When moving into a care home like our care home here in Evesham, one question regularly asked by residents, or their families, is what help we provide with medication.
As a residential care home, we cannot prescribe medication (this remains the jurisdiction of your GP). However, our staff are trained to help administer your medication to you – taking the worry about remembering to take your tablets at the right time and at the right doses. Below, we talk a little bit about our systems and processes so you know what help to expect.
What happens to my medication when I move in?
Before moving into the care home, we will assess your needs during a one-on-one chat with yourself or an elected family member. One of the questions on our assessment will be what type of medications you take (if any). We will also ask at which GP you’re currently registered. If the GP is outside our local area in Wychavon, we will ask if you’d like to move your GP surgery to one that is closer to the care home, to help us coordinate your meds orders – but this remains your choice.
On moving day, we will then ask you to bring your current supply of medication (ideally to last a week or two) which will be signed into our secure medication cupboard. The volume and administration instructions (such as dose, timings and how to prepare the meds) will be recorded on a Medication Administration Record (known as a MAR chart) so that staff know how best to help you take your medication. Any allergies you have will also be noted down on the MAR.
We will also complete a medication profile for you which details the medication you take, the reason you take it, and how you like to be supported in taking the medication. This profile is kept secure in the medication cupboard for our staff’s reference.
How our care home respects your choice with medication?
If you have capacity and would prefer to self-administer your medication without help from staff, we will always respect your decision. As per best practice, we will ask you to sign a waiver confirming that you have decided to self-administer your medication, and we will also conduct a risk assessment where we will consider the risks posed from this activity (e.g. another resident accessing your medication) and the control measures we’ve put in place to reduce these risks to a manageable level.
If you lack capacity as per the Mental Capacity Act, we will complete a best interest decision for you on how we help you to take your medication, consulting your wishes and the opinions of any stakeholders in your care (like your family members, your doctor or social worker).
What time of day do care staff provide medication?
At Cedar Lodge, we schedule meds rounds regularly throughout the day to cater to the various timings of your medication. But we also appreciate some of your tablets, inhalers, eyedrops and creams may be prescribed to be taken as and when required. This is known by the Latin phrase Pro Re Nata, meaning ‘when required’, which we abbreviate to the acronym PRN. If your medication is PRN, it will be logged as such in your meds profile as well as on a separate PRN sheet in your MAR charts.
If you are prescribed creams like Epimax to safeguard your skin, we will also keep these creams in our locked medication cupboard. When we apply these creams (typically during morning and evening personal care, although we will be guided by your prescription) we record this activity in your profile in our creams book. This is so we can keep track that your creams are being applied correctly.
We conduct regular audits of our medication systems to ensure we are adhering to best practice.
What happens if there’s an error when doing my medication?
In the regrettable instance that you suffer a medication error, we will refer to the instructions on your medication’s safety data sheet and contact your GP for advice. If outside the usual contact hours of your GP surgery, we will call 111 to seek a clinician’s opinion on next steps. If there is an immediate risk to your health, we will otherwise call 999 and refer the incident to the local safeguarding team for Worcestershire if harm has been caused. We will also notify yourself and your family of the error under our duty of candour obligations and record any actions from the incident in our lessons learnt folder. Fortunately, such incidents are rare, but by operating a robust policy for medication errors we hope we inspire faith in our processes. Staff are subject to competencies and retraining to keep their knowledge of medication fresh and up to date.
How we order your medication
Most residents will move in with a limited supply of their medication to last them 1-2 weeks. During this time, our care home will register you on the NHS proxy access website. This website allows us to order your medication directly on your behalf, subject to your consent. Once we make your order, it goes through to your GP who signs off on the order. We would also register you with our nominated local pharmacy, called Evesham Pharmacy, which enables the GP to send the approved medication order to the NHS’ electronic prescription service (known as the Spine), from which Evesham Pharmacy can drawn down the prescription and dispense the medication. Once they’ve dispensed the medication, Evesham Pharmacy will deliver the medication to our care home for us to sign in for you. This means you don’t need to worry about ordering and collecting your medication each month – we can do this for you.
Meds Reviews and Final Comments
It may have been a while since you’ve last seen your GP, so we also like to offer residents the opportunity to have a medication review with their GP shortly after moving into our care home. We coordinate this assessment on your behalf so everyone has a good idea of your present health and required medication. During the reviews, your doctor will assess the medication you’re currently on against the backdrop of your health status, to understand whether the medication is still required or whether it would be better for you to remove a tablet, increase/reduce its dose or introduce a new medication to better alleviate your symptoms. If you feel you’re no longer benefitting from a given tablet you take, we can always help you facilitate a meds review with your GP and we will periodically request these during your stay with us – especially when there’s been a change in your health.
Medication is an ever-evolving aspect of residents care, with lots of different things to consider. By explaining the processes in our care home, we hope we’ve shown how we can alleviate much of the admin and worry around the medication your take – leaving you more time to enjoy your retirement! If you have any questions about medication, care or would like to learn more about our home, call today to request a show round. Our number is 01386 293 033.