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Shared Lives Schemes - managing medicines

Categories:
  • Organisations we regulate

Shared Lives Schemes offer an alternative to residential care or more traditional care at home services. They’re for people who need support with their day to day lives.

Shared Lives Schemes recruit and support carers who offer care and support in their own homes. The care and support can be temporary, a day service, or an overnight service. It can be provided together with a live-in or long term arrangement.

Shared Lives Schemes register with CQC to provide personal care. Medicines administration is an ancillary activity to personal care and regulated by CQC. We regulate at scheme level, through agency locations. We have no powers to enter shared lives carers’ homes. But schemes must support people to manage their medicines - in a way that meets NICE guidance.

Guidance

NICE guideline NG67 Managing Medicines for People Receiving Social Care in the Community includes the following population and settings:

  • adults (aged 18 years and over) who take or use medicines and who are receiving social care in the community (and their families and carers).
  • Shared Lives Scheme living arrangements

Medicines support

Where possible people should make decisions about and manage their own care. This includes their medicines. Sometimes people need support with taking medicines. Shared Lives Schemes should make sure that Scheme carers consider:

  • to what extent a person currently manages their own medicines, and whether this could be improved
  • the person's understanding of why they are taking their medicines
  • what support the person needs, for example, reading medicine labels, using inhalers or applying creams
  • whether the person has any problems taking their medicines, particularly if taking multiple medicines
  • related social, cultural, emotional, religious and spiritual needs
  • whether they have any specific nutritional and hydration needs, including the need for nutritional supplements or other support

Joint working and information sharing

Schemes and carers should work with health professionals and other social care practitioners. This enables people to receive integrated, person-centred support. People should get the support they need to be included in medicine reviews. Health and social care professionals should consider people’s communication needs to meet the Accessible Information Standard. They should make information available about how people take their medicines if the person's care transfers to another service.

If a person does not or may not have mental capacity to make decisions about their medicines (permanently or fluctuating) Shared Lives Schemes and carers must follow the Mental Capacity Act Code of Practice when making assessments and decisions about this including giving medicines covertly.

Records and administration

People should be supported to administer their own medicines when they want to and where this is safe. Shared Lives Schemes should work with people and their Shared Lives carers to develop a self-management plan for medicines by considering risk, values and benefits.

Shared lives carers may administer medicines or support a person to take medicines. They must keep records in line with NICE guideline NG67. This includes details of all support for prescribed and over the counter medicines, such as:

  • reminding a person to take their medicine
  • giving the person their medicine
  • recording whether the person has taken or declined their medicine

Shared Lives Schemes should have robust processes to make sure carers keep accurate, up to date medicines administration records. They should have assurance that people are receiving their medicines as prescribed and in a person-centred way. People have the right to refuse to take a medicine if they have the mental capacity to make that decision.

Ordering and supply

Shared Lives Schemes should be confident that people living with scheme carers will get the medicines they need. They must have reliable access to both prescribed and over the counter medicines. Shared lives schemes and carers should work with medicines suppliers as needed. They must make reasonable adjustments to help people manage their medicines. For example, large print dispensing labels, easy read leaflets, and accessible administration charts.

NICE NG67 says providers should “consider using a monitored dosage system only when an assessment by a health professional (for example, a pharmacist) has been carried out, in line with the Equality Act 2010, and a specific need has been identified to support medicines adherence. Take account of the person's needs and preferences and involve the person and/or their family members or carers and the social care provider in decision-making.”

Transporting, storing and disposal

Responsibility for transporting, storing and disposing of medicines usually stays with the person and/or their family members or carers. Shared Lives Schemes should work with people and their carers to store medicines safely. They must store medicines in a way that meets the manufacturer’s requirements. For example, this could mean medicines need refrigeration. Shared Lives carers do not need a separate medicines fridge. Carers should store controlled drugs safely and consider the risk of misuse and diversion. These medicines do not need to be stored in a separate controlled drug cupboard.

Training and governance

Shared Lives Schemes should check that carers have suitable training to support a person to manage their medicines safely and effectively. Shared Lives Schemes must be confident that carers are managing medicines safely. They must give people and carers the support they need.

Last updated:
11 December 2019

 


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