Training and competence in medicines optimisation for adult social care staff

Regulation 18: Staffing addresses all aspects of staffing, training, qualifications, competence and skills.

This includes learning and development, from induction to continuing professional development, supervision and appraisal.

Care providers should identify any other training for care home staff who are responsible for managing and administering medicines. If there is a medicines-related safety incident, you may need to review those learning and development needs to prevent any future incidents.

There is no minimum age to be able to work in adult social care. But there are some general rules for school leavers under 18 years.

You should carefully assess when it is appropriate for a young person to deliver personal care - including medicines support.

Training

Your medicines policy should include training needs. It should be relevant to the type of care setting where staff are working and the tasks to be undertaken.

Training should be accessible and staff should be supported to take part.

Areas to consider include:

• induction training for all staff at the start of their employment
• how to identify training, learning and development needs for staff
• how staff will be supervised during their training
• who will carry out competency assessments and how this will be documented
• different medicines systems and processes, for example original packs, multi-compartment compliance aids or electronic medicines administration systems
• ongoing training and supervision for experienced staff
• review of training needs, for example if processes change or in response to errors or incidents
• where and how records will be kept and updated.

Care staff may need additional training to administer medicines using specialist techniques and equipment. Examples include:

• inhalers and nebulised medicines
• oral syringes
• eye drops
• rectal or vaginal preparations
• buccal administration
• other medical devices such as hosiery devices.

Some nursing tasks can be delegated to care staff, who will need additional training. Examples include:

• subcutaneous injection
• administration of medicines through feeding tubes
• catheter care.

Competence

NICE guidelines SC1 and NG67 recommends that all staff who support people’s medicines needs have an annual review of their knowledge, skills and competencies relating to managing and administering medicines.

You should have a formal process to assess staff competence. You must not allow new staff to manage or administer medicines before assessing their competence.

The person who assesses staff should be competent in the medicines support tasks that your service delivers. They will assess the knowledge, understanding and skills of the staff.

You must keep records of staff competency assessments and note when they are due for review.

Healthcare professionals and other registrants (for example nursing associates) working in adult social care services must maintain their professional standards as set out by their regulator.

Learning providers

Skills for Care produced medicines management resources for adult social care providers, commissioners and training providers.

They provide a detailed framework to enable you to assess whether your training and educational material covers all key required elements in sufficient detail and supports the quality assurance of medicines management training.

NICE guidance suggests using an 'accredited learning provider’ so staff can be assessed by an external assessor. For example, you could refer to the Skills for Care Quality Assured Care Learning Service.