DC122-Safe Collection and Handling of Prescriptions Policy

Registration Number: {{org_field_registration_no}}

Safe Collection and Handling of Prescriptions Policy

1. Introduction and Purpose

{{org_field_name}} is committed to the safe, person-centred, lawful and accountable collection, handling, transportation and handover of prescriptions and prescribed medicines for service users receiving domiciliary care in England. This policy supports compliance with the Health and Social Care Act 2008, the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, including Regulation 9 Person-centred care, Regulation 10 Dignity and respect, Regulation 11 Need for consent, Regulation 12 Safe care and treatment, Regulation 13 Safeguarding service users from abuse and improper treatment, Regulation 17 Good governance, Regulation 18 Staffing, Regulation 19 Fit and proper persons employed, and Regulation 20 Duty of candour. It also reflects the Care Quality Commission (Registration) Regulations 2009, NICE guideline NG67 Managing medicines for adults receiving social care in the community, NICE quality standard QS171, the Mental Capacity Act 2005, UK GDPR and the Data Protection Act 2018, and relevant controlled drugs and medicines legislation.

The primary aim of this policy is to ensure that service users receive their prescribed medications accurately, safely, and in a timely manner, while safeguarding their confidentiality and promoting their well-being.

Staff must not prescribe medicines, amend prescriptions, change dose timings, give clinical advice, request unnecessary medicines, dispose of medicines without authority, or make decisions about starting, stopping or altering medicines. Any query about a prescription, dose, route, frequency, formulation, side effects, missed dose, refusal, duplication, allergy, interaction, or medicine availability must be referred promptly to the supplying pharmacy, prescriber, GP, community nurse or other appropriate healthcare professional, and the advice received must be recorded in the service user’s care record.

2. Scope of the Policy

This policy applies to all staff who may be involved in any part of the prescription and medicines support pathway, including care workers, senior care workers, care coordinators, administrative staff, field supervisors, the registered manager, nominated individual and any other manager responsible for medicines governance.

This policy applies to:

requesting repeat prescriptions where this has been agreed in the service user’s care plan;
collecting paper prescriptions, electronic prescription tokens, dispensed medicines, appliances or prescribed items;
checking prescription and dispensing information for obvious discrepancies;
transporting prescriptions and medicines safely;
handing medicines to the service user or authorised representative;
recording collection, receipt, concerns, refusals, missing items, discrepancies and incidents;
escalating concerns to the pharmacy, GP, prescriber, community nurse, safeguarding lead, commissioner or CQC where required.

This policy does not authorise staff to prescribe, clinically assess, diagnose, change medicines, administer medicines, support covert administration, dispose of medicines, or undertake delegated healthcare tasks unless these duties are separately agreed, risk assessed, documented in the care plan, and staff have been trained and assessed as competent under the relevant policy.

3. Prescription Request and Collection Procedures

To ensure the safe and efficient collection of prescriptions, the following procedures must be followed:

Prescription Request

Staff must only request prescriptions where this task is recorded in the service user’s care plan or authorised by the registered manager in an urgent situation.
Staff must check the current care plan, medication administration record where applicable, existing medicine supplies, recent hospital discharge information, and any known changes before requesting a prescription.
Requests must be made in line with the GP practice or prescriber’s repeat prescription process and must allow sufficient time to avoid missed doses.
Staff must not request medicines that are no longer prescribed, no longer required, duplicated, refused by the service user, discontinued following hospital discharge, or already available in sufficient quantity.
Each request must record the date, time, requester, medicine name, strength, form, dose/frequency where known, quantity requested where applicable, reason for request, GP/prescriber or pharmacy contacted, and any advice or response received.
Any uncertainty, discrepancy, urgent need, unavailable item, allergy concern, potential duplication, missed medicine, or risk of running out must be escalated to the pharmacy, GP, prescriber or community nursing team and recorded in the service user’s care record.
Staff must not accept or act on informal verbal changes to medicines unless these are confirmed by an authorised prescriber or pharmacist and recorded in line with the Medication Management Policy.

Authorisation and Consent

Staff must obtain and record the service user’s consent before requesting, collecting, transporting or handing over prescriptions or medicines on their behalf. Consent must be decision-specific, informed, voluntary and recorded in the care plan.
Consent may be written, electronic or clearly documented in the care record. Where ongoing support is provided, consent must be reviewed at least annually and sooner if the person’s circumstances, capacity, representative arrangements, medicines or risks change.
The service user may withdraw consent at any time. Withdrawal of consent must be respected, recorded and escalated to the registered manager where this may place the person at risk.
Where there is reason to doubt the person’s capacity to consent to prescription collection or medicines support, staff must follow the Mental Capacity Act 2005 and the organisation’s Consent and Mental Capacity Policy. A decision-specific mental capacity assessment and best interests decision must be recorded before support is provided, unless urgent action is needed to prevent harm.
Where a representative gives instructions, staff must check and record the representative’s authority, such as lasting power of attorney for health and welfare, deputyship, appointeeship where relevant, or documented authority agreed in the care plan. Family involvement alone does not automatically authorise decisions about medicines.
Any disagreement about consent, capacity, best interests or representative authority must be escalated to the registered manager and, where necessary, to the GP, prescriber, pharmacist, commissioner, safeguarding team or legal representative.

Collection from Pharmacy or Dispensing Service

Staff must carry official identification and any written or electronic authorisation required by the pharmacy or dispensing service.
Staff must collect prescriptions and medicines only from the pharmacy, dispensing doctor, appliance contractor or collection point agreed in the care plan, unless an alternative arrangement has been authorised and recorded.
Before leaving the pharmacy, staff must check, as far as reasonably practicable and without opening sealed packaging unnecessarily, that the medicines or items belong to the correct service user and that the name, address or date of birth, medicine name, strength, formulation, quantity, directions, date of dispensing, expiry date where visible, and number of items supplied appear consistent with the prescription, collection note, pharmacy bag label or medication list.
Staff must ask the pharmacy to resolve any discrepancy before accepting the item where possible. Discrepancies include missing items, unexpected items, damaged packaging, incorrect name, incorrect strength, unclear directions, changed appearance, insufficient quantity, expired items, or items requiring fridge storage where no safe transport arrangement is available.
Staff must request written pharmacy confirmation or advice where the pharmacy changes brand, formulation, packaging, dose instructions, quantity, or supply arrangements and this may affect safe support.
Staff must record the collection date, time, pharmacy, items collected, staff member collecting, any discrepancy, advice received, and action taken.
Staff must not sign to confirm accuracy unless they have completed the required checks within their role and competence. Signing for collection confirms receipt only; it does not confirm clinical appropriateness.

3.1 Medicines Support Assessment and Care Plan

Before staff provide prescription collection or medicines-related support, the service user’s medicines support needs must be assessed and recorded in the care plan. The assessment must identify what support the person needs, what they can do independently, their preferences, communication needs, known allergies, risks, consent arrangements, mental capacity considerations, nominated pharmacy, GP or prescriber details, and any time-critical or high-risk medicines.

Prescription collection must only be provided where it is included in the care plan or has been authorised by the registered manager in urgent circumstances. The care plan must state who is responsible for ordering prescriptions, collecting prescriptions, collecting dispensed medicines, checking supplies, storing medicines in the person’s home, reporting concerns, and arranging urgent medical or pharmacy advice.

Where {{org_field_name}} starts providing medicines support, the service user’s GP practice and supplying pharmacy must be informed, unless the service user with capacity refuses this and the risk has been assessed and recorded.

The medicines support assessment and care plan must be reviewed at least annually, and sooner where there is a change in medicines, a hospital admission or discharge, a medicines incident, a safeguarding concern, a change in capacity, a change in the person’s ability to manage medicines, or a request from the service user, representative, pharmacist, GP, prescriber, commissioner or staff member.

3.2 Electronic Prescriptions and Prescription Tokens

Where electronic prescriptions are used, staff must follow the service user’s agreed nominated pharmacy or dispensing arrangements. Staff must not change the nominated pharmacy, access online GP or NHS accounts, use the NHS App, request login details, or manage electronic prescription services on behalf of a service user unless this is expressly agreed in the care plan, consent has been recorded, data protection risks have been assessed, and the registered manager has authorised the arrangement.

Prescription tokens, text messages, emails or electronic references must be treated as confidential information. They must be shared only with authorised staff, the service user, their authorised representative, the GP practice, prescriber or pharmacy where necessary for the safe collection of the prescription.

Any failed electronic prescription transmission, missing electronic prescription, pharmacy system problem, or mismatch between the prescription and supplied medicines must be reported to the pharmacy or GP practice promptly and recorded in the care record.

4. Handling and Transportation of Prescriptions and Medicines

Prescriptions, prescription tokens, pharmacy receipts and medicines must be handled securely, confidentially and without unnecessary delay. Staff must maintain a clear chain of custody from collection to handover.

Medicines must remain in the original pharmacy packaging and must not be removed, decanted, split, relabelled or repackaged by care staff.
Prescriptions and medicines must be transported directly to the service user unless an alternative route has been authorised by the registered manager and recorded.
Medicines must be carried in a secure, clean, discreet bag or container that protects them from loss, damage, contamination, unauthorised access, excessive heat, cold, moisture or direct sunlight.
Medicines must not be left unattended in vehicles, public places, staff homes or communal areas. Where unavoidable in exceptional circumstances, the staff member must keep the items out of sight, locked securely, and for the shortest possible time, and must inform the manager.
Fridge medicines must only be transported where safe arrangements are in place. Staff must use an appropriate cool bag or temperature-controlled container where required, minimise transport time, and follow pharmacy advice. Any concern about temperature exposure must be reported to the pharmacy before the medicine is used.
Controlled drugs, high-risk medicines and time-critical medicines must be prioritised for direct delivery and must be recorded carefully at collection and handover.
If delivery cannot be completed, staff must contact the office or on-call manager immediately for instructions. Medicines must not be left outside a property, posted through a letterbox, left with an unauthorised person, hidden in a safe place, or taken home by staff unless the registered manager has authorised an emergency arrangement and the risk assessment is recorded.
If a prescription or medicine is lost, stolen, damaged, tampered with, delivered to the wrong person, or exposed to unsafe storage conditions, staff must report this immediately to the registered manager. The pharmacy, GP or prescriber, service user or representative, and safeguarding or police must be contacted where appropriate. The incident must be recorded and investigated.

5. Receipt and Handover of Medications

On arrival at the service user’s home, the care worker must confirm the service user’s identity using at least two identifiers, normally full name and date of birth, unless the care plan states a different safe method due to communication needs.

Medicines must be handed only to the service user or to an authorised representative named in the care plan. Staff must not hand medicines to neighbours, visitors, relatives or other persons unless this is specifically authorised in the care plan or by the registered manager following a risk assessment.

At handover, staff must check and record:

date and time of handover;
name of service user;
items supplied, including medicine name, strength, form and quantity where practicable;
name of the person receiving the medicines;
staff member completing the handover;
any missing, damaged, unexpected, unclear or refused items;
any advice sought or received from the pharmacy, GP or prescriber.

Where the service uses medication administration records, eMAR or care planning software, staff must ensure the medicine receipt is recorded in the correct place and that any changes requiring manager, pharmacy, GP or prescriber review are escalated before medicines support continues.

If the service user refuses to accept the medicines, is not at home, lacks capacity to understand the handover, appears confused about the medicines, or the staff member has any concern about safety, the staff member must contact the office or on-call manager immediately. Staff must not leave medicines unattended or in an unauthorised location.

6. Storage and Security of Medications

Medicines supplied to a service user should normally be stored in the service user’s own home and remain the property and responsibility of the service user, unless another lawful arrangement is recorded. {{org_field_name}} will agree and record safe storage arrangements with the service user or authorised representative as part of the care plan.

Storage arrangements must consider the person’s consent, capacity, preferences, independence, safeguarding risks, risk of misuse, children or visitors in the home, pets, environmental conditions, manufacturer or pharmacy storage advice, and whether the medicine is a controlled drug, fridge item, high-risk medicine or time-critical medicine.

Staff must not remove medicines from a service user’s home, store medicines at the office, store medicines in staff homes, or transfer medicines between service users unless this has been authorised by the registered manager and is lawful, necessary, risk assessed and recorded.

Where medicines require refrigeration, staff must check that safe storage arrangements are available in the person’s home. Any concern about fridge failure, incorrect storage, expired medicines, damaged packaging, missing medicines, excess stock or unsafe access must be reported to the office and pharmacy or prescriber where appropriate.

Where a locked medicines box or cabinet is used, the care plan must state who holds the key or access code, how access is managed, and what staff must do if access is unavailable.

7. Managing Controlled Drugs

Controlled drugs must be managed with additional care because of the risk of harm, misuse, diversion, theft or error. Staff must follow the Medication Management Policy, the care plan, pharmacy or prescriber advice, and relevant controlled drugs legislation.

Where staff collect or handle controlled drugs, the care plan must identify the medicine, the level of support required, storage arrangements, who is authorised to receive the medicine, and any additional risks. Controlled drugs must be transported directly, kept secure, and handed over without unnecessary delay.

A clear audit trail must be maintained for controlled drugs collected or handled by staff. Records must include the date and time of collection, pharmacy or source, medicine name, strength and form, quantity collected where known, name and signature or electronic confirmation of the staff member collecting, name and signature or confirmation of the person receiving, and any discrepancy or concern.

Any missing controlled drug, incorrect quantity, damaged packaging, suspected misuse, suspected diversion, theft, unexplained discrepancy, refusal, or concern about unsafe storage must be reported immediately to the registered manager. The registered manager must consider whether to contact the pharmacy, GP or prescriber, safeguarding adults team, commissioner, police, NHS England controlled drugs accountable officer where applicable, and CQC where the incident meets notification criteria.

Staff must not dispose of controlled drugs unless this is expressly covered by the Medication Management Policy, lawful, authorised, witnessed where required, and fully recorded.

8. Documentation and Record Keeping

Accurate, complete, secure and up-to-date records must be kept for all prescription requests, collections, transport, handovers, discrepancies, refusals, incidents, advice received and actions taken. Records may be paper-based or electronic, but must be legible, factual, dated, timed, attributable to the staff member, and stored securely.

Records must include, where applicable:

service user’s name and identifying details;
consent or best interests decision;
prescription request details;
pharmacy, GP or prescriber contacted;
medicine or item requested or collected;
collection date, time and staff member;
handover date, time and recipient;
discrepancies, refused items, missing items, damaged items, urgent medicines, controlled drugs or fridge medicines;
advice received from pharmacy, GP, prescriber or healthcare professional;
incident reference numbers, safeguarding referrals, CQC notifications or duty of candour actions where applicable.

Medicine-related records must be retained in line with {{org_field_name}}’s Records Management Policy, data protection law, commissioner requirements and any relevant legal or safeguarding requirements. Records must not be destroyed while they are required for an ongoing complaint, safeguarding enquiry, investigation, claim, audit, police matter, CQC review or other regulatory process.

Staff must never falsify, backdate, omit, obscure or alter medicine records. Any correction must be dated, timed, attributable and leave the original entry readable or auditable.

9. Training, Competency and Supervision

Staff must not request, collect, transport, hand over, record or otherwise support prescriptions or medicines unless they have received role-appropriate training, have been assessed as competent, and are authorised by {{org_field_name}} to undertake the task.

Training must include, as relevant to the role:

this policy and the Medication Management Policy;
CQC fundamental standards relevant to medicines;
NICE NG67 principles for medicines support in the community;
consent and mental capacity;
confidentiality and data protection;
prescription request and collection processes;
checking medicines within the limits of the care worker role;
controlled drugs, high-risk medicines, time-critical medicines and fridge medicines;
safe transport and handover;
recording requirements, MAR/eMAR where used, and escalation of discrepancies;
medicine-related safeguarding concerns;
incident reporting, duty of candour and statutory notifications.

Competency must be assessed before staff work unsupervised and must be reviewed at least annually, and sooner after a medicine-related incident, concern, complaint, audit finding, return from extended absence, change in role, or change in procedure. Competency assessment may include observation, questioning, review of records, supervision, spot checks, scenario discussion and audit findings.

Staff who make repeated errors, fail to follow this policy, or are not assessed as competent must be removed from medicines-related duties until retraining, supervision and reassessment have been completed.

10. Confidentiality and Data Protection

The company is committed to protecting the privacy of service users:

Prescription information must be treated as confidential and shared only with authorised personnel.
All documentation must comply with GDPR and the Data Protection Act 2018.
Any breaches of confidentiality must be reported immediately.
Prescription information, pharmacy labels, MAR charts, electronic prescription tokens, text messages, emails and online prescription information are confidential health and care information. Staff must access, use and share this information only where necessary for the service user’s care and only with authorised people.
Staff must not photograph prescriptions or medicines, send prescription information by personal messaging apps, store information on personal devices, share login details, or discuss medicines in public places. Any electronic sharing must use approved secure systems and must be limited to the minimum necessary information.
Any actual or suspected data breach involving prescription or medicines information must be reported immediately in line with the Data Protection and Confidentiality Policy.

11. Medicine-Related Incidents, Safeguarding, Notifications and Duty of Candour

All prescription and medicines-related incidents, near misses, errors, omissions and concerns must be reported immediately to the registered manager or on-call manager and recorded in the incident system and care record.

Reportable incidents include, but are not limited to:

prescription requested incorrectly or not requested on time;
prescription or medicine collected for the wrong person;
wrong medicine, strength, quantity, formulation or label identified;
missing, damaged, expired, contaminated or tampered medicine;
medicine delivered late where this may affect the person’s health;
medicine delivered to the wrong address or unauthorised person;
fridge medicine exposed to unsafe temperature;
controlled drug discrepancy, loss, suspected theft, misuse or diversion;
failure to hand over medicines safely;
refusal of medicines or refusal to accept delivery where this creates risk;
data breach involving prescription or medicine information;
any incident requiring pharmacy, GP, prescriber, emergency services, safeguarding, police, commissioner or CQC involvement.

The registered manager must ensure that immediate action is taken to protect the service user from harm. This may include contacting the pharmacy, GP, prescriber, NHS 111, emergency services, community nurse, safeguarding adults team, commissioner, police or CQC.

Medicine-related safeguarding concerns must be managed under the Safeguarding Adults Policy. Concerns may include neglect, acts of omission, deliberate withholding, misuse, theft, coercion, diversion, unexplained missing medicines, unsafe family management, or staff failure to follow safe procedures.

Where an incident meets CQC statutory notification criteria, the registered person must notify CQC without delay using the required CQC process. CQC Registration Regulation 18 requires notification of specified incidents so CQC can take follow-up action where needed, and CQC states that failing to notify relevant incidents is an offence.

Where a notifiable safety incident has occurred, {{org_field_name}} must follow the Duty of Candour Policy. This includes acting openly and transparently, informing the service user or relevant person, providing a truthful account of what is known, apologising, explaining further enquiries, keeping a written record, and sharing learning and actions taken. CQC states that duty of candour applies to every CQC-regulated health and social care provider.

All medicine incidents must be investigated proportionately. The investigation must identify immediate actions, root causes, staff training or competency issues, communication failures, system failures, care plan updates, safeguarding actions, notifications made, lessons learned and actions to prevent recurrence.

11.1 Refusals, Missing Items and Unavailable Medicines

If a service user refuses a prescription request, refuses collection, refuses to accept medicines, or states that they do not want a prescribed medicine, staff must respect the person’s decision where they have capacity, record the refusal, and report it to the office. The registered manager must consider whether the GP, prescriber, pharmacy, representative or commissioner should be informed, particularly where refusal may place the person at risk.

If an item is unavailable, out of stock, owed by the pharmacy, missing from the pharmacy bag, or cannot be supplied in time, staff must ask the pharmacy what action is being taken and when the medicine will be available. Where there is a risk of missed doses or harm, the staff member or manager must contact the GP, prescriber, NHS 111, community nurse or other appropriate professional for advice.

All advice received and actions taken must be recorded in the care record.

11.2 Hospital Discharge, Medication Changes and Transfers of Care

When a service user returns from hospital or another care setting, staff must not assume that previous medicines remain current. The office or responsible manager must check the discharge information, updated prescription, pharmacy supply, care plan and MAR/eMAR where used.

Any discrepancy between the discharge summary, current medicines in the home, pharmacy supply, GP prescription, care plan or MAR/eMAR must be escalated to the pharmacy, GP, prescriber or community nurse before staff provide medicines support, unless urgent action is required to prevent harm.

Staff must ensure that accurate, up-to-date information about the person’s medicines is available to those involved in their care, in line with consent, confidentiality and data protection requirements.

12. Monitoring, Audit and Continuous Improvement

The registered manager is responsible for ensuring that prescription collection and handling processes are safe, effective and compliant. Audits must be completed at planned intervals and after significant incidents or concerns.

Audits must include, where applicable:

consent and care plan authorisation for prescription support;
evidence that medicines support needs have been assessed and reviewed;
prescription request records;
collection and handover records;
controlled drug records and discrepancies;
fridge medicine transport arrangements;
incident, near miss and safeguarding records;
MAR/eMAR accuracy where used;
evidence of pharmacy, GP or prescriber advice and actions taken;
staff training, competency and supervision records;
service user, representative, staff and pharmacy feedback;
themes, trends, repeated errors and action plans.

Audit findings must be reviewed by the registered manager and used to update care plans, risk assessments, staff training, supervision, procedures and this policy. Actions must be assigned to named persons with timescales and followed up to completion.

Learning from incidents, complaints, safeguarding enquiries, CQC feedback, NICE guidance, pharmacy advice and audits must be shared with relevant staff and used to improve practice.

13. STOMP, STAMP and Psychotropic Medicines

Where {{org_field_name}} supports autistic people, people with a learning disability, or children and young people where applicable, staff must be alert to the risks of over-medication, inappropriate psychotropic medicines, chemical restraint, or medicines used to control behaviour without appropriate clinical review.

Staff must report concerns about excessive sedation, changes in alertness, unexplained deterioration, repeated PRN use, medicines used mainly to control behaviour, or lack of review to the registered manager. The registered manager must seek advice from the GP, prescriber, pharmacist, community learning disability team, mental health team or commissioner as appropriate.

Staff must never stop, reduce or alter psychotropic medicines themselves. Concerns must be escalated and recorded.

14. Equality, Communication and Accessible Information

Staff must support service users to understand prescription collection and medicines support in a way that meets their communication needs, language, culture, disability, sensory needs and preferences. This may include involving an authorised representative, interpreter, advocate, easy-read information, large print, communication aids, or additional time for discussion.

Staff must not assume that a person understands their prescription or medicines because they have accepted a pharmacy bag. Any concern about understanding, capacity, coercion, distress, refusal, confusion or communication barriers must be reported to the registered manager and recorded.

15. Roles and Responsibilities

The registered provider is responsible for ensuring that safe systems are in place for prescription collection and handling and that the service complies with legal and regulatory requirements.

The registered manager is responsible for implementing this policy, ensuring staff training and competency, monitoring compliance, investigating incidents, making safeguarding referrals and CQC notifications where required, and ensuring lessons are learned.

Care coordinators and office staff are responsible for ensuring that prescription support is agreed in the care plan, records are completed, concerns are escalated, and communication with pharmacies, GP practices, prescribers and staff is accurate and timely.

Care workers are responsible for following this policy, working within their role and competence, completing required records, reporting concerns immediately, protecting confidentiality, and never undertaking medicines-related tasks that they have not been trained and authorised to perform.

Service users and/or authorised representatives are responsible, where able, for informing {{org_field_name}} of changes to prescriptions, medicines, pharmacy arrangements, consent, capacity, risks or preferences.

Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
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