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Self-administered medicines in care homes

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  • Organisations we regulate

It is important for people living in care homes to maintain their independence.

'Self-administration' is when a person in a care home can look after and take their own medicines.

People have the right to choose to manage their own medicines. Staff should consider a person's choice and whether there is a risk to them or others.

NICE guidance SC1

NICE says that staff should assume a person can self-administer (unless a risk assessment indicates otherwise). When people are receiving short term respite, or intermediate care, they need to keep their skills. This includes keeping the skills they need to take their own medicines when they return home.

Process

You should have a policy in place for self-administration of medicines. Your process for self-administration of medicines (including controlled drugs) should include:

  • individual risk assessment
  • obtaining or ordering medicines
  • storing medicines
  • keeping records
  • reminding or prompting people to take their medicines if necessary
  • monitoring adherence
  • disposing of unwanted medicines

Individual risk assessment

Self-administration can vary from person to person and for different medicines. Care home staff should assess the risk for each person. They need to find out how much support a person needs to carry on taking and looking after their own medicines.

Risk assessment should consider:

  • the person’s choice
  • if self-administration will be a risk to the themselves or other people
  • if they can take the correct dose of their own medicines at the right time and in the right way. For example, do they have the mental capacity and manual dexterity. This can be different for different types of medicine. For example, some people may be able to take tablets but struggle with eye drops.
  • how often you will need to repeat or review the assessment. Base this on the person’s need (for example, during an acute illness)
  • how you will store the medicines
  • the responsibilities of the care home staff. Write these in the person’s care plan. Include an effective way of monitoring adherence

The care home manager should coordinate the risk assessment. They should decide who to involve. Assess the risk individually for each person. Involve the person and their family members or carers if they wish. Involve care home staff with the training and skills for the assessment.

Involve other health and social care practitioners as appropriate. For example, the GP and pharmacist can offer help and advice. They could identify how to adjust medicines to make them easier to self-administer.

Support to self-administer

Self-administering medicines is not an ‘all or nothing’ situation. For example, some people might keep and use their own inhalers but not their other medicines. Support may include practical help such as providing a glass of water. Other support could include:

  • reminder charts
  • large print labels
  • easy to open containers
  • help measuring liquids
  • using compliance aids
  • devices to help with inhalers or eye drops
  • colour-coded labels

Support may also be providing the person with suitable information about their medicine. This includes explaining how to take it and any potential side effects.

Storing medicines

Store medicines for self-administration as identified in the person’s risk assessment. For example, you might store the medicines in a lockable cupboard or drawer in their room. The storage place must not be accessible to other people. People should be able to access any medicines that they need, when they need to take or use them.

If a person in a residential setting is self-administering, they can hold their own controlled drugs. These must be their own individually-dispensed supply.

Keeping records

You must keep records when:

  • you supply medicines (including controlled drugs) for self-administration
  • you remind people to take their medicines themselves

Staff do not need to fill in the administration section of the MAR chart. The chart must show that the person self-administers. It should also show how you check adherence.

Last updated:
14 September 2018

 


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