New guidance published by NICE this week sets out recommendations for good practice on the systems and processes for managing medicines in care homes. The guideline considers prescribing, handling and administering medicines to residents living in care homes (including all children, young people and adults) and the provision of care or services relating to medicines in care homes.
The guidance emphasises the need for person-centred care. It states that health and social care practitioners should ensure that care home residents have the same opportunities to be involved in decisions about their treatment and care as people who do not live in care homes. Residents should be supported to help them to take a full part in making decisions.
NICE has also said that health professionals prescribing medicines should assume that residents have the capacity to make decisions about their medicines, assessing resident’s mental capacity in line with appropriate legislation if there are any concerns about whether the resident is able to give informed consent.
Other recommendations in the guidelines cover:
- Developing and reviewing policies for safe and effective use of medicines.
- Sharing information about residents’ medicines via an appropriate process.
- Ensuring records are accurate and up to date.
- Identifying, reporting and reviewing medicines-related problems, learning from medicines errors in care homes.
- Having a clear safeguarding process in place for reporting medicines-related safeguarding incidents.
- Appropriate medicines reconciliation and review – Keeping accurate lists and reviewing medicines individual residents are taking.
- Procedures for prescribing, ordering, dispensing and supplying medicines.
- Assisting residents to look after and take their medicines themselves.
- Administering medicines to residents, including training care home staff.
Professor Gillian Leng, deputy chief executive and director of health and social care at NICE said “Care home residents are often vulnerable and often have complex needs requiring them to take a number of medicines. This sometimes makes them particularly dependent on care home staff to help them take their medicines. This guideline provides clear advice on medicines management systems and processes that place the resident firmly at the centre of decision-making, ensuring that their needs are paramount and can be addressed safely and effectively.”
Ian Turner, chairman of the Registered Nursing Home Association and member of the Guideline Development Group said“moving towards a situation where we have more commonality around managing medicines in care homes and better standards has got to be a significant step forward. It will mean that any issues with medicines are picked up early and that homes are better supported. The medicines review process needs to entail better communication between the pharmacist, care home and GP. Currently we are still moving towards understanding how often residents should have their medicines reviewed and what the review should involve. This guideline will be extremely helpful in providing clarity around this issue, and in ensuring that medicines reviews are meaningful to everybody. For individual residents, this means they will be on an optimum medicines regime. And, if you can reduce the number of medicines, the problem of volume becomes easier in the care home.”
The guideline can be viewed on the NICE website at the following link: