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Over the counter medicines and homely remedies
Over the counter (OTC) medicines can be purchased from a pharmacy or other outlets. Such outlets could include petrol stations, convenience stores or supermarkets.
OTC medicines include products that:
- ease the symptoms of a condition that is self-limiting
- treat a condition when the person does not normally need to seek medical care or treatment.
A homely remedy is a medicine used to treat minor ailments. They are purchased over the counter. They do not need to be prescribed. They are kept as stock in a care home to give people access to medicines that would commonly be available in any household.
If you are offering people treatment for minor ailments with homely remedies, you should have a process for how to do this safely. Include this process in the care home medicines policy.
NICE guideline SC1 on managing medicines in care homes recommends that the process should include:
- the name of the medicine and what it is for
- which residents may be excluded from receiving specific homely remedies - for example you must not give paracetamol to a resident who already takes medicines that contain paracetamol
- the dose and frequency
- the maximum daily dose
- where any administration should be recorded, such as on the medicines administration record (MAR)
- how long the medicine or product should be used before referring the resident to a GP.
NICE SC1 also recommends that care home staff, who give non-prescription medicines or other over the counter products (homely remedies) to residents, should be named in the homely remedies process. They should sign the process to:
- confirm they have the skills and competence to administer the homely remedy
- acknowledge they will be accountable for their actions.
Take advice on the suitability of homely remedies for individuals from a healthcare professional, such as a GP or pharmacist. This could be in advance of or at the time of need.
Storing homely remedies:
- all homely remedies should be clearly identifiable as a ‘homely remedy’
- they should be stored securely and kept separate to the residents prescribed medication.
Supporting people to self care
You should support people who receive social care to access OTC products to enable them to self care. You must have appropriate safeguards in place.
Access to OTC medicines to self care is an issue of equality. You should have policies in place to support people who wish to access OTC products in a timely manner.
This is different to the use of homely remedies.
Guidance for Clinical Commissioning Groups (CCGs) on conditions for which OTC medicines should not routinely be prescribed in primary care was published in March 2018.
This guidance has the potential to impact on people receiving social care. CCGs should have local arrangements in place to support the implementation of this guidance.
NHS England has advised that there are exceptions to the guidance such as:
- patients being treated for long term conditions
- circumstances where the product licence does not allow the medicine to be bought over the counter
- “individual patients where the clinician considers that their ability to self-manage is compromised because of medical, mental health or significant social vulnerability to the extent that their health and/or wellbeing could be adversely affected, if reliant on self care”.
Providers must liaise closely with clinicians to:
- identify people who are affected
- make appropriate arrangements.
A GP may recommend the person, relatives or care staff buy a specific product. This may be to treat a minor ailment for a particular person, such as olive oil for treatment of ear wax. You must record verbal or written instructions in the individual care plan.
Considerations for providers
You should have a policy to support people who wish or need, to self care. This should include the necessary safeguards to support people to self care when carers or relatives provide OTC products. For example, how you protect people who may lack mental capacity to make decisions.
It is good practice to discuss health needs and medicines with the person and their family. This could be on admission to the care home or when a home care service is commissioned. The discussion should also include the use of OTC products.
People (or their relatives) may provide their own OTC products. This should be in consultation with a healthcare professional, such as a GP or pharmacist. These products are not for general use and must remain the property of that person.
All OTC products purchased on behalf of the person or brought into a care setting should be:
- checked, to make sure they are suitable for use
- in date
- stored according to the manufacturer guidance
Check all purchased medicines for potential interactions with prescribed medicines. You must check these with an appropriate healthcare professional before using the medicines.
If care staff are responsible for administration, record this on a MAR in line with policy.
There should be a clear care plan - including how to trigger reviews. This will make sure that medicines given are safe and still appropriate.
- Last updated:
- 15 September 2020