Transcript Document

CARE
WITH
MEDICATION
Prescribed medicine is the most
frequent treatment provided for
patients in the NHS.
GPs in England issue more than
660 million prescriptions every
year = (1.8 million a day)
There are estimated 200 million
prescriptions in hospitals.
Standards of prescribing in this
country are high and the majority
of drug treatment is provided
safely.
Care Homes Regulations 2001
Regulation 13(2) requires
the registered person
‘to make arrangements for
the…safe administration..of
medicines’ prescribed for
the people they care for.
Domiciliary Care Agencies
Regulations 2002
The registered person shall :
‘… specify circumstances in which
domiciliary care workers may
administer or assist in the
administration of medication… and
the procedures to be adopted…’
Regulation 14(6)(a)
• ‘…make arrangements for
recording, handling, safe keeping,
administration & disposal of
medicines…’
Regulation 14(7)
Care Homes Reports
2004 NCSC report :Medication Management
• incorrect medication give
• poor recording of administration
• medicines inappropriately handled, sometimes
by untrained staff
• inappropriate storage conditions
follow-up study commissioned by CSCI
‘Handled with Care?’ (February 2006)
‘Handled
with Care?’
• Slight overall improvement in performance with
exception of nursing homes for older people
• Nearly half the care homes for older people and
younger adults, providing 210,000 places, are still
not meeting the minimum standard
• Similar proportion of children’s homes failed –
nearly 6000 places
• Wide variation of performance from area to area
‘One third of homes do not
meet the standards relating to
managing medication safely and
operating safe working
practices’
‘Homes themselves need to put
their house in order and place
medication management at the
top of their agendas’
Actions required by Care Homes
• Review policies and practices in managing
medication
• Make use of existing good practice guidance
and demonstrate progress
• Support and closely monitor the practices
of care workers in relation to this standard
• Develop policies and practices which are
culturally sensitive
Domiciliary Care
‘TIME TO CARE’
• Report published Oct 2006
• 58% of agencies achieved the medication
standard in 2005-06
• Similar findings & concerns to those in
care homes
Why does it go wrong?
• Weak/bad management
• Poor procedures
• Poor records
• Staff not following procedures
• Inadequate training
• Staff not assessed as competent
• Complacency
Three Essential Safeguards
• Written procedures, reviewed and
monitored to make sure safe practice
is followed
• Correct level of training before giving
medicines, followed by competency
assessments, supervision and updates
• Only give medicines from containers
filled, labelled and provided from a
pharmacy (or from a dispensing
doctor)
Durham and Tees Valley
Social Care
Medication Strategy
Group
Middlesbrough Primary Care Trust
Middlesbrough Borough Council
Redcar and Cleveland Council
Redcar and Cleveland Primary Care Trust
Durham County Council
Commission for Social Care Inspection
Darlington Borough Council
Independent Providers Durham Darlington Teesside
Hartlepool Borough Council
Durham Employer Care and Health Alliance
Stockton Borough Council
Centre of Vocational Excellence for Social Care
CELS
City &Guilds
Skills for care
And…….
There have also been
high profile cases of
corporate
manslaughter
associated with
medication brought
against care home
managers and carers.
A common finding of
enquiries is poor
quality training as a
fundamental cause.
A substantial number
of home care services
are failing standards
relating to medication’
READ ALL ABOUT IT
NORTH EAST
LEADS THE WAY
ON MEDICATION
• Have the care workers had
sufficient and appropriate training
to meet the needs of the people
they care for?
• Is there a formal means to assess &
record staff competence in
medication handling &
administration?
• Do the policies and procedures
support staff to manage all aspects
of medication handling?
The indications are that there is a
serious deficit in the competence of
carers to administer medication safely.
The training to date has been
knowledge based and often distance
learning.
Estimates indicate that there are
89,000 – 123,000 carers who require
assessment of this competence in the
Northern East Region.
The aim of the group was to
develop a regional strategy
and policy for the safe
administration of medication.
Produced in consultation with
the Commission for Social
Care Inspection. (CSCI).
SAFE
HANDLING
OF
MEDICINES
A training plan was devised that
closely follows the NVQ Code of
Practice especially around the
competence of the assessors
and expert witnesses.
Outcome
Two significant documents have been produced:
A Strategy for the Safe Handling,
Management and Administration of
Medication by Carers across the
North East of England
Model of Good Practice for the
Development of those
involved in Handling,
Management and
Administration of Medication
across the North East of
England…………….
The documents are freely
available to all employers
to adopt or amend to suit
their needs.
WORKBOOKS
INTERMEDIATE CERTIFICATE IN
SAFE HANDLING OF MEDICINES
OPEN COLLEGE NETWORK LEVEL 1
- MEDICATION
NATIONAL VOCATIONAL QUALIFICATIONS
• The level 2 units
– HSC221 – Assist in the administration of
medication
– HSC236 – Receive and Store medication and
products
• Are suitable for health and social care
staff who are assisting health care
professionals
NATIONAL VOCATIONAL QUALIFICATIONS
• The most appropriate accredited
knowledge and competency assessment
is the NVQ level 3 Optional Unit
– HSC375 – Administer Medication to
Individuals
Assessment Process
• Initial Assessment carried out by
appropriate assessor
who will ensure that the candidate
meets:
– Requirements of the award
– Skills for Life development if
appropriate
Assessor
• Hold assessor award A1 or achieve it
within 12 months of commencing the role
• Be occupationally competent
– Clinically updated
– Currently competent
• Be familiar with the award body
requirements for documentation
LSC estimate that it costs £145
• More
–
–
–
–
–
–
Tailored & unique
No knowledge or skills
Already have NVQ 3
Fragmented assessment
Peripatetic assessor
Tutor assesses
• Less
– Several learners together
– Prior knowledge and skills
– Does not have NVQ level 3
– Holistic assessment
– Work based assessor
– Assessor assesses
CLEMENT O’DONOVAN
WORKFORCE DEVELOPMENT
MANAGER
MIDDLESBROUGH
DEPARTMENT OF SOCIAL
CARE