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Archived: Pulse - Plymouth

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Inspection report

Date of Inspection: 10, 11, 16 October 2013
Date of Publication: 14 November 2013
Inspection Report published 14 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 10 October 2013, 11 October 2013 and 16 October 2013, observed how people were being cared for and talked with people who use the service. We talked with carers and / or family members, talked with staff, reviewed information given to us by the provider and talked with other authorities.

Our judgement

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

Reasons for our judgement

We looked at three people's medication records. We saw each person's care and support plan included information and risk assessments about what assistance the person needed with their medication, such as "unable to self-medicate", "medication managed by care worker as prescribed by GP". We saw information about how and from where medicines were delivered or needed to be ordered, for example, "delivered in compliance pack by the pharmacy", and "[X] needs re-ordering from the hospital". This meant people knew the levels of medication assistance they should expect.

We saw records of people's prescribed medicines on their care plans. These detailed the name of the medication, the dosage, how much and how often it should be taken, and why it was prescribed. We looked at medication administration records in people's homes we visited. We saw these contained any specific instructions, for example, "wear gloves to lightly rub gel into affected areas. Leave four hours between applications". We found the administration records were signed on each occasion the medication was administered or the person was prompted to take their medicines, and medicines were accounted for if they were omitted for any reason. This could be, for example, pain relief prescribed to be given as required and it was omitted because it was "not required".

We saw care workers had included information about medication and any side effects, GP appointments about medication, changes to medication, and details of new deliveries of medicines in the daily log. There were also stock checks and logs of any medicines returned to the dispensing pharmacy. These were signed and dated by the care worker completing this. We also saw a record of sample signatures of care workers. This meant audits of medication administration records, stock checks and returned medicines' records were easily traceable to individual care workers.

We spoke with four care workers and looked at training records. The care workers told us they had completed a course about medication management as part of their induction training and they also had annual refresher training on this subject. The office team told us that care workers who either did not complete medicines management training or who completed the training but did not pass the "competency test", would not be allowed to work. They told us this was an essential competency expected of every care worker and the office team, including the registered nurses. They also said that this competency had to be achieved before any new care worker could go into anyone's home even if they were shadowing an experienced, competent care worker as part of their induction. This showed that people receiving assistance and/or prompting with medicines were receiving their medicines when they needed them and in a safe way.