Late last year, CQC announced that it was going to carry out themed inspections of 250 home care providers in addition to planned reviews. The themed inspections will start in April 2012 and will look at:
· Respecting and involving people who use services;
· Care and welfare of people who use services; and
· Supporting workers.
The announcement came following the Equality and Human Rights Commission own inquiry into home care which uncovered “poor treatment” which threatened service users’ human rights.
At Ridouts we have seen CQC looking more carefully at medication management of home care providers. It has been at the forefront of residential care for a long time and with CQC visits to home care providers set to increase, it is likely that this topic will be a growing trend.
Assistance with medication is not covered by the definition of personal care for which providers of home care are registered. However, where assistance is given to service users, which can cover a whole range of situations from prompting and supervising, all the way to actual administering medication, the service provider is taking responsibility for medication management. Such providers must ensure that this is carried out in compliance with the regulatory requirements. Providers should have appropriate policies and procedures in place to deal with the varying degrees of assistance given and ensure that staff are adequately trained to undertake their role.
Even where a service user is deemed capable of actual self-administration but requires prompting and supervising to ensure they take their medication, carers needs to know what they are prompting and supervising. A list of current medications a service user requires assistance with should be clearly set out in their care plan (and kept up to date) with details of what assistance is required. A carer should clearly record what medication is actually taken even if only prompting and supervision is given. This should be regularly reviewed and any necessary action taken. Without this information it is extremely difficult to act and protect those individuals who have been deemed to be some of the most vulnerable in society.
Consideration must also be given to a variety of other issues, including consent and capacity issues, possible side effects, what to do in the event medication is missed or refused and indeed if there is an administration error. Providers should refer to the Essential Standards on Quality and Safety as well as Guidance the Essential Standards for further guidance. Whilst there are increasing pressures on home care providers including restrictions in budget and time, corners cannot be cut when a provider has taken on the responsibility of looking after a service user. If a provider is responsible for assisting a service user with their medication, they cannot approach this half-heartedly. Pro-active medication management will have better consequences than re-acting when things go wrong.