Medication Policy

1. Overview

Tigh a'Chomainn Camphill operates under strict guidelines for the administration of any type of medication. Only trained co-workers are to administer medication to residents and we employ a thorough audit process for any type of medication process in Tigh a'Chomainn Camphill. Malpractice with regards to medication is a reportable offence and falls under the category of abuse.

2. What you need to know and do

Training

All co-workers intended to administer medication will receive adequate training. This includes the online medication training, for which Tigh a'Chomainn Camphill requires a minimum 90% score for a pass. Following the test, co-workers will be shown and will have to practically demonstrate how medication is administered with a resident. Only after the relevant line manager signs off on the practical demonstration, which is recorded in the appropriate medication folder, can a co-worker administer medication. Co-workers will also have to be shown how the relevant Medication Administration Sheet (MAR) is to be filled out. If staff have had a break from administering medication of more than 6 months or are observed to have shown poor practice, they will have to undergo either the practical or both parts of the training again (as deemed appropriate by a manager).

Storing of Incoming and Outgoing medication

 If medication enters a residential service at Tigh a'Chomainn Camphill for keeping, this will have to be recorded in an ‘incoming medication book’. Medication stored in residential houses or day service groups needs to be placed in a lockable medication cupboard with the key either removed or placed in a lockable key safe box that residents or unqualified co-workers cannot access. Medication coming into the day service should be agreed by the parent or carer that Tigh a'Chomainn Camphill staff have the authority to administer it – a sample permission form is attached. It should also be recorded on a Medication Received form. Equally, medication leaving a service will have to be recorded in an ‘outgoing medication book’. Where medication is taken back to the pharmacy for disposal, co-workers are to obtain a receipt of this and file it in the medication folder.

Where appropriate, co-workers will pass unwanted or expired medication back to the family or carer in order that it can be disposed of appropriately. This process will require a signature from the family member or carer who takes receipt of the medication.

In supported living, each resident will have an individual medication plan, the storage of medication and support to take medications will be agreed individually, some residents may take medication independently or with prompting.

Administration of medication

Prescribed medication is only to be administered to the person it is prescribed to. Furthermore, co-workers need to check the following details are correct and match the MAR sheet, which must be filled out for every time that the medication is due to have been administered (this includes times where people are on leave or refuse medication): name, strength, dosage, time restrictions or any other relevant information on the label. The co-worker then needs to fill out the MAR sheet as outlined on the sheet.

Any adverse drug reaction (ADR) or suspected ADR must be reported immediately to the prescribing doctor.

Incidents

Most commonly incidents around medication revolve around spillage or contamination of medication. These require proper recording as per MAR sheet and an incident report covering exactly what happened. This will then be discussed with the responsible manager who will decide if further action or changes in administration systems are necessary.

All errors in medicine administration must be reported to the relevant manager. As a result, they will contact the prescribing G.P for advice. All errors in administration must be documented in the resident’s notes and, if necessary, RIDDOR must be informed and incident/accident forms completed. In serious errors, the Care Inspectorate must be notified via eForms.

Home Remedies

Tigh a'Chomainn Camphill holds some home remedies in its medicine cupboards within residential houses, which follow the same audit trail as all other medication, i.e. full record of incoming, administration and outgoing of the medication. These are only to be given to residents who have explicit written permission by their GP to be given these as required. Co-workers are to follow the prescribed information leaflet for the specific medicine and contact the GP if symptoms do not improve as outlined in the leaflet.

Self-medicating residents

Some residents are able to self-administer some or all of their medication. The medication is subject to the full audit trail in the houses, this will have to be fully audited, too. The appropriate level of support should be noted in the person’s care plan and risk assessment. If families and carers are unable to provide Tigh a'Chomainn Camphill with a MAR sheet for the medication they wish us to administer, we will use our own MAR sheet. Note this is individualised in supported Living and auditing will only be in place where required.

Audit

Audit Calculation Sheets must be completed monthly. A full Medication Audit is to be completed annually. A record is made of any action required and the date that action is implemented. Where possible, the audit will be not carried out by the responsible manager for a more transparent and accurate process.

3. References

Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR); Medication Act 1968; Regulation of Care Act 2001 (The Scottish Commission for the Regulation of Care).