Managing medicines in care homes is a guideline that applies across both health and social care.
The management of medicines is governed by legislation, regulation and professional standards, which are monitored and enforced by different regulatory organisations across England, Wales and Northern Ireland.
Care Quality Commission regulatory changes in England are expected in October 2014 as a result of the Health and Social Care Act (2012). It is expected that the recommendations in the guideline will not change as a result of this because the guideline is based on current evidence. Following publication of the updated regulations, the guideline will be assessed to ensure that any relevant regulations are appropriately referenced.
People living in care homes have the same rights and responsibilities as those who do not live in care homes in relation to NHS care; this is set out in the NHS Constitution for England. Treatment and care should take into account an individual's needs and preferences. Care homes residents should have the opportunity to make informed decisions about their care and treatment, in partnership with their health professionals and social care practitioners. Person-centred care is particularly important when considering safeguarding and mental capacity issues; these issues are considered in the guideline in relation to medicines.
Helping residents to help look after and take their medicines themselves is important in enabling residents to retain their independence. Care home staff should assume residents are able to look after and manage their own medicines when they move into a care home, unless indicated otherwise. An individual risk assessment should be undertaken to determine the level of support a resident needs to manage their own medicines.
The guideline considers all aspects of managing medicines in care homes and recommends that all care home providers have a care home medicines policy. The policy should ensure that processes are in place for safe and effective use of medicines in the care home. Sections of the guideline provide recommendations for different aspects of managing medicines covered by the care home medicines policy.
A NICE quality standard on managing medicines in care homes was published in March 2015.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.