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Inspection report

Date of Inspection: 14 October 2013
Date of Publication: 6 November 2013
Inspection Report published 06 November 2013 PDF

People should be given the medicines they need when they need them, and in a safe way (outcome 9)

Meeting this standard

We checked that people who use this service

  • Will have their medicines at the times they need them, and in a safe way.
  • Wherever possible will have information about the medicine being prescribed made available to them or others acting on their behalf.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 14 October 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information sent to us by local groups of people in the community or voluntary sector. We talked with local groups of people in the community or voluntary sector and used information from local Healthwatch to inform our inspection.

Our judgement

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to safely manage them.

Reasons for our judgement

Medicines were kept safely. We saw that monthly stocks of medicines were stored in two locked medicines trolleys, which was kept in separate locked rooms. Medicines, requiring low temperature storage, were kept in a locked refrigerator. Staff monitored the temperature of the fridge daily to make sure medications were being stored at the appropriate temperature.

Medicines were prescribed and given to people appropriately. We saw records to show that the staff had received training in the safe handling and administration of medicines. Guidance was available on the administration of 'as required' medicines, for example, painkilling tablets, which were only to be taken when needed. Guidance was also available on the administration of over the counter or non-prescription remedies which were available for some of the people who used the service. We looked at one of the care plans and saw that the prescribed medicines being dispensed were consistent with the information detailed in the person’s care plan. Medication audits, to check that procedures were being followed and appropriate records kept, were being carried out monthly. The supplying pharmacist had also visited Townend Close, earlier this year, to check the arrangements for medication were being properly managed. Their report had not highlighted any issues.

The service uses a pre dispensed system for medication. This meant medication is dispensed by the pharmacist in a sealed package, which holds each day’s medication in a single container. The medication was delivered to the home, from the pharmacist with a printed medication administration record (MAR) which detailrd who the medication was for, what the medication was and how often it should be given. However, some medication, although prescribed, did not have a printed MAR and staff had handwritten the instructions. This, we were told, was because the medication might have 'fallen' outside the monthly cycle and therefore had been dispensed separately or was for a person who was on a temporary stay, and dispensed without a MAR. The homes policy for medication stated that all handwritten MAR sheets should be signed by the person completing it and countersigned. We saw that this procedure was being followed. The reason for this was to make sure the information was correct and had been checked by two members of staff, therefore minimising the risk of an error being made..

Medicines were disposed of appropriately. We saw that unused medicines were recorded on the medicines administration chart and stored securely ready for collection by the pharmacist. There was also a duplicate record book being used, which the pharmacist signed to acknowledge what medication had been returned for disposal.

At the time of our inspection a small number of people managed their own medication. We saw that they had access to secure storage for medication in their own bedrooms and that a risk assessment had been completed, detailing the action staff should take to support the person to maintain their independence around self-administration.

We observed medication being given at breakfast and lunch time. The person giving out medication had been appropriately trained, took time to make sure people took their medication properly, explained the reason for the medication and sat with people who needed additional help to make sure they took their medication safely. Some people had specific requirements with regard to taking medication, for example, taking their pills before meals. And we observed this taking place. The measures in place meant that people were given their medication safely and in accordance with the prescribers instructions.