Medication Fact Sheet Domiciliary Care - QCS

Medication Fact SheetDomiciliary CareDuring the Coronavirus pandemic (COVID-19) informationis changing very quickly as the government and otherorganisations try to adapt to different ways of working.The virus spread very quickly which has meant that careproviders have changed some of the usual ways of working.It’s important to make sure that you can carry on caring forservice users safely in their own homes.Medication Management is an area that often causesworry and mistakes sometimes happen. The Care QualityCommission have provided guidance on medication forproviders on areas that are causing concerns during thepandemic. You need to know what your responsibilities are.This fact sheet will explain what you need to understand ashome care workers. We will cover the following areas: Multi-compartment compliance aids (MCAs) Re-using named patient drugs as medicines supply Delegated tasks Access to medicines Medicines awaiting return to community pharmacy Handwritten medicine administration records (MARs) Using sedation to enforce social distancing guidelinest: 0333 405 33 33e: info@qcs.co.ukMaking sure service users get theright medicines at the right time arepart of the 6 Rights of Medication.During the COVID-19 pandemic it’simportant service users can still gettheir correct medication.You must make sure that; All prescriptions are ordered 7DAYS before they run out. The service user doesn’t ordermore than usual. If a service user is self-isolating athome and collecting medicationis not part of the agreed careplan, ask check if the serviceuser has arranged for family orfriends to collect OR speak to thepharmacist about delivery.w: www.qcs.co.ukMay 2020 v1.0

Medication Fact SheetDomiciliary CareMedication AdministrationRecords (MAR)Medication Administration Records often causeconfusion. If you make a mistake, service users mayget the wrong medication, the wrong dose or theymay get the medication at the wrong time. When CQCcarry out inspections they look at MARs to make sureservice users are being cared for safely.During COVID-19, you may have fewer staff or youmay not have as many managers working. It’simportant however that the information on a MARis up to date and accurate. Wherever possible,best practice is to have printed a MAR from thePharmacist. If you are using paper MARs, CQC havesaid home care providers must make sure that ; If you have to write out a MAR, they must have been written and checked by a person trained andassessed as competent to do so. Medicines must be recorded each time medicines support is provided.The MAR chart must be filled our for each individual medicine on every occasionDisposing of MedicationYou must keep the following records if youdispose of medication. The date you disposed itThe name of the Service UserThe name of the medicationWhether it was a tablet, a liquid, an inhaleretcHow many /much you disposed ofThe name of the member of staffdisposing of the medicationIts probably a good idea to say whichpharmacy took the unwanted medicationYou must not flush it down the toilet orsink or sluiceThere are special procedures for controlleddrugs that must be followedt: 0333 405 33 33e: info@qcs.co.ukReturning Unused MedicationYour medication policy will tell you that it’simportant to make sure that medication is disposedof safely and correctly. When you are working insomeone’s home, the medication prescribed for aservice user, belongs to them.If you need to support someone with theirmedication, the care plan will say what you needto do. It must also say what you must do with anyunused or out of date medication.You need to check who is responsible for returningmedication to the pharmacy if it’s not clear on thecare plan.During COVID-19, returning medication is moredifficult. You will need to check with the localpharmacy if they will accept it back. It’s also worthchecking what will happen to the packaging that hasservice user information on.w: www.qcs.co.ukMay 2020 v1.0

Medication Fact SheetDomiciliary CareDelegated Tasks During your Induction training you will have been toldhow important it is to only do things that you have beentrained and assessed as competent to do. It’s alsoimportant to only do things that it says in the care planand if you aren’t sure about something, to check withyour manager first before you do anything.There are some activities that care workers may beasked to carry out. Examples might be medicationthrough a PEG tube (percutaneous endoscopicgastrostomy tube) or giving insulin injections.CQC have reminded care providers that these are‘delegated tasks’ and must only be carried out by staffwho have had training to carry out the task, and theyhave been assessed as competent. Your manager will need to make sure that there areenough staff with these skills if your organisationagrees to take on these delegated tasks. It is the healthcare worker’s (e.g. a nurse) responsibilityto make sure that when they delegate a task, the careworker understands what they have to do, why they aredoing it, what to do if something goes wrong and how tocarry out the task. You must not agree to do something without firstchecking with your manager.The Routes ofMedicationThere are many ways that medicationcan be administered; Buccal - held inside the cheek Inhalable - breathed in through atube or mask t: 0333 405 33 33e: info@qcs.co.ukEnteral - delivered directlyinto the stomach or intestine(with a PEG tube or Jejunos- tomyTube)Infused - injected into a vein withan IV line and slowly dripped inover timeIntramuscular - injected into amuscle with a syringeIntrathecal - injected into thespineIntravenous - injected into a veinor into an IV lineNasal - given into the nose byspray or pumpOphthalmic - given into the eye bydrops, gel, or ointmentOral - swallowed by mouth as atablet, capsule, lozenge, or liquidOtic - given by drops into the earRectal - inserted into the rectumSubcutaneous - injected justunder the skinSublingual - held under the tongueTopical - applied to the skinTransdermal - given through apatch placed on the skinw: www.qcs.co.ukMay 2020 v1.0

Medication Fact SheetDomiciliary CareMulti Compartment ComplianceAids These are sometimes known as Blister Packs. Supplying medication in blister packs takes apharmacist a long time. During the COVID-19 pandemic,you may find that the pharmacist may not supplymedication in multi compartment compliance aids.Your service user will be given medication in the originalpackaging.Pharmacies are short staffed like every business duringthe COVID-19 pandemic. You can administer from original packaging. The MAR will need to be up dated with all themedication, dosage and times clearly documented. Your training will have explained how to safelyadminister medication from original packaging. If the service user is self managing their medicationand not have blister packs is going to reduce theirindependence, its important to discuss this with the GP. Do not leave medication in cups or pot, this issecondary dispensing and may lead to medicationerrors, and possible safeguarding issues.You must follow your policy and procedure.The 6 Rights ofMedicationAdministrationA mnemonic to remember this isPatients Do Drugs Round The Day Right PatientsRight DrugsRight DoseRight RouteRight TimeRight DocumentationThere will need to be a risk assessment in place if theservice user previously had Blister packs and now hasoriginal packaging.t: 0333 405 33 33e: info@qcs.co.ukw: www.qcs.co.ukMay 2020 v1.0

Medication Fact SheetDomiciliary CareMental Capacity Act Important pointsQ: My service user has a headache,can they take paracetamol duringCOVID-19? Check what your ‘over the countermedication’ policy and proceduresays Every adult has the rightto make his or her owndecisions. You must assumethey have capacity to do sounless it is proved otherwise.Check with the service user’sdoctor or pharmacist to makesure it isn’t going to causea problem with any othermedication they takeYou must not assumesomeone lacks capacitybecause they have aparticular medical conditionor disability. People have the right tomake decisions that othersmight think is unwise. acting on behalf of a personwho lacks capacity, you mustconsider if there is a way thatyou can give them as muchfreedom as possible and thatit protects their rights andif you need to act on theirbehalf in the first place.Tell you manager if you have tosupport administration. It willneed to go on a MAR chartMake sure the service users takethe correct dose. And they do nottake too many in 24 hoursIf the symptoms don’t go awayafter a 48 hours contact the GPRemember that some peoplemay not always have a cough ortemperature with COVID-19, tellyour manager asap A person must not betreated as unable to makea decision just because heor she makes an unwisedecision. Everyone has theirown values, beliefs andpreferences which may notbe the same as those of otherpeople. A person is not to betreated as unable to make adecision unless all possiblesteps to help them do so have Anything you do or decidebeen taken without success. for or on behalf of a person You should try very hardwho lacks mental capacityto encourage and supportmust be in their bestpeople to make the decisioninterests.for themselves. When making a decision orIf someone lacks capacity,it is important to involve theperson as far as possible inmaking decisions.Using Sedation to enforce Social Distancing Rules The government has clear rules - ‘You must stayat home’ unless you need to travel for work. This isreally difficult for every- one. For service users whodon’t have the capacity to understand, this it can beconfusing. If a service user is refusing to stay at home youmust tell your manager. We have an Easy Read Fact Sheet in the QCSResource Centre that you can use to explain to theService User why they need to stay at home. Your manager can speak to the communitymental health team for advice.t: 0333 405 33 33e: info@qcs.co.uk Using sedation to keep them at home is not goodpractice.w: www.qcs.co.ukMay 2020 v1.0

Medication Fact SheetDomiciliary CareHand washing techiques to stay healthyFollow these five steps every time.1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands,between your fingers, and under your nails. Make sure to also include your forearms whenwashing your hands.3. Scrub your hands for at least 20 seconds. How long? Hum the “Happy Birthday” song frombeginning to end twice.4. Rinse your hands well under clean, running water.5. Dry your hands using a clean towel or air dry them.t: 0333 405 33 33e: info@qcs.co.ukA hand washing guide by the NHS can also be found here.w: www.qcs.co.uk

Medication Fact SheetDomiciliary CareQuality Compliance SystemsQuality Compliance Systems (QCS) is the leading compliance management system for the Caresector. Our service provides over 80,000 Care, Dental and Medical professionals with access to themostcomprehensive set of customised policies, procedures and compliance toolkits, enabling ourusers to stay compliant with current CQC policies. Over 2,700 dedicated pages are reviewed andupdated regularly in line with legislative and regulatory requirements, and Best Practice guidelines,by our team of experts. Instant updates are delivered digitally, 24/7, directly to our customers viathe online management system and QCS App.Stay in touchDid you know we have a mobile app that’s part of your company’s membership ? It will work whenyou are out on your visitsWe also have a Facebook discussion group for Dom scussiongroup/t: 0333 405 33 33e: info@qcs.co.ukw: www.qcs.co.ukMay 2020 v1.0

Medication Fact Sheet Domiciliary Care May 2020 v1.0 The 6 Rights of Medication Administration A mnemonic to remember this is Patients Do Drugs Round The Day Right Patients Right Drugs Right Dose Right Route Right Time Right Documentation t: 0333 405 33 33 e: info@qcs.co.uk w: www.qcs.co.uk