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Storing controlled drugs in care homes
The Misuse of Drugs Act 1971 places controls on certain medicines. We call these 'controlled drugs'.
The Misuse of Drugs Regulations 2001 split those drugs into five schedules. The schedules correspond to the drugs' therapeutic usefulness and misuse potential. The Home office has produced a list of the most commonly prescribed controlled drugs.
Care homes usually hold medicines dispensed and labelled for individuals. Care homes with nursing may also hold stocks of controlled drugs. These homes might consider holding stocks if people are at the end of their lives. You may need a Home Office controlled drugs licence to hold stock.
Residential homes must not hold stocks of controlled drugs. They must only hold controlled drugs prescribed and dispensed for an individual person.
Controlled drug cupboards
The controlled drugs cupboard must meet British Standard BS2881:1989 security level 1. The Safe Custody Regulations specify the quality, construction, method of fixing, and lock and key for the cupboard.
The controlled drugs cupboard must be:
- secured to a wall and fixed with bolts that are not accessible from outside the cupboard
- fitted with a robust lock
- made of metal with strong hinges. The walls of the room should be of a suitable thickness and made of a suitable material, for example bricks. This means that the cupboard must be securely fixed to a wall
If you use a safe to store controlled drugs, they should be stored in a separate container within it. You must also show how the safe complies with the safe custody regulations.
- you can fix the cupboard to an internal wall as long as it is secure
- you do not need to store the controlled drugs cupboard within another cupboard
- you must restrict access to the cupboard proportionally
- the cupboard should be in a suitable location
- store spare keys securely
- for safe practice, only use the cupboard to store controlled drugs
Controlled drugs schedules
You must store schedule 2 medicines in a cupboard. Keep records of these medicines in your controlled drugs register. Common examples include morphine, diamorphine, methadone, fentanyl, alfentanil, oxycodone, methylphenidate, dexamphetamine, ketamine and tapentadol.
You do not need to record schedule 3 medicines in the controlled drugs register. Some services may choose to do so. You must store certain schedule 3 medicines in the controlled drugs cupboard. This includes, for example, buprenorphine and temazepam.
There are other schedule 3 medicines that you do not need to store in the controlled drugs cupboard. Common examples include midazolam, tramadol and barbiturates (phenobarbitone).
You do not need to store certain schedule 4 and 5 medicines in the controlled drugs cupboard. And you do not need to record them in your controlled drugs register. Some services may choose to do so. Examples include morphine sulfate solution (Oramorph®) 10mg/5mL, zopiclone, codeine and benzodiazepines.
Managing controlled drug stocks
Check stocks regularly.
For good practice, two staff members should sign when:
- receiving controlled drug stocks
- checking stock balances
- administering the medicines
- disposing of these medicine stocks
If you have controlled drugs awaiting disposal, separate them from those in use.
None of the medicine refrigerators on the market meet the Misuse of Drugs Safe Custody Regulations. Store those controlled drugs which need to be refrigerated in a medicines fridge. You can store them in the same medicines fridge as other medicines. You must store them separately within the fridge. For example, you might store them in a separate lockable box.
You must have a policy or standard operating procedure which details how you manage controlled drugs within your home. This should include what to do if there's a discrepancy. Include details of the name and contact details of anyone who you need to informed. Include details of the NHS Controlled Drugs Accountable Officer (CDAO) at NHS England.
Keep comprehensive records when administering topical controlled drugs, for example as patches. These should include the site of application and the frequency of rotation of the site.
- Last updated:
- 02 December 2019