Prescribing medicines for people in care homes

GP practices should have a written process for prescribing and issuing prescriptions to their patients who live in care homes. All medicines prescribed should be recorded in the person's GP patient medical record and their care record. Records are likely to include instructions on how to use the medicine (for example, where to apply a cream and how much to use), how long the medicine should be used, how long the medicine will take to work and what it is for.

People working in health and social care (practitioners) should work together to make sure that everyone knows when medicines have been stopped, started or changed. Care home staff should update records of medicines administration as soon as possible with details of any changes to a person's medicines.

Prescribing by telephone, video link or online

Health professionals should only use telephone, video link and online prescribing rarely. If they do, they should follow this up by sending the details to the care home in writing as soon as possible. Occasionally details of medicines may be sent by text. The care home should have a process for recording the details of these text messages and making sure the information is kept confidential.

Prescribing variable dose and 'when required' medicines

Sometimes the amount (or dose) of a medicine the person takes is different (called a variable dose medicine). The dose might depend on the symptoms (for example, when paracetamol is taken for pain relief or laxatives for constipation) or the results a blood test (for example, when a test for blood clotting shows that more warfarin is needed to stop blood clots). In other cases, the medicine is only needed when there are symptoms (called a 'when required' medicine). For these types of medicines:

  • when and how the medicine should be used, how it should be monitored and what it is expected to do should be noted in the person's care record

  • the prescription should have instructions on how much of the medicine should be used and how often it should be taken (including the maximum amount of the medicine to be taken each day) and how long it should be used for

  • enough should be prescribed to last for the expected time of treatment.