Control and Use of Medicine

 

 

Policy aimed at; Employers and Employees

 

 

 

Issued Feb 2006

 

Updated August 2018

 

 

 

Control and use of medicines

 

Bath Junior Gateway Club recognises that although this policy is aimed at residential care homes, there are areas relevant to our work whilst on club holidays and trips. Bath Junior Gateway Club will use the policy as a guide to our procedures.

A shorter policy appropriate to club activities is attached.

 

Introduction

 

This document sets out procedures and guidelines in relation to the storage and administration of drugs and the recording requirements relating to this. This document should be read within the context of the wider policies and procedures of our organisation. In particular, reference should be made to your policies on:

 

 Duty of care

 Members plans (where in use)

 

Meeting health care needs, and Infectious Diseases and Precautions which should form part of your Health and Safety manual.  As drugs can reasonably be described as substances hazardous to health, this document should be read in conjunction with the procedures regarding the implementation of COSHH.

 

Legal Obligations

 

The legal obligations in relation to the use of drugs and medicines in a care home include:

 

Regulation 13(1) of the Care Homes Regulations 2001 requires the person registered to make adequate arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines.

 

Regulation 21(1) of the Children's Homes Regulations 2001 requires the registered person to make suitable arrangements for the recording, handling, safekeeping, safe administration and disposal of any medicines received into the children's home.

 

The relevant legislation includes:

The Medicines Act 1968

The Misuse of Drugs Act 1971

The Misuse of Drugs (safe custody) regulations 1973

It is the responsibility of the Club Leader of the service to ensure that: staff receive approved training in the administration of medication before they administer any medication for each shift there is an identified person with lead responsibility for the administration of medication.

 

Categories Of medication

 

The law distinguishes between different categories of medicine. The categories are:

 

Prescription-only medicine [POM] - obtained on a prescription from a doctor, dentist or nurse prescriber.

 

Controlled drugs Specific [POM] medicines such as Morphine, Diamorphine (heroin), Cocaine, Pethidine, etc. Because the potential for misuse, special additional restrictions apply to the prescription, storage, administration and recording of these drugs.

 

Pharmacy medicine [P] class medicines may only be purchased from a community pharmacy (chemist's shop) with a pharmacist present.

 

General sales list medicines [GSL] medicines (examples include paracetamol, proprietary cold remedies like “Lemsip", etc.) can be purchased through a wide variety of retail outlets, such as supermarkets and garages.

 

Pharmacists

 

It is recommended that only one pharmacy is used where the service obtains medicines on behalf of service users. This will enable the pharmacist to maintain a patient medication record, which will ensure a continuity of care when supplying medication.

 

When taking someone else's prescription to the pharmacy to be made up, it is important that you check the following:

 

 the name and address is correct

 the details of the medicine and dosage are clear

 the service has a record of what has been prescribed

 the prescription has been signed by the prescribing doctor

 that you have completed the reverse of the prescription form correctly.

 

Storage

 

A record of all drugs received into or disposed of within a service must be kept and must contain at least the information contained within the Medication Administration and Stock Control Record OP6 or a monitored dosage system.

It is the responsibility of the person receiving or disposing of drugs to complete and sign this record.

 

The following procedure must be followed when storing all medicines:

 

The storage instructions of each medicine must be checked and followed.

All medications held in services must be kept in their original containers, fully labeled with the name of the user, name and dosage of the medicine, and kept in a secure place, e.g. in a locked medicine cupboard. All “controlled" (dangerous) drugs must be kept in a cupboard that complies with the Misuse of Drugs Act (Safe Storage) requirements

 

If the medicine requires refrigeration, it must be kept in a separate drug refrigerator, or if local arrangement allows, a secure Iockable container in the general refrigerator

 

Storage facilities for drugs that require special conditions, e.g. those that are required to be kept below a specific temperature, must be as directed by the pharmacist.

 

Medications must never be transferred to another container, unless it is appropriate to do so, e.g. for home leave. In these cases the drugs must be in containers that are cleady labelled with the individual's name, name of medication, dosage and time to be administered.

 

Medications should never be used to “top up" another supply.

 

Labels on medications must contain precise details of the name, dosages and times of administration of the medication, as well as the name of the user.

Instructions such as “as directed" are not acceptable .. Staff should ask the GP to put full instructions on the prescription

 

Labels on medicine containers must never be changed by staff.

 

Keys for the medicine cupboard (or other secure place) in which drugs are stored must be held in a secure place or held by a responsible staff member.

The drugs must only be accessible to competent staff who have received approved training and are authorised to administer medication.

 

For prescription-only medication, no more than 2 month's supply is held within a service.

 

New supplies of drugs must be ordered regularly and systems must be developed in each workplace to ensure that required drugs are always available. It may be helpful to use a monitored dosage system. This should be discussed with the pharmacist.

 

Disposal

 

All medicines that are no longer required or are no longer useable must be disposed of and recorded in a Medication Administration and Stock Control Record if a monitored dosage system is not in use.

 

Medicines for disposal must be returned to a pharmacist or dispensing GP and it is advisable for a receipt to be obtained from the GP or pharmacist confirming the return of the drugs for disposal.

 

Administration

 

The following procedure must be followed when administering all medicines:

 

1. Identify who is the lead person on shift for administering medicines.

 

2. Know the uses of the medicine to be administered, its normal dosage, side effects, precautions and contra-indications.

 

3. Be aware of the person's service user plan and service user risk assessments relating to medication or medical treatment.

 

4. Read the Medication Administration and Stock Control Record (Monitored Dosage System).

 

5. Check that the instructions on the label of a medicine are unambiguous and clearly understood.

 

6. Check that the person is not allergic to the medication before administering it.

 

7. Give the medication:

 

Right dosage: Carefully check the label on the medication, and dispense the correct amount. Use proper measuring spoons if you are dealing with liquids.

Don't guess. Check that the medication is not out of date.

 

Right time: Check the records to ensure that the dosage has not already been given. Make sure you are giving the medication at the right time. Medicines have to be taken at the prescribed intervals to get maximum benefit from them.

 

Right person: Make sure that the person in front of you is the person whose name is on the medication and the records.

Right route: Check how medicine should be taken. For example, should it be swallowed whole or dissolved in water? Should it be taken by mouth or in some other way? Check that the individual has swallowed any medication they take by mouth.

 

8. Never give one service user's medication to another service user, even if the medication is identical. A record of all drugs administered (or non-administered) must be kept and must be recorded on the Medication Administration and Stock Control Record or a monitored dosage system. It is the responsibility of the person administering the drugs to complete and sign this record.

 

"Controlled" drugs will need to be checked by more than one person before being given. In this case always ensure that someone will be available at the appropriate time. (The GP/pharmacist will advise if drugs are "controlled".)

 

Refusal to take medication, incorrect medication or adverse reactions to medication

 

If a service user refuses a medicine, staff cannot force treatment. Where the individual concerned is sectioned under a treatment order of The 1983 Mental Health Act, further advice should be sought from the medical consultant or community nurse.

 

Failure by a service user to take a prescribed medicine, overdose, incorrect administration or adverse reaction to any medication must be reported to the service user's GP immediately for advice, or treated as an emergency if the situation warrants it; staff must dial 999 for an ambulance.

 

General sales medication

 

Applications such as sun cream, calamine lotion, etc. may be bought and used without reference to a doctor or pharmacist. Any concern over the application or possible allergic reaction of such items should be discussed with the GP or pharmacist.

 

All other administrations of non-prescribed medicines must be discussed with the pharmacist or GP prior to administration.

 

For predictable situations such as colds, etc. appropriate medication can be determined in advance with the GP or pharmacist and recorded in the individual's personal file. Medicines must only be given to the service user for whom they were prescribed or purchased.

 

Service users who control and administer their own medication

 

All service users, over the age of 16, who are deemed responsible to keep and administer their own medication should be allowed to do so. A service user risk assessment must take place to confirm this and may need to be agreed with other relevant professionals. Factors such as the following need to be considered:

 

Does the person understand and accept their need for the medicine and the effect of not taking it?

 

 Is the person motivated to remember to take their medication?

 Is the person able to manage time in relation to taking medication?

 

 

Does the person understand the instructions for taking or applying the medication?

 What are the benefits of self-medication, and what are the risks?

 

Does the person understand and accept the requirements of the safe storage of medication? Are there risks to others?

 

How will staff know whether the person has taken the medication?

 

In circumstances where the service user is keeping their own medication then facilities must be provided for the safekeeping of the medication in a personal, e.g. Iockable drawer/cupboard.

 

In circumstances where an individual is to be encouraged/supported to administer their medication for the first time or with a new drug, a service user plan identifying the process to be followed must be agreed and recorded. This plan should be discussed by all the staff members who will be involved in assisting the individual with the task and must be shown to the person's GP before implementation.

 

Service users who are temporarily absent

 

In circumstances when a service user will be temporarily absent from the service and drugs need to be administered during the absence, the manager of the service must:

 

ensure that adequate supplies of the necessary drugs are available to the service user in the place that they are visiting

 

ensure that such drugs are held in suitable containers and are appropriately labeled with the name of the service user, the drug name, dosage, dates and time of administering

 

assure themselves that any persons who will be responsible for the administration of the drugs during the absence are sufficiently competent to do so and that they have been provided clear directions on the administration

ensure that a note is made on the Medication Administration and Stock Control Record or monitored dosage system that details the absence.

 

General

 

Pour liquid medication from the side of the bottle away from the label so as not to obscure name and directions, etc.

 

Unless otherwise directed never open “capsules” the powder/granules/mini pills will be rendered inert by the acidity of the stomach. The purpose of the capsules is to allow slow release in the intestinal tract.

 

Staff involved in medical treatment, must take extreme care to avoid contamination by either blood, bodily fluids or excreta. See the procedures regarding Meeting Health Care Needs and Infectious Diseases and Precautions in the Health and Safety Manual.

 

Disposable gloves must be worn when dealing with open wounds or when in contact with any bodily fluid.