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Inspection report

Date of Inspection: 5 March 2014
Date of Publication: 10 June 2014
Inspection Report published 10 June 2014 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 5 March 2014, observed how people were being cared for and talked with people who use the service. We talked with staff and were accompanied by a pharmacist.

Our judgement

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

Reasons for our judgement

Appropriate arrangements were in place in relation to obtaining medicines. The pharmacy opened seven days a week, and a pharmacist was always 'on call'. The weekend pharmacy service included the supply of medicines for patients to take home.

Nurses told us that patients often had to wait a long time for their 'take home' medicines to be prescribed and dispensed, after being told they could go home. When we visited the discharge lounge at 2.30pm we met two patients who had been waiting since the morning 'ward round' to be discharged. However, both had been warned they would have to wait until the afternoon for their medicines. Both were very happy about the care and treatment they had received while in hospital and praised the staff. This meant that people were sometimes inconvenienced but received the medicines they needed.

Appropriate arrangements were in place in relation to recording medicines. We looked at a total of 18 prescription charts on three wards. We saw four unexplained 'gaps' (where it was unclear whether the dose of medicine had been given) but all other administration records were completed. The Trust showed us the checks (audits) it has carried out across the hospital on the recording of medicine administration. A committee meets each month to review practice with medicines. This meant that the trust monitored the recording of medicines and that prescription charts showed if medicines had been given.

Medicines were prescribed and given appropriately. We met pharmacists and pharmacy technicians, who were checking that medicines were prescribed safely, on the three wards we visited. We found that the trust was meeting its target for 70% of all patients to have their medicines checked (reconciled) by pharmacy staff within 48 hours of admission. Medicines reconciliation was recorded on the prescription charts we saw. This meant that patients continued to receive the medicines they were taking before they came into hospital, unless the doctor stopped them for medical reasons.

Medicines were safely administered. We watched a nurse administering medicines on one ward. We saw that medicines were given to patients in a safe and friendly way. Patients were asked if they needed any medicine for pain relief, where appropriate. However, one patient told us that they had not been given any pain relief medicine when they asked for it, on another ward. They said "I am well-treated on this ward but on the previous ward medicines were always late".

Medicines were kept securely. However, the provider may wish to note that the temperature in rooms used to store medicines was above the recommended maximum temperature. This meant that medicines could deteriorate and be less effective or unsafe to use. The provider may also wish to note that the temperature of one medicine refrigerator was too low. This meant that medicines in the fridge could freeze and then be unfit for use.

Medicines that are controlled drugs (CDs) were also stored securely. We checked the stock of a sample of CDs on two of the wards we visited. We found that the amounts corresponded to the stock balances in the CD registers. This reduces the risk of mishandling and misuse. However, we asked the trust's CD accountable officer to investigate a comment about CDs made to us by a patient.