This guideline has been developed to help ensure that adults who receive social care in the community get the support they need to manage their medicines safely and effectively. Social care in the community is defined as care and support in their own home for adults who:
Note that a person's own home includes extra care housing, Shared Lives Scheme (formerly Adult Placement Scheme) living arrangements, sheltered housing (such as supported housing or specialist accommodation), supported living and temporary accommodation (such as for people who are homeless).
An increasing number of people need social care and support in the community, which may include help with managing their medicines, as reported in the Department of Health's policy on health and social care integration (2013).
People receiving social care in the community may be at a greater risk of medicines-related problems. For example, if they have multiple long-term conditions (multimorbidity) or are taking multiple medicines (polypharmacy). Family members, carers and care workers often help people to take and look after their medicines, for example, by ordering prescription medicines or reminding a person to take their medicines.
Care workers who are responsible for providing medicines support have limited supervision by health professionals. There is variation in staff training and low pay, which leads to a high turnover of staff (32% of care workers leave within 12 months; 56% within 2 years). This can result in a lack of continuity of care and inflexibility in changing care arrangements (Commissioning home care for older people. Social Care Institute for Excellence, 2014).
This guideline focuses on adults (aged 18 and over) and considers how to assess their medicines support needs, with an emphasis on enabling and supporting people to manage their own medicines as much as possible, when they are able to do so. It covers how support should be planned and delivered, with health and social care providers sharing accurate and up-to-date information, and working together to deliver high-quality care.
This guideline also addresses the medicines management systems and processes that need to be in place so that people receive the medicines they need in a safe and effective way. This includes ensuring that care workers receive support and training to provide medicines support for the people that they care for, and know how and when to get help and advice.
Finally, the guideline encourages a person-centred, 'fair blame' culture where people, their family members, carers and care workers can raise concerns about medicines, and social care providers have robust governance arrangements to help keep people safe in line with Regulation 13 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.