When staff give medicines to people in care homes

Process for making sure medicines are used safely and effectively

Care homes should have a process in place to make sure that medicines are used safely and effectively. This process should include information about:

  • what to do with medicines that need to be given in a special way (for example, patches, creams, inhalers, eye drops or injections)

  • recording what was taken or used as soon as possible

  • something known as the '6 R's', which stands for right resident, right medicine, right route, right dose, right time, resident's right to refuse

  • what to do if the person is having a meal or is asleep

  • using the right equipment to give the medicine

  • how to record and report mistakes, side effects and when a person refuses to take a medicine

  • how to handle and use medicines that are prescribed for 'when required' use

  • how to manage medicines when the person is away from the care home (for example, when they visit relatives)

  • monitoring medicines (for example, for side effects) and checking how well medicines are working.

Staff in the care home, the health professional who prescribes the medicines and a pharmacist should agree with the person when they should have their medicines (for example, what time of the day). This could mean avoiding busy times such as the morning medicines round.

Care homes should try to avoid disruptions when medicines are being given out. This might include:

  • making sure that enough trained staff are on duty so that staff have enough time to spend with each person and to check that the medicines have been taken correctly

  • changing the times for giving out medicines

  • avoiding staff breaks when medicines are being given out.

Recording medicines that are taken or used

When recording medicines that have been taken or used, staff in the care home should:

  • make a note in the record as soon as the person has taken the medicine, including the date and time

  • make a note when a medicine has not been taken or used and the reasons why.

One member of staff should do the recording because mistakes in recording are less likely than if more than 1 person does it.

When health professionals (for example, district nurses) give medicines to people in care homes, they should make their records available to care home staff if asked. The care home staff should record any medicines given by health professionals visiting the home in the resident's medicines administration record. Health professionals who are visiting the care home might see the person alongside care home staff who are responsible for giving medicines.

Care home staff should make an entry on the medicines administration record when they give a medicine that needs a separate record kept (for example, when giving warfarin they would add 'see warfarin administration record').

When giving controlled drugs, care home staff should sign the controlled drugs register and the medicines administration record.

When the person is away from the home

When a person is going to be away from the care home (for example, visiting family members), staff should give the following information to the person and/or their family members or carers:

  • details of the medicines the person is taking with them

  • clear directions and advice on taking the medicines

  • the time of the last and next dose of each medicine

  • details of who they can contact if they have any questions about the medicines (this might be someone from the care home or a pharmacy or a GP).

The care home should have a process to make sure that people have the medicines they need when they are away from the home. Details of medicines taken with them should be recorded in the person's care plan.