It’s essential for all nursing and residential homes which stock controlled drugs to have a system in place to safely and effectively manage their medications.
After all, having efficient processes and systems in place will help to protect patients’ health, as well as the reputation of care providers. There can be legal consequences for the provider and registered manager if controlled chemicals are not managed correctly, so getting this right is a must.
Regulation 13 of the Health and Social Care Act 2008 states:
“The registered person must protect service users against the risks associated with the unsafe use and management of medicines, by means of the making of appropriate arrangements for the obtaining, recording, handling, using, safe keeping, dispensing, safe administration and disposal of medicines used for the purposes of the regulated activity.”
The Care Quality Commission (CQC) provides detailed advice on compliance with regards to medical mismanagement within their guide to Essential standards of quality and safety.
However, if you are looking for some quick and simple measures that you can follow in your nursing or care home, read on below to discover three simple steps you can take to follow best practice for medication management.
#1 Record, Manage and Control
The key to creating a system that protects your home from medical mismanagement is organisation. In order to be organised, you’ll need to put the correct procedures in place, and you’ll also need to keep a detailed record of everything. During a CQC inspection, a home's reporting methods will be reviewed to determine the effectiveness of the processes and systems that are in place to monitor patient safety.
Nice.org.uk recommend the ‘6 R’s of administration’ when recording the administration of medicine. The 6 R’s of administration are as follows:
The 6 R’s should be considered and recorded during each medication administration. In order to stay organised and keep a record of the 6R’s we recommend using one of the following controlled drug record books.
As mentioned above, organisation is a key component when implementing and supporting a strategy for medication management. It is also important to focus on providing each member of staff with the tools and information to follow through with your strategy.
Although we suggest having certain members of staff responsible for the control of drugs, it is important that each member of staff understands these processes and can follow the correct procedures when necessary.
Besides understanding procedures, staff should also recognise the importance of proper medical control. If correct procedures are not followed the care provider may be liable, and understanding correct drug control protects the provider and the residents.
#3 Effective Handling and Appropriate Storage
Alongside being organised and implementing the correct procedures, it is also important to have the appropriate equipment to safely store medication and controlled drugs. Homes should ensure that a member of staff has responsibility for medicine storage and stock control at all times.
All medication must be stored in the appropriate conditions, and access to medicines should be locked and restricted to specific staff members.
Storage for controlled drugs depends on the schedule of the drug and the conditions the medication requires. Residential care homes would benefit from individual lockable cabinets that allow residents to self-administer and store their personal medications.
A nursing home will likely require a more secure drug cabinet with restricted access in order to avoid medical mismanagement. It may also be necessary to control the conditions of particular controlled medications and a medical pharmacy fridge may be more suitable.
All medications that are stored must be regularly inspected, replenished and disposed of in line with regulations.