision between using paper MAR and eMAR.

EMAR can result in a reduction in medication errors and improve efficiency. Access Medication Management helps you manage and improve safety and efficiency in every step of the medication processes in a care home or nursing home.

However, there are still care homes and nursing homes using paper MAR. Others are using basic eMAR systems. All have their reasons. Sometimes, it is a case of cost, fear of disruption, incompatibility with existing systems, lack of awareness of what is available or having more immediate priorities to address first.

In short, using original pack dispensing, with a full spec electronic medication management system, integrated with your care planning system and your pharmacy is definitely the best way of managing medicines in your care home or nursing home.

We know how effective medication management can be and we desire to assist others, so they can experience the benefits of it too. Don't just take it from us, here are some quotes and stats from Erskine, who use the system:

But it might not be feasible for you, or at least not currently. That said, it is certainly something you should explore if you have not done so already. If you’re still uncertain about which option is best for your care home, contact us and we can talk about the kind of options available and what they entail.