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Domestic (Homely or Non-prescribed) Medicines in Care Homes Policy

Policy Statement

This policy describes {{org_field_name}}ā€™s approach to the taking by residents of homely or over the counter (non-prescribed medicines) in relation to any prescribed medicines that they might also take.

A domestic medicine is one that can be bought over the counter to treat minor symptoms for short periods only (eg headache, cough, indigestion). Examples include mild pain relief medicines, cough medicines, antihistamines (type of medicine that is used for treating reactions to allergies), anti-diarrhoea (type of medicine used for treating diarrhoea) preparations and laxatives (type of medicines used for treating constipation). A homely remedy may be purchased by the resident or their family or carer, or by {{org_field_name}} with medical advice.

{{org_field_name}} is aware that in 2017 NHS England launched a consultation on ā€œover-the-counterā€ (OTC) medicines, those non-prescription medicines available from pharmacies and supermarkets, etc. Guidance was subsequently produced to advise GPs and prescribers to reduce the prescription of OTC medicines for certain minor conditions and, instead, to advise patients of what product they should purchase over-the-counter and how to apply it.

The policy of {{org_field_name}} is that implementing the OTC guidance should not restrict safe access to necessary medicines for vulnerable people, including people living in care homes. In addition, {{org_field_name}} recognises that many residents will be exempt from the requirement to purchase an OTC medicine because the medicine is being used for a long-term condition. Others may be exempt if the clinician considers that a resident lacks the ability to self-manage their medication.

Legislation and Guidance

The policy and procedures which the home has developed are in line with the applicable national standards for health and social care, relevant legislation and best practice guidance relating to the management and administration of medication in adult social care, including:

The home will ensure that any registered nurses working at the home who are involved in covert medicine administration follow the Nursing and Midwifery Council (NMC) professional code of practice.

Homely Remedies Procedures

In {{org_field_name}} only designated care staff named as having had appropriate training and having been assessed as competent to give homely non-prescription medicines should do so. Designated staff lists should be kept up to date. Records should be kept of all training.

The home keeps a supply of such domestic remedies from a limited list, developed from consultation with local pharmacists. The supply of products is limited to protect against misuse, and new medications are only added by agreement with a GP or pharmacist. Only medications from this supply should be used as homely remedies.

The home will record in the personā€™s care plan any over-the-counter products that the person should not use on medical advice.

If a person and/or their relatives request that they should be given a homely remedy, the matter will be referred to and checked out with the GP or a local pharmacist to ensure it is safe to give.

All domestic medicines kept and supplied by the home are:

Where a GP or other prescriber advises or recommends that a resident purchases and uses a specific OTC medicine or product, the clinician will be expected to provide verbal or written instructions on the use of the medicine. {{org_field_name}} will use this information to support the resident in taking the medicine or applying the product.

Storage, safe-keeping and safe use

For each over-the-counter product kept by the home for occasional use or as required, in line with NICE guidance, the home will keep a record of:

All administrations should be recorded on the individualā€™s MAR chart and/or on a separate chart which can be cross referenced to the main chart.

Where over-the-counter medicines have been prescribed by the GP, they will be administered in line with the medication policy and procedures for prescribed medication.

Homely medicines bought by people who live here (eg relatives)

It is possible that a person, possibly with the help of their relatives, will buy or have supplied their own homely remedies. Accordingly, the home routinely asks people and relatives to disclose and discuss if they are taking any additional medicines to their prescribed medicines so that the home, in exercising its duty of care, can include them in its medicinesā€™ reconciliation procedures and check that they are safe to use.

This process is followed for people and those who have agreed that the home should be responsible for giving them their medicines.

The home will discuss with the person and those involved in the supply of this additional medication the importance of sharing the information so that any risks in their use can be assessed and controlled. The home might also wish to confirm that the medication used is not illegal.

People with capacity who insist on taking homely remedies against the homeā€™s medically based advice that they are unsafe, will be asked to sign a disclaimer stating that the home cannot be held responsible for any adverse outcome.

If people are taking unsafe over-the-counter medication, when they appear to lack the mental capacity to appreciate the risks, the home will carry out a best interestsā€™ assessment with all those involved in their care and decide on the appropriate course of action. The home is mindful that if it imposes any agreed restrictive measures, which are considered in a personā€™s best interests, where they lack capacity, its actions might need to be authorised under deprivation of liberty safeguardsā€™ procedures.

Staff practice and training


Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}

Reviewed on: {{last_update_date}}

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