SCH151. Medication Non-compliance in Care Homes
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Medication Non-compliance in Care Homes Policy
Most people living in care homes are prescribed some form of medication at some time as part of their treatment by their doctor or nurse. {{org_field_name}} believes that the correct and effective administration of such medication is essential for the health and wellbeing of the people living here and, in this regard, the home believes that it is an important part of the care given by the home that people who self-medicate are enabled to take their medication as prescribed and that people who need support are administered their medication by staff effectively and as prescribed.
The organisation understands that the correct taking of such medication is essential for people’s health and wellbeing but also that there are circumstances whereby some people will fail to comply with their prescribed treatments, eg people who self-medicate failing to take their medication as directed or people being supported refusing their prescribed medication, or failing to swallow it and then disposing of it.
In such cases, the organisation is clear that its staff have no right to force non-compliant people to take their medication but that they do have a duty to monitor and refer all cases of non-compliance back to the original prescriber, to the person’s GP and/or nurse or key worker.
Legislation and Guidance
{{org_field_name}} will act at all times in compliance with relevant legislation and best practice guidance relating to the management and administration of medication in adult social care, including:
- The Medicines Act 1968
- The Misuse of Drugs Act 1971
- The Misuse of Drugs (Safe Custody) Regulations 1973
- SC1 Managing Medicines in Care Homes (March 2014) National Institute for Health and Care Excellence (NICE)
- QS85 Medicines Management in Care Homes (March 2015) National Institute for Health and Care Excellence (NICE)
- The Safe and Secure Handling of Medicines (December 2018) Royal Pharmaceutical Society
The home understands that The Safe and Secure Handling of Medicines, published by the Royal Pharmaceutical Society, is written primarily for healthcare settings. However, the RPS state that some of its content is applicable to adult social care settings and can be used to inform social care policies.
Procedures
Any member of staff who is unsure of what to do regarding medication in any given situation should contact their line supervisor or {{org_field_name}} manager immediately.
Self-administering people
{{org_field_name}} understands “self-administering people” to refer to people living here who are responsible for collecting, storing and taking their own medication without assistance from care staff.
- {{org_field_name}} believes that everyone has the right to manage and administer their own medication if they wish to and are safe to do so.
- In cases where there is evidence that a person who self-medicates is failing to comply with their prescription, or is taking the wrong amounts of a medicine, then the case should be referred to their GP and/or to their key worker.
- People who self-medicate should be offered help and assistance to maintain their self-medicating status whenever possible and wherever an assessment indicates that this is possible or appropriate.
Non-self-administering people
{{org_field_name}} understands “non-self-administering people” to refer to those who require help from care home staff in the collecting, storing and/or taking of their medication. Such help can range from helping someone to take their medication out of a bottle or packet to actually administering the correct amounts and helping the person to take it.
All such help should be entered into the plan of care.
- Where people are helped with or administered their medication by care home staff, those staff should encourage compliance by ensuring that people actually take their medication at the time that it is given. Staff should directly observe the taking of medication and medicines should never be left “to be taken later”. Staff should only sign a person’s medication MAR chart after the medicines have been taken and if this has been directly observed.
- Staff should always be aware of the medication being taken by each person and should report any change in condition that may be due to non-compliance immediately to their line manager or supervisor. The line manager or supervisor should then discuss the case with the person’s GP and/or nurse, key worker or with the community pharmacist.
- People have the right to refuse medication and such refusal should be recorded. All such incidents should then be referred back to the prescriber, the person’s GP and/or nurse, key worker or community pharmacist.
- Care home staff may make such efforts to encourage the person to take their medication as are reasonable and appropriate under the medicines policy. This includes using every effort to communicate the need to take the medication and to ascertain the reason for non-compliance. However, staff have no right to force non-compliant people to take their medication. The use of undue pressure by any member of staff may be recognised by the organisation as the basis for disciplinary action.
- Medical advice should be sought immediately if care home staff believe that refusal to take medication constitutes an urgent risk to the person.
Training
In {{org_field_name}}:
- All new staff will receive training as part of their induction covering basic information about common medicines and how to recognise and deal with medication problems, including non-compliance. Those who will be involved in medicines administration in the home will have competency assessments and additional training to the level required by their roles and responsibilities.
- All training will reflect up-to-date evidence-based guidelines in what to do if a person does not take the medicines prescribed for them.
Nursing staff are expected to keep themselves up to date as required in their revalidation process and as specified in their professional code of conduct (The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates, October 2018).
Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
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