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Supported living schemes - managing medicines

Categories:
  • Organisations we regulate

Supported living schemes offer personalised support to help people live in their own home as independently as possible.

Some of the people living in the schemes will receive personal care (an activity we regulate). There are separate contracts for the personal care and for housing. Not everyone living in supported living schemes receives personal care.

We do not specifically refer to medicines administration in our definition of ‘personal care’. A CQC registered provider may provide personal care to a person and also administer their medicines. The medicines administration is considered ‘ancillary to’ the personal care they are receiving.

A scheme might support people to administer their medicines but not provide personal care. The medicines administration is not an ‘ancillary activity’. It does not fall into the scope of regulation by CQC.

We regulate at scheme level. We have no powers to enter individual homes.

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).
  • supported living

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. Supported living schemes should 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

Supported living schemes 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), supported living schemes must follow the Mental Capacity Act Code of Practice when making assessments and decisions. This includes giving medicines covertly.

Records and administration

People should be supported to administer their own medicines when they want to and where this is safe. Supported living schemes should work with people to develop a self-management plan for medicines. This plan must consider risk, values and benefits.

Care staff 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

Supported living schemes should have robust processes to make sure care staff 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. Care staff should make sure that people can access health care professionals for appropriate medicine reviews.

Ordering and supply

Supported living schemes should be confident that people will get the medicines they need. They must have reliable access to both prescribed and over the counter medicines. Supported living schemes should work with medicines suppliers as needed to 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

Where the service is responsible for transporting or disposing of medicines this should be risk assessed and records kept. Unwanted or waste medicines can be returned to a community pharmacy for safe disposal.

Supported living schemes should work with people to store medicines in a way that meets their individual needs and the manufacturer’s requirements. Medicines should be stored in people’s home, rather than centrally. Some medicines need refrigeration. Supported living schemes 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

Care staff should be trained and competent to support a person to manage their medicines safely and effectively. Supported living schemes must be confident that people receive their medicines safely and when needed. They should make sure that medicines errors are investigated and reported.

Last updated:
17 January 2020